用高效疗法治疗的无复发性多发性硬化症患者的认知变化:偏磁边缘病变的预测价值
Vincenzo Daniele Boccia1, Elisa Leveraro2, Emilio Cipriano1
1Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università degli Studi di Genova Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili, Genova, Liguria, Italy.
Journal of neurology, neurosurgery, and psychiatry
|January 31, 2025
概括
高效疗法可以改善多发性硬化症 (MS) 管理,但认知能力下降仍然存在. 在MRI上对磁边缘损伤 (PRL) 预测MS患者的符号数字模式测试 (SDMT) 下降,突出显示慢性炎症.
科学领域:
- 神经免疫学 神经免疫学
- 神经成像是一种神经成像.
- 认知神经学 认知神经学
背景情况:
- 高效的疾病修饰疗法 (HETs) 已经推进了多发性硬化症 (MS) 护理.
- 尽管有HET,持续的认知衰退仍然是患者面临的重大挑战.
研究的目的:
- 为了评估符号数字模式测试 (SDMT) 性能在稳定的复发性复发性多发性硬化症 (RRMS) 患者在HETs上的变化.
- 确定基线MRI生物标志物,预测这些患者的认知变化 (SDMT).
主要方法:
- 在HET上对RRMS患者进行24个月的随访,不包括复发或MRI活动的患者.
- 使用SDMT和可靠的变化指数评估认知变化.
- 基线MRI包括FLAIR,T1-MPRAGE和对偏磁边缘病变 (PRLs) 和同强度病变 (ISO) 的定量敏感度映射 (QSM).
主要成果:
- 包括90名RRMS患者;51.1%的人在基线有PRL.
- 在24个月后,14.4%的人显示SDMT下降,8.9%的人改善.
- 多变量分析将PRL与较高的SDMT下降风险联系在一起 (OR:14.82),ISO病变与较弱的SDMT改善联系在一起 (OR:1.07).
结论:
- 即使在两年内没有临床或MRI活动的MS患者中,SDMT变化也会发生.
- 偏磁边缘病变 (PRLs) 成为MS认知衰退的重要预测因素.
- 这些发现强调了分隔性慢性炎症在MS进展中的作用.
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