GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium.
Psychology and Cognitive Neuroscience Research Unit, University of Liège, Liège, Belgium.
J Neurol. 2024 Jun;271(6):3537-3545. doi: 10.1007/s00415-024-12316-1. Epub 2024 Mar 28.
Cognitive fatigue is a major symptom of Multiple Sclerosis (MS), from the early stages of the disease. This study aims to detect if brain microstructure is altered early in the disease course and is associated with cognitive fatigue in people with MS (pwMS) compared to matched healthy controls (HC). Recently diagnosed pwMS (N = 18, age < 45 years old) with either a Relapsing-Remitting or a Clinically Isolated Syndrome course of the disease, and HC (N = 19) matched for sex, age and education were analyzed. Quantitative multiparameter maps (MTsat, PD, R1 and R2*) of pwMS and HC were calculated. Parameters were extracted within the normal appearing white matter, cortical grey matter and deep grey matter (NAWM, NACGM and NADGM, respectively). Bayesian T-test for independent samples assessed between-group differences in brain microstructure while associations between score at a cognitive fatigue scale and each parameter in each tissue class were investigated with Generalized Linear Mixed Models. Patients exhibited lower MTsat and R1 values within NAWM and NACGM, and higher R1 values in NADGM compared to HC. Cognitive fatigue was associated with PD measured in every tissue class and to MTsat in NAWM, regardless of group. Disease-specific negative correlations were found in pwMS in NAWM (R1, R2*) and NACGM (R1). These findings suggest that brain microstructure within normal appearing tissues is already altered in the very early stages of the disease. Moreover, additional microstructure alterations (e.g. diffuse and widespread demyelination or axonal degeneration) in pwMS may lead to disease-specific complaint of cognitive fatigue.
认知疲劳是多发性硬化症（MS）的主要症状，从疾病的早期阶段就开始出现。本研究旨在检测脑微观结构是否在疾病早期发生改变，并与 MS 患者（pwMS）的认知疲劳相关，与匹配的健康对照组（HC）相比。最近诊断为 pwMS（N=18，年龄<45 岁）的患者有复发缓解型或临床孤立综合征型疾病病程，以及匹配性别、年龄和教育程度的 HC（N=19）被纳入分析。对 pwMS 和 HC 的定量多参数图（MTsat、PD、R1 和 R2*）进行了计算。参数是在正常表现的白质、皮质灰质和深部灰质（NAWM、NACGM 和 NADGM）内提取的。独立样本的贝叶斯 T 检验评估了组间脑微观结构的差异，而使用广义线性混合模型调查了认知疲劳量表评分与每种组织类型中每个参数之间的关联。与 HC 相比，患者的 NAWM 和 NACGM 中的 MTsat 和 R1 值较低，NADGM 中的 R1 值较高。认知疲劳与每个组织类别中的 PD 以及 NAWM 中的 MTsat 相关，与组无关。在 pwMS 中，在 NAWM（R1、R2*）和 NACGM（R1）中发现了与疾病相关的负相关。这些发现表明，在疾病的早期阶段，正常表现组织内的脑微观结构已经发生改变。此外，pwMS 中额外的微观结构改变（例如弥漫性和广泛的脱髓鞘或轴突变性）可能导致与疾病相关的认知疲劳的特定抱怨。
