Genç Barış, Şen Sedat, Aslan Kerim, İncesu Lütfi
Department of Radiology, Samsun Education and Research Hospital, İlkadım, Samsun, 55060, Turkey.
Department of Neurology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
Neuroradiology. 2023 May;65(5):899-905. doi: 10.1007/s00234-023-03122-z. Epub 2023 Feb 1.
Studies on hypothalamic changes in patients with relapsing remitting multiple sclerosis (RRMS) are very scarce, despite the fact that the relationship with the hypothalamus is frequently reported. The aim of the study was to determine the volume of the hypothalamic subunits and the total hypothalamus and its relationship with the total demyelinating lesion volume (TLV) and expanded disability status scale (EDSS) in RRMS patients.
In this cross-sectional study, anterior-superior, superior tubular, posterior hypothalamus, anterior-inferior, inferior tubular subunits of hypothalamus, and total hypothalamus volume were calculated, with fully automatic analysis methods using volumetric T1 images of 65 relapsed RRMS patients and 68 healthy controls (HC). Volume changes in the hypothalamus and its subunits in RRMS patients were examined using multivariate analysis of covariance (MANCOVA). The relationship of these volumes with EDSS and TLV was investigated by partial correlation analysis.
There is volume reduction in total hypothalamus (F = 13.87, p < 0.001), anterior-superior (F = 19.2, p < 0.001), superior tubular (F = 10.1, p = 0.002) subunits, and posterior hypothalamus (F = 19.2, p < 0.001) volume in RRMS patients. EDSS correlates negatively with anterior-superior (p = 0.017, r = - 0.333), superior tubular subunits (p = 0.023, r = - 0.439), posterior hypothalamus (p < 0.001, r = - 0.511), and whole hypothalamus volume (p = 0.001, r = - 0.439). TLV correlates negatively with anterior superior (p < 0.001, r = - 0.565), anterior inferior (p = 0.002, r = - 0.431), superior tubular subunits (p = 0.002, r = - 0.432), posterior hypothalamus (p < 0.001, r = - 0.703), and whole hypothalamus (p < 0.001, r = - 0.627) volumes.
This study demonstrates a reduction in total hypothalamus volume, anterior-superior, superior tubular, and posterior hypothalamus in patients with RRMS. Anterior-superior and superior tubular subunit, posterior hypothalamus, and total hypothalamus volume were negatively correlated with TLV and EDSS scores.
尽管经常报道复发缓解型多发性硬化症（RRMS）患者与下丘脑的关系，但关于RRMS患者下丘脑变化的研究非常稀少。本研究的目的是确定RRMS患者下丘脑亚单位和整个下丘脑的体积，及其与总脱髓鞘病变体积（TLV）和扩展残疾状态量表（EDSS）的关系。
在这项横断面研究中，使用全自动分析方法，通过65例复发RRMS患者和68例健康对照（HC）的容积T1图像，计算下丘脑的前上、上管状、下丘脑后部、前下、下管状亚单位以及整个下丘脑的体积。采用多变量协方差分析（MANCOVA）检查RRMS患者下丘脑及其亚单位的体积变化。通过偏相关分析研究这些体积与EDSS和TLV的关系。
RRMS患者的整个下丘脑（F = 13.87，p < 0.001）、前上（F = 19.2，p < 0.001）、上管状（F = 10.1，p = 0.002）亚单位和下丘脑后部（F = 19.2，p < 0.001）体积减小。EDSS与前上（p = 0.017，r = - 0.333）、上管状亚单位（p = 0.023，r = - 0.439）、下丘脑后部（p < 0.001，r = - 0.511）和整个下丘脑体积（p = 0.001，r = - 0.439）呈负相关。TLV与前上（p < 0.001，r = - 0.565）、前下（p = 0.002，r = - 0.431）、上管状亚单位（p = 0.002，r = - 0.432）、下丘脑后部（p < 0.001，r = - 0.703）和整个下丘脑（p < 0.001，r = - 0.627）体积呈负相关。
本研究表明RRMS患者的整个下丘脑、前上、上管状和下丘脑后部体积减小。前上和上管状亚单位、下丘脑后部以及整个下丘脑体积与TLV和EDSS评分呈负相关。
