多发性硬化症中颈脊髓节段的纵向评估
Longitudinal assessment of cervical spinal cord compartments in multiple sclerosis.
作者信息
Tsagkas Charidimos, Huck-Horvath Antal, Cagol Alessandro, Haas Tanja, Amann Michael, Barakovic Muhamed, Ruberte Esther, Melie-Garcia Lester, Weigel Matthias, Pezold Simon, Schlaeger Regina, Kuhle Jens, Sprenger Till, Kappos Ludwig, Bieri Oliver, Cattin Philippe, Granziera Cristina, Parmar Katrin
机构信息
Neurologic Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland; Translational Imaging in Neurology (ThINk) Basel, Departments of Head, Spine and Neuromedicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland; Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Departments of Head, Spine and Neuromedicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland; Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH), Bethesda, MD, United States of America.
Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
出版信息
Mult Scler Relat Disord. 2023 Mar;71:104545. doi: 10.1016/j.msard.2023.104545. Epub 2023 Feb 3.
BACKGROUND
Although cervical spinal cord (cSC) area is an established biomarker in MS, there is currently a lack of longitudinal assessments of cSC gray and white matter areas.
OBJECTIVE
We conducted an explorative analysis of longitudinal changes of cSC gray and white matter areas in MS patients.
METHODS
65 MS patients (33 relapsing-remitting; 20 secondary progressive and 12 primary progressive) and 20 healthy controls (HC) received clinical and upper cSC MRI assessments over 1.10±0.28 years. cSC compartments were quantified on MRI using the novel averaged magnetization inversion recovery acquisitions sequence (in-plane resolution=0.67 × 0.67mm), and in-house developed post-processing methods. Patients were stratified regarding clinical progression.
RESULTS
Patients with clinical progression showed faster reduction of cSC areas over time at the level of cSC enlargement (approximate vertebral level C4-C5) compared to stable patients (p<0.05). In addition, when compared to the rostral-cSC (approximate vertebral level C2-C3), a preferential reduction of cSC and white matter areas over time at the level of cSC enlargement (p<0.05 and p<0.01, respectively) was demonstrated only in patients with clinical progression, but not in stable MS patients and HC. Compared to HC, MS patients showed comparable changes over time in all cSC compartments.
CONCLUSIONS
MS patients with clinical disease progression demonstrate subtle signs of a more pronounced tissue loss at the level of cSC enlargement. Future studies should consider larger sample sizes and more extended observation periods.
背景
尽管颈脊髓（cSC）面积是多发性硬化症（MS）中已确立的生物标志物，但目前缺乏对cSC灰质和白质区域的纵向评估。
目的
我们对MS患者cSC灰质和白质区域的纵向变化进行了探索性分析。
方法
65例MS患者（33例复发缓解型；20例继发进展型和12例原发进展型）和20名健康对照者（HC）在1.10±0.28年的时间里接受了临床和颈脊髓上部MRI评估。使用新型平均磁化反转恢复采集序列（平面分辨率=0.67×0.67mm）和内部开发的后处理方法在MRI上对cSC各部分进行定量分析。患者根据临床进展进行分层。
结果
与病情稳定的患者相比，临床进展的患者在cSC扩大水平（大致椎体水平C4-C5）处，cSC面积随时间的减少更快（p<0.05）。此外，与颈脊髓上部（大致椎体水平C2-C3）相比，仅在临床进展的患者中显示出cSC扩大水平处cSC和白质区域随时间优先减少（分别为p<0.05和p<0.01），而病情稳定的MS患者和HC则未出现这种情况。与HC相比，MS患者在所有cSC部分随时间的变化相当。
结论
临床疾病进展的MS患者在cSC扩大水平处显示出更明显组织损失的细微迹象。未来的研究应考虑更大的样本量和更长的观察期。
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