Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Neurological Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
Magn Reson Imaging. 2023 Nov;103:185-191. doi: 10.1016/j.mri.2023.07.016. Epub 2023 Aug 1.
A combined resting state functional connectivity MRI (fcMRI) and diffusion tensor imaging (DTI) metric called structural and functional connectivity index (SFCI) was recently proposed for tracking disease status and progression in multiple sclerosis (MS). The metric combines fcMRI and transverse diffusivity (TD) along different functional pathways involved in principle symptomatic domains of MS. In a longitudinal study of patients with MS receiving the same MS therapy, initial worsening of transcallosal (TC) motor and frontoparietal (FP) cognitive networks, as measured by fcMRI and DTI over the first year was followed by stabilization in the second year of follow-up. In this study we have (i) probed relationships between individual and composite neurological measures of MS with SFCI and its individual components along TC motor and FP cognitive pathways and (ii) compared sensitivity of SFCI to treatment-induced longitudinal changes with each individual imaging measure.
Twenty five patients with MS (15 female, age 42 ± 8 y) participated in this study and were scanned at 3 T whole body MRI scanner with diffusion tensor imaging (DTI) and resting-state functional connectivity MRI (fcMRI) scan protocol at baseline and 6, 12, 18 and 24 months after starting fingolimod. fcMRI and TD along TC and FP pathways were combined to form structural and functional connectivity index (SFCI) at each time point. Correlations between individual/combined neurological measures and individual imaging components/SFCI at baseline and were evaluated and compared. In addition, efficacies of individual and combined imaging metrics in tracking network integrity were compared.
Individual TD along the TC pathway was significantly inversely correlated with all individual/composite neurological scores. There were moderate correlations of TC and FP components of SFCI with most of the neurological scores, and the pathway-combined SFCI was significantly correlated with all neurological scores. Trend-level increases of both TC and FP fcMRI were observed during the second year of follow-up, both TC and FP TD increased significantly in the first year and then stabilized during the second year. A trend toward a decrease in combined imaging metrics along TC and FP were observed during the first year, followed by a trend toward an increase in these metrics during the second year, while a significant decrease in SFCI during the first year followed by a significant increase during the second year was observed.
SFCI was more effective in tracking network integrity/disease progression than individual pathway-specific components, which supports its use as an imaging marker for MS disease status and progression.
最近提出了一种联合静息态功能连接磁共振成像（fcMRI）和弥散张量成像（DTI）的度量标准，称为结构和功能连接指数（SFCI），用于跟踪多发性硬化症（MS）的疾病状态和进展。该指标结合了 fcMRI 和沿涉及 MS 主要症状域的不同功能途径的横向扩散（TD）。在一项对接受相同 MS 治疗的 MS 患者进行的纵向研究中，第一年通过 fcMRI 和 DTI 测量发现胼胝体（TC）运动和额顶认知网络的初始恶化，随后在第二年的随访中稳定下来。在这项研究中，我们（i）探测了 SFCI 及其沿 TC 运动和 FP 认知途径的各个组成部分与个体和综合 MS 神经测量之间的关系，（ii）比较了 SFCI 对治疗诱导的纵向变化的敏感性与每个单独的成像测量。
25 名 MS 患者（15 名女性，年龄 42±8 岁）参与了这项研究，并在 3T 全身 MRI 扫描仪上进行了扫描，具有弥散张量成像（DTI）和静息状态功能连接 MRI（fcMRI）扫描方案，在基线和开始fingolimod 后 6、12、18 和 24 个月。在每个时间点，将 fcMRI 和 TD 沿 TC 和 FP 途径结合起来形成结构和功能连接指数（SFCI）。评估和比较了基线时个体/综合神经测量与个体成像成分/SFCI 的相关性。此外，还比较了个体和综合成像指标在跟踪网络完整性方面的功效。
TC 途径的个体 TD 与所有个体/综合神经评分呈显著负相关。SFCI 的 TC 和 FP 成分与大多数神经评分具有中等相关性，而途径组合的 SFCI 与所有神经评分显著相关。在随访的第二年观察到 TC 和 FP fcMRI 的趋势性增加，TC 和 FP TD 在第一年显著增加，然后在第二年稳定。在第一年观察到 TC 和 FP 沿 TC 和 FP 的组合成像指标呈下降趋势，随后在第二年观察到这些指标呈上升趋势，而在第一年观察到 SFCI 显著下降，第二年观察到 SFCI 显著增加。
SFCI 在跟踪网络完整性/疾病进展方面比个体途径特异性成分更有效，这支持了它作为 MS 疾病状态和进展的成像标志物的使用。
