多发性硬化症进展的预测因素:常规磁共振成像研究的系统评价。
Predictors of multiple sclerosis progression: A systematic review of conventional magnetic resonance imaging studies.
机构信息
Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Department of Neurology, Poursina Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
出版信息
PLoS One. 2024 Apr 16;19(4):e0300415. doi: 10.1371/journal.pone.0300415. eCollection 2024.
INTRODUCTION
Multiple Sclerosis (MS) is a chronic neurodegenerative disorder that affects the central nervous system (CNS) and results in progressive clinical disability and cognitive decline. Currently, there are no specific imaging parameters available for the prediction of longitudinal disability in MS patients. Magnetic resonance imaging (MRI) has linked imaging anomalies to clinical and cognitive deficits in MS. In this study, we aimed to evaluate the effectiveness of MRI in predicting disability, clinical progression, and cognitive decline in MS.
METHODS
In this study, according to PRISMA guidelines, we comprehensively searched the Web of Science, PubMed, and Embase databases to identify pertinent articles that employed conventional MRI in the context of Relapsing-Remitting and progressive forms of MS. Following a rigorous screening process, studies that met the predefined inclusion criteria were selected for data extraction and evaluated for potential sources of bias.
RESULTS
A total of 3028 records were retrieved from database searching. After a rigorous screening, 53 records met the criteria and were included in this study. Lesions and alterations in CNS structures like white matter, gray matter, corpus callosum, thalamus, and spinal cord, may be used to anticipate disability progression. Several prognostic factors associated with the progression of MS, including presence of cortical lesions, changes in gray matter volume, whole brain atrophy, the corpus callosum index, alterations in thalamic volume, and lesions or alterations in cross-sectional area of the spinal cord. For cognitive impairment in MS patients, reliable predictors include cortical gray matter volume, brain atrophy, lesion characteristics (T2-lesion load, temporal, frontal, and cerebellar lesions), white matter lesion volume, thalamic volume, and corpus callosum density.
CONCLUSION
This study indicates that MRI can be used to predict the cognitive decline, disability progression, and disease progression in MS patients over time.
简介
多发性硬化症(MS)是一种慢性神经退行性疾病,影响中枢神经系统(CNS),导致进行性临床残疾和认知能力下降。目前,尚无特定的影像学参数可用于预测 MS 患者的纵向残疾。磁共振成像(MRI)已将影像学异常与 MS 患者的临床和认知缺陷联系起来。在这项研究中,我们旨在评估 MRI 在预测 MS 患者残疾、临床进展和认知下降方面的有效性。
方法
根据 PRISMA 指南,我们全面搜索了 Web of Science、PubMed 和 Embase 数据库,以确定在复发缓解型和进行性 MS 中使用常规 MRI 的相关文章。经过严格的筛选过程,选择符合预设纳入标准的研究进行数据提取,并评估潜在的偏倚来源。
结果
从数据库搜索中总共检索到 3028 条记录。经过严格筛选,有 53 条记录符合标准并纳入本研究。中枢神经系统结构的病变和改变,如白质、灰质、胼胝体、丘脑和脊髓,可用于预测残疾进展。与 MS 进展相关的几个预后因素,包括皮质病变的存在、灰质体积的变化、全脑萎缩、胼胝体指数、丘脑体积的变化以及脊髓横截面积的病变或改变。对于 MS 患者的认知障碍,可靠的预测因素包括皮质灰质体积、脑萎缩、病变特征(T2 病变负荷、颞叶、额叶和小脑病变)、白质病变体积、丘脑体积和胼胝体密度。
结论
本研究表明,MRI 可用于预测 MS 患者随时间推移的认知下降、残疾进展和疾病进展。