Reinhardt Caroline, Angstwurm Klemens, Freudenstein David, Lee De-Hyung, Wendl Christina, Linker Ralf A
Department of Neurology, University of Regensburg, Universitätsstr. 84, 93053, Regensburg, Germany.
Department of Neuroradiology, University of Regensburg, Regensburg, Germany.
Neurol Res Pract. 2024 Aug 8;6(1):40. doi: 10.1186/s42466-024-00339-y.
Atrophy of white and grey matter volumes occurs early in the brains of people with multiple sclerosis (pwMS) and has great clinical relevance. In clinical trials, brain atrophy can be quantified by magnetic resonance imaging (MRI) with automated software tools.
In this study, we analyze volumes of various brain regions with the software "md brain" based on routine MRI scans of 53 pwMS in a real-world setting. We compare brain volumes of pwMS with an EDSS ≥ 3.5 and a disease duration ≥ 10 years to the brain volumes of pwMS with an EDSS < 3.5 and a disease duration < 10 years as well as with or without immunotherapy.
pwMS with an EDSS ≥ 3.5 and a disease duration ≥ 10 years had significantly lower volumes of the total brain, the grey matter and of the frontal, temporal, parietal and occipital lobe regions as compared to pwMS with an EDSS < 3.5 and a disease duration < 10 years. Regional brain volumes were significantly lower in pwMS without immunotherapy.
The study showed that higher EDSS, longer disease duration and absence of immunotherapy was associated with lower volumes in a number of brain regions. Further real-world studies may include larger patient cohorts in longitudinal analyses.
多发性硬化症患者（pwMS）大脑中的白质和灰质体积萎缩在疾病早期就会出现，且具有重要的临床意义。在临床试验中，脑萎缩可以通过磁共振成像（MRI）和自动化软件工具进行量化。
在本研究中，我们基于53例pwMS在真实环境中的常规MRI扫描，使用“md brain”软件分析了各个脑区的体积。我们将扩展残疾状态量表（EDSS）≥3.5且病程≥10年的pwMS的脑体积与EDSS<3.5且病程<10年的pwMS的脑体积进行比较，同时也比较了接受或未接受免疫治疗的pwMS的脑体积。
与EDSS<3.5且病程<10年的pwMS相比，EDSS≥3.5且病程≥10年的pwMS的全脑、灰质以及额叶、颞叶、顶叶和枕叶区域的体积显著更低。未接受免疫治疗的pwMS的区域脑体积显著更低。
该研究表明，较高的EDSS、较长的病程和未接受免疫治疗与多个脑区体积较低有关。进一步的真实环境研究可能会在纵向分析中纳入更大的患者队列。
