Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue
Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue
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DOI：
10.3174/ajnr.a2412
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发表时间：
2011-05-01
影响因子：
3.5
通讯作者：
Filippi, M.
中科院分区：
文献类型：
--
作者：
Riccitelli, G.;Rocca, M. A.;Filippi, M.
背景和目的：疲劳影响高达 90% 的多发性硬化症患者。我们评估了伴有疲劳的 ARMS 患者与 HC 以及具有相似特征但无疲劳的患者相比，正常出现的 WM 和 GM 的病变和萎缩的区域分布。 材料和方法：我们对 14 名无疲劳的 RRMS 患者、10 名伴有疲劳的 RAMS 患者和 14 名 HC 患者进行了脑部双回波和高分辨率 T1 加权扫描。使用 SPM5 软件比较疲劳和非疲劳 MS 患者之间 GM、WM 损伤和 T2 病变的体素分布。我们报告的结果为 P < .05，经 FWE 校正。结果：疲劳型 MS 和非疲劳型 MS 患者的 T2 病变分布和局部 WM 萎缩没有差异。与HC相比，MS患者胼胝体后部WM明显萎缩，左侧额上沟、左侧中央前回、后扣带皮层、右侧丘脑、左侧额中回GM明显萎缩。与 HC 相比，非疲劳性 MS 患者没有发现额外的萎缩区域，而疲劳性 MS 患者的左中央沟也出现萎缩。与非疲劳性多发性硬化症患者相比，疲劳性多发性硬化症患者左中央沟和中央前回的萎缩更为严重。在 MS 患者中，疲劳严重程度与左侧中央前回 GM 萎缩之间存在显着相关性（r = 0.73，P < .0001 未校正）。 结论：初级感觉运动区萎缩可能导致 MS 相关疲劳。
BACKGROUND AND PURPOSE: Fatigue affects up to 90% of patients with MS. We assessed the regional distribution of lesions and atrophy of the normal-appearing WM and GM in patients with ARMS with fatigue compared with HC and patients with similar characteristics, but without fatigue.MATERIALS AND METHODS: From 14 patients with RRMS without fatigue, 10 with RAMS with fatigue, and 14 HC, we acquired brain dual-echo and high-resolution T1-weighted scans. Voxel-wise distributions of GM, WM damage, and T2 lesions were compared between patients with fatigued and nonfatigued MS by using SPM5 software. We report results at P < .05, FWE corrected.RESULTS: T2 lesion distribution and regional WM atrophy did not differ between patients with fatigued and nonfatigued MS. Compared with HC, patients with MS had significant WM atrophy in the posterior part of the corpus callosum and significant GM atrophy of the left superior frontal sulcus, left precentral gyrus, posterior cingulate cortex, right thalamus, and left middle frontal gyrus. No additional areas of atrophy were found in patients with nonfatigued MS compared with HC, whereas patients with fatigued MS also had atrophy of the left central sulcus. Atrophy in the left central sulcus and the precentral gyrus was more severe in patients with fatigued versus nonfatigued MS. In patients with MS, significant correlations were found between fatigue severity and GM atrophy in the left precentral gyrus (r = 0.73, P < .0001 uncorrected).CONCLUSIONS: Atrophy of the primary sensorimotor area is likely to contribute to MS-related fatigue.