在患有多发性硬化症的人群中,偏磁边缘损伤演变和临床和放射性疾病进展之间的关联
Jack A Reeves1, Alexander Bartnik1, Dejan Jakimovski1
1From the Buffalo Neuroimaging Analysis Center (J.A.R., A.B., D.J., M.M., N.B., F. Salman, F. Schweser, M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; Department of Biostatistics (G.W.), School of Public Health and Health Professions, State University of New York at Buffalo; and Center for Biomedical Imaging at the Clinical Translational Science Institute (B.W.-G.), University at Buffalo, State University of New York.
Neurology
|October 24, 2024
概括
在多发性硬化症 (MS) 中,偏磁边缘病变 (PRL) 的解决与更好的临床结果有关. 缺乏新的PRL也表明疾病进展有所改善,突出了MS治疗的目标.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 技术进步允许在体内可视化多发性硬化症 (MS) 中的慢性活性脑病变,使用对铁敏感的MRI,称为偏磁边缘病变 (PRLs).
- 在患有多发性硬化症 (pwMS) 的人群中,PRLs是未来临床疾病进展的既定预测因素.
- 了解PRL演变 (消失或新出现) 对MS病理生理学的影响,对于开发向疗法和临床试验终点至关重要.
研究的目的:
- 在多发性硬化症 (pwMS) 患者中,研究对磁性边缘病变 (PRL) 的演变与临床残疾进展和大脑缩之间的纵向关联.
- 为了确定PRL消失或新的PRL出现是否与随时间的临床残疾和大脑体积的变化相关.
- 为针对MS慢性活性炎症的临床试验提供敏感终点的发展提供信息.
主要方法:
- 一项前性的纵向队列研究包括患有多发性硬化症 (pwMS) 的人和健康的对照人 (HCs),可获得3T MRI和临床数据.
- 在基线和随访时评估PRL,并将其分类为消失,新出现或持久.
- 线性模型分析了PRL演变率 (失踪,新出现) 和确认残疾进展率 (CDP),复发活动独立进展率 (PIRA) 和脑缩率 (FDR校正) 之间的年化关联.
主要成果:
- 较高的PRL消失率与确认残疾进展率 (CDP) 和独立于复发活动的进展率 (PIRA) 的降低有关.
- 新出现的PRL显着与PIRA的增加率有关.
- 在FDR校正后,新出现的PRL或PRL消失与大脑体积变化之间没有发现显著的关联.
结论:
- 现有PRL的解决和没有新的PRL与pwMS中改善的临床结果有关.
- 这些发现强调了针对微质介导的大脑炎症的重要性.
- 旨在预防新的PRL出现的临床策略是管理MS进展的必要条件.
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