Fujimori Juichi, Nakashima Ichiro
Division of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Heliyon. 2024 Mar 18;10(6):e28136. doi: 10.1016/j.heliyon.2024.e28136. eCollection 2024 Mar 30.
To determine which disease-modifying therapies should be used in patients with multiple sclerosis (MS), identifying patients at high and low risk for brain volume loss (BVL) is important. Although the BVL rate in MS is nearly constant from early to late disease onset, regardless of the disease stage, individual differences have been noted. Moreover, as disease duration increases, the risk of chronic progression increases, and brain atrophy becomes more noticeable. Therefore, measuring prognosis using a classification that considers BVL rate and disease duration is appropriate. We aimed to investigate the BVL in Japanese patients with MS.
Herein, with an observational period of approximately 3.5 years, 82 Japanese patients with MS were included. The volumes and annualised volume changes (AVCs) of the grey matter (GM) and whole brain were evaluated using ico
Whole-brain AVCs varied, especially among patients with a disease duration within approximately 16 years. Cluster analysis using two variables, disease duration and whole-brain AVC, identified the SM (short to middle duration and mild atrophy rates), SS (short to middle duration and severe atrophy rates), and L (long duration) groups. The optimal cut-off values for disease duration and whole-brain AVC to discriminate among the three groups were 15.8 years and -0.43%, respectively. Compared with the SM group, the SS group had higher Multiple Sclerosis Severity Scale (MSSS) and Expanded Disability Status Scale (EDSS) scores, lower information processing speed (IPS), higher lesion loads, higher whole-brain and GM volume loss, and higher GM atrophy rates. Moreover, among the 63 patients with MS included in the SM and SS groups, whole-brain AVCs were significantly correlated with the EDSS and MSSS scores and IPS.
BVL rates vary, especially among Japanese patients with MS with short to middle disease duration, and BVL degree is associated with poor prognosis.
为了确定应在多发性硬化症（MS）患者中使用哪些疾病修饰疗法，识别脑容量损失（BVL）高风险和低风险的患者很重要。尽管MS患者的BVL率从疾病早期到晚期几乎恒定，与疾病阶段无关，但个体差异已被注意到。此外，随着疾病持续时间的增加，慢性进展的风险增加，脑萎缩变得更加明显。因此，使用考虑BVL率和疾病持续时间的分类来测量预后是合适的。我们旨在研究日本MS患者的BVL情况。
在此，纳入了82名日本MS患者，观察期约为3.5年。使用ico评估灰质（GM）和全脑的体积及年化体积变化（AVC）。
全脑AVC各不相同，尤其是在疾病持续时间约16年以内的患者中。使用疾病持续时间和全脑AVC这两个变量进行聚类分析，确定了SM（短至中期病程和轻度萎缩率）、SS（短至中期病程和重度萎缩率）和L（长病程）组。区分这三组的疾病持续时间和全脑AVC的最佳临界值分别为15.8年和-0.43%。与SM组相比，SS组的多发性硬化症严重程度量表（MSSS）和扩展残疾状态量表（EDSS）得分更高，信息处理速度（IPS）更低，病灶负荷更高，全脑和GM体积损失更大，GM萎缩率更高。此外，在SM组和SS组纳入的63名MS患者中，全脑AVC与EDSS、MSSS得分及IPS显著相关。
BVL率各不相同，尤其是在疾病持续时间短至中期的日本MS患者中，且BVL程度与预后不良相关。
