Huang Chuxin, Li Yanyu, Chen Yanjing, Liao Xuan, Zhang Huiting, Wang Zhiyuan, Liu Jun, Lu Wei
Department of Radiology; Department of Neurology, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Department of Radiology, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
Neural Regen Res. 2023 Nov;18(11):2520-2525. doi: 10.4103/1673-5374.371371.
Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory demyelinating disease of the central nervous system. However, whether and how cortical changes occur in NMOSD with normal-appearing brain tissue, or whether any cortical changes correlate with clinical characteristics, is not completely clear. The current study recruited 43 patients with NMOSD who had normal-appearing brain tissue and 45 healthy controls matched for age, sex, and educational background from December 2020 to February 2022. A surface-based morphological analysis of high-resolution T1-weighted structural magnetic resonance images was used to calculate the cortical thickness, sulcal depth, and gyrification index. Analysis showed that cortical thickness in the bilateral rostral middle frontal gyrus and left superior frontal gyrus was lower in the patients with NMOSD than in the control participants. Subgroup analysis of the patients with NMOSD indicated that compared with those who did not have any optic neuritis episodes, those who did have such episodes exhibited noticeably thinner cortex in the bilateral cuneus, superior parietal cortex, and pericalcarine cortex. Correlation analysis indicated that cortical thickness in the bilateral rostral middle frontal gyrus was positively correlated with scores on the Digit Symbol Substitution Test and negatively correlated with scores on the Trail Making Test and the Expanded Disability Status Scale. These results are evidence that cortical thinning of the bilateral regional frontal cortex occurs in patients with NMOSD who have normal-appearing brain tissue, and that the degree of thinning is correlated with clinical disability and cognitive function. These findings will help improve our understanding of the imaging characteristics in NMOSD and their potential clinical significance.
视神经脊髓炎谱系障碍（NMOSD）是一种中枢神经系统的炎性脱髓鞘疾病。然而，在脑组织外观正常的NMOSD患者中是否以及如何发生皮质变化，或者任何皮质变化是否与临床特征相关，目前尚不完全清楚。本研究在2020年12月至2022年2月期间招募了43例脑组织外观正常的NMOSD患者以及45名年龄、性别和教育背景相匹配的健康对照者。使用基于表面的高分辨率T1加权结构磁共振图像形态分析来计算皮质厚度、脑沟深度和脑回指数。分析显示，NMOSD患者双侧额中回前部和左侧额上回的皮质厚度低于对照参与者。对NMOSD患者的亚组分析表明，与没有任何视神经炎发作的患者相比，有视神经炎发作的患者在双侧楔叶、顶上叶皮质和距状周皮质的皮质明显更薄。相关性分析表明，双侧额中回前部的皮质厚度与数字符号替换测验得分呈正相关，与连线测验得分和扩展残疾状态量表得分呈负相关。这些结果证明，脑组织外观正常的NMOSD患者双侧额叶区域存在皮质变薄，且变薄程度与临床残疾和认知功能相关。这些发现将有助于提高我们对NMOSD成像特征及其潜在临床意义的理解。
