Opfer Roland, Schwab Matthias, Bangoura Sabine, Biswas Mousumi, Krüger Julia, Spies Lothar, Gocke Carola, Gaser Christian, Schippling Sven, Kitzler Hagen H, Ziemssen Tjalf
jung diagnostics GmbH, Hamburg, Germany.
Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany.
Neuroradiology. 2025 Jan;67(1):99-107. doi: 10.1007/s00234-024-03516-7. Epub 2024 Nov 28.
BACKGROUND: The aim of this study was to investigate the dynamics of annual whole brain volume loss (BVL/year) and annual thalamic volume loss (ThalaVL/year) in patients with relapsing-remitting multiple sclerosis (PwRRMS) during the course of the disease. METHODS: A longitudinal database of magnetic resonance imaging (MRI) scans of 195 healthy individuals (age range, 22.8-63.7 years) and longitudinal MRI data of 256 PwRRMS (age range, 20.1-60.8 years) were analyzed and compared. BVL/year and ThalaVL/year were computed for healthy individuals as well as for all patients with MS using a Jacobian integration approach. A linear regression was used to compute the relationship between age and BVL/year and ThalaVL/year for healthy individuals. The linear regression was then used to decompose the BVL/year and ThalaVL/year into a multiple sclerosis (MS)-related and an age-related component for each PwRRMS. PwRRMS were dichotomized into early-phase RRMS (disease duration ≤ 6 years) and later-phase RRMS (disease duration > 6 years), and a t-test was performed to test for differences between these groups. RESULTS: The 135 early-phase patients (disease duration, ≤ 6 years) had statistically significantly higher MS-related BVL/year than the later-phase patients (n = 121) (- 0.21% vs. - 0.06%, p = 0.007). For MS-related ThalaVL/year, the difference between the groups was even more pronounced (- 0.39% vs. - 0.00%, p < 0.0001). CONCLUSIONS: Our results indicate that in PwRRMS, the MS-related components of BVL/year and ThalaVL/year are accelerated in early phases and slowdown in later phases of the disease. This might explain why early intervention often leads to improved outcomes in patients with MS.
背景:本研究旨在调查复发缓解型多发性硬化症(PwRRMS)患者在疾病过程中每年全脑体积损失(BVL/年)和每年丘脑体积损失(ThalaVL/年)的动态变化。 方法:分析并比较了195名健康个体(年龄范围22.8 - 63.7岁)的磁共振成像(MRI)扫描纵向数据库以及256名PwRRMS(年龄范围20.1 - 60.8岁)的纵向MRI数据。使用雅可比积分法计算健康个体以及所有MS患者的BVL/年和ThalaVL/年。采用线性回归计算健康个体年龄与BVL/年和ThalaVL/年之间的关系。然后使用线性回归将每个PwRRMS的BVL/年和ThalaVL/年分解为与多发性硬化症(MS)相关的成分和与年龄相关的成分。将PwRRMS分为早期复发缓解型多发性硬化症(病程≤6年)和晚期复发缓解型多发性硬化症(病程>6年),并进行t检验以检验这些组之间的差异。 结果:135名早期患者(病程≤6年)与后期患者(n = 121)相比,与MS相关的BVL/年在统计学上显著更高(-0.21%对-0.06%,p = 0.007)。对于与MS相关的ThalaVL/年,两组之间的差异更为明显(-0.39%对-0.00%,p < 0.0001)。 结论:我们的结果表明,在PwRRMS中,BVL/年和ThalaVL/年与MS相关的成分在疾病早期加速,在疾病后期减缓。这可能解释了为什么早期干预通常会使MS患者的预后得到改善。
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