临床定义的ALS阶段分类与大脑病理负担之间的不匹配
Pedram Parnianpour1, Michael Benatar2, Hannah Briemberg3
1Neuroscience and Mental Health Institute, University of Alberta, 562 Heritage Medical Research Centre, 11313-87 Ave, Edmonton, AB, T6G2S2, Canada. parnianp@ualberta.ca.
Journal of neurology
|January 28, 2024
概括
肌缩侧面硬化症 (ALS) 患者表现出通过纹理分析检测到的大脑退化. 根据患者分层标准,疾病进展模式有很大差异,这表明目前临床试验分阶段的局限性.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 生物标志物 生物标志物
背景情况:
- 肌缩侧面硬化症 (ALS) 是一种进展性神经退行性疾病.
- 在体内了解大脑退化对于临床分层至关重要.
- 当前的分期系统可能无法完全捕捉病理负担.
研究的目的:
- 根据体内脑退化,研究ALS患者的临床分层.
- 为了评估纹理特征",自相关性" (autoc) 作为生物标志物.
- 通过不同的分层标准来比较疾病进展模式.
主要方法:
- 招募了149名ALS患者和144名健康对照 (HC).
- 在T1加权的MRI扫描上进行了纹理分析,以提取"自相关性" (autoc).
- 根据临床试验标准,国王学院分期和疾病进展率 (DPR) 进行分层患者.
主要成果:
- 在ALS患者中观察到内部囊中自动的增加.
- 大脑退化模式根据分层标准 (早期/高级阶段,缓慢/快速进展) 变化.
- 纵向自动变化发生在各种大脑区域,患者子组之间的模式不同.
结论:
- 临床分层的ALS患者显著影响观察到的大脑退化模式.
- 对"自相关性"的纹理分析揭示了明显的进展标记.
- 目前基于临床试验的分层可能不足以准确地描述ALS病理性脑负担.
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