Spinal cord tract diffusion tensor imaging reveals disability substrate in demyelinating disease
Spinal cord tract diffusion tensor imaging reveals disability substrate in demyelinating disease
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DOI：
10.1212/wnl.0b013e318296e8f1
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发表时间：
2013-06-11
期刊：
影响因子：
9.9
通讯作者：
Cross, Anne H.
中科院分区：
文献类型：
--
作者：
Naismith, Robert T.;Xu, Junqian;Cross, Anne H.
目的：本研究评估了主要颈髓束的组织完整性，通过使用扩散张量成像（DTI），以确定与特定的临床功能进行了这些tracts.Methods的关系：这是一个横断面研究的37例多发性硬化症或神经肌病与远程颈髓疾病。确定手指振动阈值、25英尺计时步行（25 FTW）、9孔桩测试（9 HPT）和扩展残疾状态量表。DTI用17个5 mm切片（0.9 x 0.9 mm平面内分辨率）覆盖颈部C1至C6。感兴趣的区域包括后柱（PC）和皮质脊髓侧束（CST）。分层线性混合效应模型包括疾病亚型（多发性硬化症与视神经肌萎缩症），疾病持续时间和sex.Results的协变量：振动阈值与径向扩散率（RD）和各向异性分数（FA）在PC（均P < 0.01），但不CST（RD，P = 0.29; FA，P = 0.14）。PC中的RD和FA以及CST中的RD与9 HPT相关（均p < 0.0001）。25 FTW与PC中的RD和FA（p < 0.0001）以及CST中的RD（p = 0.008）相关。扩展残疾状态量表与PC和CST的RD和FA相关（p < 0.0001）。结论：DTI可作为脊髓束水平脊髓组织损伤的影像学标志物。RD和FA显示出与临床结局的强烈和一致的关系，具体到临床模式。
Objective: This study assessed the tissue integrity of major cervical cord tracts by using diffusion tensor imaging (DTI) to determine the relationship with specific clinical functions carried by those tracts.Methods: This was a cross-sectional study of 37 patients with multiple sclerosis or neuromyelitis optica with remote cervical cord disease. Finger vibratory thresholds, 25-foot timed walk (25FTW), 9-hole peg test (9HPT), and Expanded Disability Status Scale were determined. DTI covered cervical regions C1 through C6 with 17 5-mm slices (0.9 x 0.9 mm in-plane resolution). Regions of interest included posterior columns (PCs) and lateral corticospinal tracts (CSTs). Hierarchical linear mixed-effect modeling included covariates of disease subtype (multiple sclerosis vs neuromyelitis optica), disease duration, and sex.Results: Vibration thresholds were associated with radial diffusivity (RD) and fractional anisotropy (FA) in the PCs (both p < 0.01), but not CSTs (RD, p = 0.29; FA, p = 0.14). RD and FA in PCs, and RD in CSTs were related to 9HPT (each p < 0.0001). 25FTW was associated with RD and FA in PCs (p < 0.0001) and RD in CSTs (p = 0.008). Expanded Disability Status Scale was related to RD and FA in PCs and CSTs (p < 0.0001). Moderate/severe impairments in 9HPT (p = 0.006) and 25FTW (p = 0.017) were more likely to show combined moderate/severe tissue injury within both PCs and CSTs by DTI.Conclusions: DTI can serve as an imaging biomarker of spinal cord tissue injury at the tract level. RD and FA demonstrate strong and consistent relationships with clinical outcomes, specific to the clinical modality.