Department of Neurology, Brigham Multiple Sclerosis Center, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Rd, Mailbox, 9002L, Boston, MA, 02115-6128, USA.
Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Neurol. 2024 Oct;271(10):6935-6943. doi: 10.1007/s00415-024-12656-y. Epub 2024 Sep 6.
Deep gray matter (DGM) atrophy and lesions are found in multiple sclerosis (MS).
To optimize automated segmentation for 7 T DGM volumetrics and assess sensitivity to atrophy and relationship to DGM lesions and disability in relapsing-remitting (RR) MS.
30 RRMS subjects [mean age 44.0 years, median Expanded Disability Status Scale (EDSS) score 2] and 14 healthy controls underwent 7 T MRI with 3D magnetization-prepared 2 rapid gradient-echoes (MP2RAGE) and fluid-attenuated inversion recovery. Customizing an automated pipeline to assess DGM structure volumes required pre-processing combining two MP2RAGE inversion times and uniform T1 images, and noise-suppressed reconstruction. DGM volumes were normalized. Brain DGM lesions and white matter T2 lesion volume (T2LV) were expert-quantified. Spearman correlations and Wilcoxon rank-sum tests were assessed.
DGM lesions were found in 77% (n = 23) of MS subjects and no controls, with thalamic lesions most prevalent (73%). An average of 3.6 DGM lesions was found per person with MS. Total DGM volumes were lower in MS vs. controls (p = 0.034), varying by region, most pronounced in the caudate (p = 0.008). DGM volumes inversely correlated with EDSS (total DGM: r = - 0.45, p = 0.014; globus pallidus: r = - 0.42, p = 0.023; putamen: r = - 0.44, p = 0.016; caudate: r = - 0.37, p = 0.047) and T2LV (total DGM: r = - 0.53, p = 0.003; putamen: r = - 0.40, p = 0.030; thalamus: r = - 0.63, p < 0.001). DGM atrophy was most closely linked to disability among all MRI measures. Thalamic lesion volume correlated inversely with thalamic volume (r = - 0.38, p = 0.045).
7 T MRI shows a link between DGM atrophy and both white matter lesions and physical disability in RRMS. Thalamic lesions are associated with thalamic atrophy.
多发性硬化症（MS）存在深部灰质（DGM）萎缩和病变。
优化 7T DGM 容积的自动分割，并评估其对萎缩的敏感性，以及与 DGM 病变和 RRMS 残疾的关系。
30 例 RRMS 患者[平均年龄 44.0 岁，中位扩展残疾状况量表（EDSS）评分 2]和 14 名健康对照者接受了 7T MRI 检查，包括三维磁化准备 2 快速梯度回波（MP2RAGE）和液体衰减反转恢复。定制用于评估 DGM 结构体积的自动化流水线需要预处理，包括结合两个 MP2RAGE 反转时间和均匀 T1 图像，以及降噪重建。DGM 体积进行了归一化。大脑 DGM 病变和脑白质 T2 病变体积（T2LV）由专家进行量化。评估了 Spearman 相关性和 Wilcoxon 秩和检验。
77%（n=23）的 MS 患者和无对照者存在 DGM 病变，最常见的是丘脑病变（73%）。每位 MS 患者平均有 3.6 个 DGM 病变。MS 患者的总 DGM 体积低于对照组（p=0.034），不同区域存在差异，尾状核最明显（p=0.008）。DGM 体积与 EDSS 呈负相关（总 DGM：r=-0.45，p=0.014；苍白球：r=-0.42，p=0.023；壳核：r=-0.44，p=0.016；尾状核：r=-0.37，p=0.047）和 T2LV（总 DGM：r=-0.53，p=0.003；壳核：r=-0.40，p=0.030；丘脑：r=-0.63，p<0.001）。DGM 萎缩与所有 MRI 测量指标中残疾的关系最为密切。丘脑病变体积与丘脑体积呈负相关（r=-0.38，p=0.045）。
7T MRI 显示 RRMS 患者的 DGM 萎缩与脑白质病变和躯体残疾之间存在关联。丘脑病变与丘脑萎缩有关。
