在放射隔离综合征中,二甲基烟酸保持脑干和椎脊髓完整性
Darin T Okuda1,2, Christina J Azevedo3, Daniel Pelletier3
1Department of Neurology, Neuroinnovation Program, Multiple Sclerosis & Neuroimmunology Imaging Program, The University of Texas Southwestern Medical Center, 5303 Harry Hines Blvd., Dallas, TX, 75390-8806, USA. darin.okuda@UTsouthwestern.edu.
在放射隔离综合征 (RIS) 中,二甲基烟酸 (DMF) 治疗对大脑体积没有影响,但改变了脑干曲率. 这表明,在减缓神经退行方面,超出传统体积测量的潜在好处.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 临床试验 临床试验
背景情况:
- 放射性隔离综合征 (RIS) 是中枢神经系统脱髓化的前体.
- ARISE试验显示,二甲基烟酸 (DMF) 延迟了临床事件,并减少了RIS中的新的MRI病变.
- 对于RIS中DMF对特定大脑结构和表面特征的影响尚未完全阐明.
研究的目的:
- 为了研究DMF对大脑,丘脑和皮质下灰质体积测量的影响,在RIS患者中.
- 评估DMF对大脑干和椎上部3D体积和表面特征的影响.
- 探索DMF在RIS中除了减少病变之外的潜在神经保护作用.
主要方法:
- 在基线和研究结束时获得了3D T1加权图像的标准化3T MRI.
- 结构图像评估使用缩正常化 (SIENA) 和FreeSurfer v7.3用于体积分析.
- 一个内部管道分析了3D形状指标,多变量混合模型评估了变化速率.
主要成果:
- 在DMF和安慰剂组之间没有观察到全脑,乳头或皮质下灰质体积的显著差异.
- 背部曲的显著差异被观察到,DMF组与安慰剂相比变化较小 (p=0.036).
- 在经历了第一次临床事件的患者中,DMF与脑髓-上椎脊髓体积减少 (p=0.044) 和背脊髓曲率 (p=0.009) 相关.
结论:
- 在RIS中DMF治疗可能会提供延伸到神经退行性影响中枢神经系统结构的好处,可能会影响脑干和脊髓形态.
- 这些发现表明,DMF在RIS中的治疗作用可能涉及除了减少脱髓化病变之外的机制.
- 需要进一步的研究来了解DMF对RIS神经退行过程的长期影响.
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