Hok Pavel, Thai Quang Thong, Bučková Barbora Rehák, Domin Martin, Řasová Kamila, Tintěra Jaroslav, Lotze Martin, Grothe Matthias, Hlinka Jaroslav
Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
Eur J Neurol. 2025 Jan;32(1):e16421. doi: 10.1111/ene.16421. Epub 2024 Jul 26.
Cognitive impairment (CI) in multiple sclerosis (MS) is associated with bidirectional changes in resting-state centrality measures. However, practicable functional magnetic resonance imaging (fMRI) biomarkers of CI are still lacking. The aim of this study was to assess the graph-theory-based degree rank order disruption index (k) and its association with cognitive processing speed as a marker of CI in patients with MS (PwMS) in a secondary cross-sectional fMRI analysis.
Differentiation between PwMS and healthy controls (HCs) using k and its correlation with CI (Symbol Digit Modalities Test) was compared to established imaging biomarkers (regional degree, volumetry, diffusion-weighted imaging, lesion mapping). Additional associations were assessed for fatigue (Fatigue Scale for Motor and Cognitive Functions), gait and global disability.
Analysis in 56 PwMS and 58 HCs (35/27 women, median age 45.1/40.5 years) showed lower k in PwMS than in HCs (median -0.30/-0.06, interquartile range 0.55/0.54; p = 0.009, Mann-Whitney U test), yielding acceptable yet non-superior differentiation (area under curve 0.64). k and degree in medial prefrontal cortex (MPFC) correlated with CI (k/MPFC Spearman's ρ = 0.32/-0.45, p = 0.019/0.001, n = 55). k also explained fatigue (ρ = -0.34, p = 0.010, n = 56) but neither gait nor disability.
k is a potential biomarker of CI and fatigue warranting further validation.
多发性硬化症（MS）中的认知障碍（CI）与静息态中心性测量的双向变化相关。然而，CI切实可行的功能磁共振成像（fMRI）生物标志物仍然缺乏。本研究的目的是在一项二次横断面fMRI分析中，评估基于图论的度秩次破坏指数（k）及其与认知处理速度的关联，将其作为MS患者（PwMS）中CI的标志物。
使用k区分PwMS与健康对照（HCs），并将其与CI（符号数字模态测试）的相关性与既定的成像生物标志物（区域度、体积测量、扩散加权成像、病变映射）进行比较。还评估了与疲劳（运动和认知功能疲劳量表）、步态和整体残疾的其他关联。
对56例PwMS和58例HCs（35/27名女性，中位年龄45.1/40.5岁）的分析显示，PwMS中的k低于HCs（中位数-0.30/-0.06，四分位间距0.55/0.54；p = 0.009，曼-惠特尼U检验），产生了可接受但非优越的区分度（曲线下面积0.64）。内侧前额叶皮质（MPFC）中的k和度与CI相关（k/MPFC斯皮尔曼ρ = 0.32/-0.45，p = 0.019/0.001，n = 55）。k还解释了疲劳（ρ = -0.34，p = 0.010，n = 56），但与步态和残疾均无关。
k是CI和疲劳的潜在生物标志物，值得进一步验证。
