新生和慢性皮质病变对多发性硬化症残疾累积的贡献
Erin S Beck1,2, W Andrew Mullins1, Jonadab Dos Santos Silva2
1National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
Brain communications
|May 31, 2024
概括
在患有多发性硬化症的患者中,皮层病变的形成并不常见,这些患者有稳定的白质病变. 现有的皮层病变,而不是新的病变,预测残疾恶化,这表明长期影响是关键.
科学领域:
- 神经科学是一个神经科学.
- 放射学 放射学是一门学科.
- 神经学 神经学
背景情况:
- 皮层病变在多发性硬化症 (MS) 中很普遍,并且与残疾和疾病进展有关.
- 目前尚不清楚MS患者是否会出现新的皮层病变,而MS患者的白质病变是稳定的.
- 皮质病变与残疾恶化的关系需要澄清关于先前存在的病变与新病变的关系.
研究的目的:
- 调查多发性硬化症患者新皮层病变的发生率,这些患者有稳定的白质病变.
- 为了确定残疾恶化是否与先前存在的或新形成的皮质病变有关.
- 探索皮层和白质病变负担对MS中残疾进展的预测价值.
主要方法:
- 长度研究涉及50名患有多发性硬化症的成年人 (33名复发性缓解型,17名进展型) 和9名活跃复发性缓解型多发性硬化症患者的比较组.
- 每年7特斯拉 (T) 大脑MRI和3T大脑/脊柱MRI2年,临床评估3年.
- 在7TMRI上识别皮质病变和磁边病变;使用扩展残疾状况尺度,9洞测试和25英尺计时步行来评估残疾.
主要成果:
- 与活性RRMS组相比,在稳定的白质病变组 (3/30稳定的RRMS,4/17渐进的) 新皮层病变的形成很少发生 (5/9).
- 新的皮质病变与增加的残疾没有相关性.
- 较高的基线皮质损伤体积,而不是白质损伤体积,预测残疾恶化和过渡到次级渐进性MS.
结论:
- 在患有多发性硬化症的多发性硬化症患者中,皮层病变的形成并不频繁,即使残疾恶化,白质病变也稳定.
- 基线皮质病变负担,而不是正在进行的病变形成,是MS中残疾恶化的重要预测因素.
- 在MS中残疾的进展似乎与早期形成的皮质病变的累积,长期影响有关.
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