日常体力活动与多发性硬化症患者脑容量和颈椎脊髓面积的相关性。
Association of daily physical activity with brain volumes and cervical spinal cord areas in multiple sclerosis.
机构信息
UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA/Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, CA, USA.
UCSF Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
出版信息
Mult Scler. 2023 Mar;29(3):363-373. doi: 10.1177/13524585221143726. Epub 2022 Dec 27.
BACKGROUND
Remote activity monitoring has the potential to evaluate real-world, motor function, and disability at home. The relationships of daily physical activity with spinal cord white matter and gray matter (GM) areas, multiple sclerosis (MS) disability and leg function, are unknown.
OBJECTIVE
Evaluate the association of structural central nervous system pathology with ambulatory disability.
METHODS
Fifty adults with progressive or relapsing MS with motor disability who could walk >2 minutes were assessed using clinician-evaluated, patient-reported outcomes, and quantitative brain and spinal cord magnetic resonance imaging (MRI) measures. Fitbit Flex2, worn on the non-dominant wrist, remotely assessed activity over 30 days. Univariate and multivariate analyses were performed to assess correlations between physical activity and other disability metrics.
RESULTS
Mean age was 53.3 years and median Expanded Disability Status Scale (EDSS) was 4.0. Average daily step counts (STEPS) were highly correlated with EDSS and walking measures. Greater STEPS were significantly correlated with greater C2-C3 spinal cord GM areas (ρ = 0.39, = 0.04), total cord area (TCA; ρ = 0.35, = 0.04), and cortical GM volume (ρ = 0.32, = 0.04).
CONCLUSION
These results provide preliminary evidence that spinal cord GM area is a neuroanatomical substrate associated with STEPS. STEPS could serve as a proxy to alert clinicians and researchers to possible changes in structural nervous system pathology.
背景
远程活动监测有可能评估现实生活中的运动功能和家庭残疾情况。目前尚不清楚日常体力活动与脊髓白质和灰质（GM）区域、多发性硬化症（MS）残疾和腿部功能之间的关系。
目的
评估结构中枢神经系统病理与肢体残疾的关系。
方法
对 50 名患有进展性或复发性 MS 且存在运动障碍的成年人进行评估，使用临床医生评估、患者报告的结果以及定量脑和脊髓磁共振成像（MRI）测量来评估。Fitbit Flex2 佩戴在非优势手腕上，可在 30 天内远程评估活动情况。进行单变量和多变量分析，以评估体力活动与其他残疾指标之间的相关性。
结果
平均年龄为 53.3 岁，扩展残疾状况量表（EDSS）中位数为 4.0。平均每日步数（STEPS）与 EDSS 和行走测量高度相关。更高的 STEPS 与更大的 C2-C3 脊髓 GM 区域（ρ=0.39， =0.04）、总脊髓面积（TCA；ρ=0.35， =0.04）和皮质 GM 体积（ρ=0.32， =0.04）呈显著正相关。
结论
这些结果初步表明脊髓 GM 区域是与 STEPS 相关的神经解剖学基础。STEPS 可以作为一种代理，提醒临床医生和研究人员注意结构神经系统病理的可能变化。
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