在二次渐进性多发性硬化症中,大脑储备和身体残疾
Nevin John1,2, Yingtong Li1, Floriana De Angelis3
1Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.
BMJ neurology open
|September 12, 2024
概括
较大的最大终身大脑生长 (MLBG) 可能会防止二次渐进性多发性硬化症 (SPMS) 的身体残疾进展. 这种大脑储备代理与96周的减弱残疾恶化有关,这表明持续的保护作用.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 医学研究 医学研究
背景情况:
- 大脑储备假设表明,更大的最大终身大脑生长 (MLBG) 可能会防止多发性硬化症 (MS) 的身体残疾.
- 以前的研究将较大的MLBG与早期MS中较慢的残疾进展联系在一起.
- 在二次渐进性多发性硬化 (SPMS) 中,MLBG和残疾进展之间的关联仍然不清楚.
研究的目的:
- 调查较大的MLBG是否与SPMS患者身体残疾进展的减少有关.
- 为了确定大脑储备的保护作用是否延伸到MS的渐进阶段.
主要方法:
- 对MS-Secondary渐进式多臂随机化试验 (NCT01910259) 的后期分析.
- 使用扩展残疾状态量表 (EDSS),9洞测试 (9HPT) 和25英尺计时步行测试 (T25FW) 评估的身体残疾.
- 根据基线内体积 (ICV) 估计的最大终身大脑生长 (MLBG);用于分析关联的Cox回归模型.
主要成果:
- 更大的MLBG独立地与96周的EDSS进展风险降低有关 (HR 0.84,p=0.04).
- 在MLBG和9HPT或T25FW测量的进展之间没有发现独立的关联.
- 该研究包括383名参与者,平均基线EDSS为6.0.
结论:
- 在SPMS中,较大的MLBG独立地与较慢的身体残疾进展有关,根据EDSS的测量.
- 最大终身大脑生长 (MLBG) 可能起到大脑储备的作用,即使在MS的次级渐进阶段,也可以保护大脑免受残疾的进展.
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