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疾病前期结构储备如何影响多发性硬化症中残疾累积

Elena Barbuti^1,2, Luca Prosperini³, Serena Ruggieri³

¹Department of Human Neurosciences, Sapienza University, Rome, Italy.

Multiple sclerosis (Houndmills, Basingstoke, England)

|October 8, 2025

概括

疾病前的结构储备,包括内体积 (ICV) 和脊髓通道区域 (SCCA),减轻了多发性硬化症 (MS) 中的长期残疾积累. 较高的ICV和SCCA与较慢的疾病进展有关,支持它们作为预后标记物的使用.

科学领域:

神经成像和神经退化
神经学和临床神经科学神经学和临床神经科学

背景情况:

多发性硬化症 (MS) 是一种慢性神经系统疾病,其特点是残疾逐渐累积.
了解影响MS残疾进展的因素,包括不依赖复发活动的进展 (PIRA) 和复发相关恶化 (RAW),对于有效的管理至关重要.
疾病前期的结构储备,以内体积 (ICV) 和脊椎沟区域 (SCCA) 为代表,可能在神经保护中发挥作用.

研究的目的:

调查前病态结构储备代理 (ICV和SCCA) 对复发性MS患者长期残疾累积的影响.
确定ICV和SCCA是否通过PIRA和RAW途径影响残疾累积.
评估ICV和SCCA在达到重大残疾里程碑上的综合影响.

主要方法:

分析了253名患有复发性多发性硬化症的患者队列,并从他们的第一个脱髓化事件 (FDE) 开始至少进行了5年的随访.
使用3D T1权重的MRI扫描来估计ICV和SCCA.
负二项回归和竞争风险模型被用来分析PIRA和RAW事件,考虑它们的同时发生.

主要成果:

较高的SCCA与较少的PIRA事件和延迟PIRA发作有关.
较大的ICV与较少的RAW事件,晚期发生RAW和RAW中较大的年龄有关.
与储备较低的患者相比,高联合储备 (较大的ICV和SCCA) 的患者在显著晚些时候和更老年时达到扩展残疾状态量表 (EDSS) ≥6.0.

结论:

以ICV和SCCA衡量的病前疾病结构储备,显著减轻了MS的长期残疾累积.
这些发现支持将ICV和SCCA整合到MS的预后模型中.
在MS进展的背景下,ICV和SCCA是神经解剖学弹性的有价值标志物.

关键词:

多发性硬化症是多发性硬化症.皮拉皮拉 (Pira Pira) 是一个名字.在 RAW 版中使用 RAW.大脑储备储备是什么?脊髓储备储备是指脊髓的储备.

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