Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Neuroimmunol. 2024 Nov 15;396:578445. doi: 10.1016/j.jneuroim.2024.578445. Epub 2024 Sep 3.
Disease-modifying therapies (DMTs) are used in an increasing number of patients with multiple sclerosis (MS). However, whether DMTs have intrinsic effects on deep gray matter (DGM) microstructure and atrophy is still poorly understood. In this study, we described the quantitative susceptibility values (QSV) and diffusion kurtosis imaging (DKI) metrics of DGM in relapsing-remitting MS (RRMS) patients and their association with cognitive deficits. We recruited 62 patients with RRMS receiving DMTs and 30 patients with RRMS not receiving DMTs underwent MRI on a 3T scanner. Fractional anisotropy (FA), kurtosis fractional anisotropy (KFA), mean diffusivity (MD), mean kurtosis (MK), QSV and volumes of bilateral caudate nucleus (CAU), amygdala (AMYG), putamen (PUT), hippocampus (Hipp), globus pallidus (GP) and thalamus (THA) were measured. Correlation analysis was performed between those image indexes with longitudinal significant changes and clinical neurological scores, including Expanded Disability Status Scale (EDSS), Digit Span Testand (DST), Symbol Digit Modalities Test (SDMT), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Significant longitudinal increases in FA, KFA and MK values were found in both groups in bilateral CAU, AMYG, PUT, Hipp, GP and THA (all p < 0.005). MD values of the right of CAU in the two groups were significant longitudinal increase (p = 0.009, p = 0.047); MD values of the right of GP (p = 0.042), the left of THA (p = 0.003), the right of THA (p = 0.001) in treated MS were significant longitudinal decrease; There were no significant longitudinal changes between treated and untreated groups in normalized deep gray matter volume. For QSV, longitudinal increase in the right of PUT (p = 0.022) in the treated MS group and in the left of Hipp (p = 0.045) in the untreated MS group. The QSV and DKI measures were highly correlated with cognitive and disability tests. The treated RRMS patients showed different longitudinal changes of MD value and QSV with untreated in several DGM regions, and these differences were correlated with cognitive and microstructural integrity.
越来越多的多发性硬化症 (MS) 患者使用疾病修正疗法 (DMTs)。然而，DMTs 是否对深部灰质 (DGM) 微观结构和萎缩有内在影响仍知之甚少。在这项研究中，我们描述了复发缓解型 MS (RRMS) 患者 DGM 的定量磁化率值 (QSV) 和扩散峰度成像 (DKI) 指标，以及它们与认知缺陷的关系。我们招募了 62 名接受 DMT 治疗的 RRMS 患者和 30 名未接受 DMT 治疗的 RRMS 患者，在 3T 扫描仪上进行 MRI 检查。测量了双侧尾状核 (CAU)、杏仁核 (AMYG)、壳核 (PUT)、海马 (Hipp)、苍白球 (GP) 和丘脑 (THA) 的各向异性分数 (FA)、峰度各向异性分数 (KFA)、平均弥散度 (MD)、平均峰度 (MK)、QSV 和容积。对与纵向显著变化相关的图像指标与临床神经学评分进行了相关性分析，包括扩展残疾状况量表 (EDSS)、数字符号测试 (DST)、符号数字模式测试 (SDMT)、简易精神状态检查 (MMSE) 和蒙特利尔认知评估 (MoCA)。在两组双侧 CAU、AMYG、PUT、Hipp、GP 和 THA 中，FA、KFA 和 MK 值均有显著的纵向增加 (均 P < 0.005)。两组右侧 CAU 的 MD 值呈显著纵向增加 (P = 0.009，P = 0.047)；治疗组右侧 GP (P = 0.042)、左侧 THA (P = 0.003)、右侧 THA (P = 0.001)的 MD 值呈显著纵向降低；治疗组与未治疗组之间的深部灰质体积无显著纵向变化。对于 QSV，治疗组右侧 PUT (P = 0.022)和未治疗组左侧 Hipp (P = 0.045)的 QSV 呈纵向增加。QSV 和 DKI 测量值与认知和残疾测试高度相关。治疗 RRMS 患者在几个 DGM 区域显示出与未治疗患者不同的 MD 值和 QSV 纵向变化，这些差异与认知和微观结构完整性有关。
