Quintanilla-Bordás Carlos, Fernández-Patón Matías, Ten Amadeo, Ferrer-Pardo Cristina, Carratala-Bosca Sara, Castillo-Villalba Jéssica, Cubas-Núñez Laura, Gasqué-Rubio Raquel, Verdini-Martínez Laura, Pérez-Miralles Francisco, Martí-Bonmatí Luís, Casanova Bonaventura
Neuroimmunology Unit, La Fe University and Polytechnic Hospital, Avda. Fernando Abril Martorell, 106, Valencia, 46026, Spain.
Grupo de Investigación Biomédica de Imagen, Health Research Institute Hospital La Fe, Valencia, Spain.
Neurol Sci. 2025 Apr;46(4):1783-1787. doi: 10.1007/s10072-024-07921-x. Epub 2024 Dec 18.
Patients with multiple sclerosis (MS) may remain in a relapsing-remitting (RRMS) course despite long-standing disease, while others will develop secondary progression (SPMS). Chronic inflammation and changes in the blood-brain barrier resulting in perturbed glucose metabolism may account for these differences. PET-MRI with kinetic analysis of 2-deoxy-2(18 F)fluoro-d-glucose (18 F-FDG) provides insight into glucose metabolism and has proven useful in several chronic inflammatory diseases. However, to our knowledge, it has never been studied in MS.
To explore potential differences in glucose distribution kinetics among individuals with long-standing SPMS and RRMS using dynamic 18-F-FDG PET-MRI.
Dynamic 18-F-FDG PET-MRI scans were obtained in 11 patients with long-standing MS: 4 with RRMS and 7 with SPMS. Kinetic analysis of PET data was performed using a three-compartment model equation that represents plasma, tissue and 18 F-FDG phosphorylation. Individual rate constants of 18-F-FDG across the compartments were calculated.
Patients with SPMS exhibited a trend towards an increased net influx rate of glucose (p = 0.059) and an increased rate constant representing glucose phosphorylation. Together, the data suggest increased uptake of glucose and glycolysis in these patients.
Dynamic 18 F-FDG PET-MRI is a feasible technique that may show information in vivo of glucose metabolism in MS. Although preliminary data suggest a potential radiological marker of progression in MS, further studies are required to confirm this hypothesis.
尽管患有多发性硬化症（MS）的时间很长，但患者可能仍处于复发缓解型（RRMS）病程中，而其他患者则会发展为继发进展型（SPMS）。慢性炎症和血脑屏障的变化导致葡萄糖代谢紊乱，可能是造成这些差异的原因。采用2-脱氧-2（18F）氟-D-葡萄糖（18F-FDG）进行动力学分析的PET-MRI可深入了解葡萄糖代谢情况，并且已被证明在几种慢性炎症性疾病中很有用。然而，据我们所知，尚未在MS中对其进行研究。
使用动态18F-FDG PET-MRI探索长期患有SPMS和RRMS的个体之间葡萄糖分布动力学的潜在差异。
对11例长期患有MS的患者进行了动态18F-FDG PET-MRI扫描：4例RRMS患者和7例SPMS患者。使用代表血浆、组织和18F-FDG磷酸化的三室模型方程对PET数据进行动力学分析。计算了各室间18F-FDG的个体速率常数。
SPMS患者表现出葡萄糖净流入率增加的趋势（p = 0.059）以及代表葡萄糖磷酸化的速率常数增加。总体而言，数据表明这些患者的葡萄糖摄取和糖酵解增加。
动态18F-FDG PET-MRI是一种可行的技术，可能显示MS中葡萄糖代谢的体内信息。尽管初步数据表明MS进展可能存在潜在的影像学标志物，但仍需要进一步研究来证实这一假设。
