多发性硬化症患者中顺磁性边缘病变与丘脑枕铁缺乏之间的关联。

Association between paramagnetic rim lesions and pulvinar iron depletion in persons with multiple sclerosis.

作者信息

Reeves Jack A, Salman Fahad, Mohebbi Maryam, Bergsland Niels, Jakimovski Dejan, Hametner Simon, Weinstock-Guttman Bianca, Zivadinov Robert, Dwyer Michael G, Schweser Ferdinand

机构信息

Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States.

出版信息

Mult Scler Relat Disord. 2025 Jan;93:106187. doi: 10.1016/j.msard.2024.106187. Epub 2024 Nov 24.

DOI:10.1016/j.msard.2024.106187

PMID:39644585

Abstract

BACKGROUND

The deep gray matter (DGM), especially the pulvinar, and the white matter surrounding chronic active lesions have demonstrated depleted iron levels, indicating a possible mechanistic link. However, no studies have investigated the potential relationship between these phenomena.

OBJECTIVES

The study aimed to determine whether PRLs were associated with pulvinar iron depletion and, if so, whether this relationship was spatially mediated.

METHODS

This retrospective analysis included 139 people with MS (pwMS) and 43 healthy controls (HCs) scanned at 3T MRI at baseline and after 5.4 ± 0.6 years. Pulvinar iron concentrations (cFe) and iron masses (mFe) were estimated from quantitative susceptibility maps and tested for associations with PRLs. A separate cohort of 96 pwMS with PRLs and propensity-matched HCs was included to evaluate peri‑plaque normal-appearing white matter (NAWM) abnormalities.

RESULTS

PRL number was associated with greater decline in pulvinar cFe (β = -0.265, p = 0.005) and mFe (β = -0.256, p = 0.006). Peri-plaque NAWM susceptibility was increased 11 mm surrounding PRLs, outside which shorter PRL-to-pulvinar distance was associated with greater decline in pulvinar cFe (β = 0.380, p = 0.005) and mFe (β = 0.348, p = 0.022).

CONCLUSIONS

Our findings support a spatially-mediated relationship between PRLs and chronic pulvinar iron depletion.

摘要

背景

深部灰质（DGM），尤其是丘脑枕，以及慢性活动性病变周围的白质已显示铁水平降低，这表明可能存在机制联系。然而，尚无研究调查这些现象之间的潜在关系。

目的

本研究旨在确定进展性视网膜病变（PRLs）是否与丘脑枕铁耗竭有关，如果有关，这种关系是否由空间介导。

方法

这项回顾性分析纳入了139例多发性硬化症患者（pwMS）和43名健康对照者（HCs），在基线时和5.4±0.6年后进行3T磁共振成像扫描。从定量磁化率图估计丘脑枕铁浓度（cFe）和铁质量（mFe），并测试其与PRLs的相关性。纳入了一个由96例患有PRLs的pwMS和倾向匹配的HCs组成的单独队列，以评估斑块周围正常外观白质（NAWM）异常。

结果

PRL数量与丘脑枕cFe（β = -0.265，p = 0.005）和mFe（β = -0.256，p = 0.006）的更大下降相关。PRLs周围11毫米处斑块周围NAWM磁化率增加，在该范围之外，PRL到丘脑枕的较短距离与丘脑枕cFe（β = 0.380，p = 0.005）和mFe（β = 0.348，p = 0.022）的更大下降相关。