Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio.
Assessing Lumbar Plexus and Sciatic Nerve Damage in Relapsing-Remitting Multiple Sclerosis Using Magnetisation Transfer Ratio.
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DOI：
10.3389/fneur.2021.763143
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发表时间：
2021
影响因子：
3.4
通讯作者：
Yiannakas MC
中科院分区：
文献类型：
--
作者：
Boonsuth R;Samson RS;Tur C;Battiston M;Grussu F;Schneider T;Yoneyama M;Prados F;Ttofalla A;Collorone S;Cortese R;Ciccarelli O;Gandini Wheeler-Kingshott CAM;Yiannakas MC
背景：多发性硬化（MS）传统上被认为是局限于中枢神经系统（CNS）的疾病。然而，神经病理学，电生理学和成像研究表明，周围神经系统（PNS）也参与，脱髓鞘，并在较小程度上，轴突变性代表主要的病理生理机制。目的：本研究的目的是使用磁化传递率（MTR）评估复发缓解型MS（RRMS）和健康对照（HC）患者体内腰丛和坐骨神经解剖位置处的PNS损伤，MTR是已知的对神经组织中髓鞘含量的改变敏感的成像生物标志物，并且先前未在MS中的PNS损伤的背景下进行探索。本研究招募了11名HC（7名女性，平均年龄33.6岁，范围24-50岁）和15名RRMS患者（12名女性，平均年龄38.5岁，范围30-56岁），并进行了磁共振成像（MRI）检查以及使用扩展残疾状态量表（EDSS）进行的临床评估。磁共振神经成像（MRN）首先用于腰丛和坐骨神经的可视化和识别，随后使用与MRN相同的扫描几何结构进行MTR成像，从而能够直接配准所有数据，以获得全局和区域平均MTR测量值。线性回归模型被用来确定HC和RRMS患者之间MTR值的差异，并确定MTR测量和EDSS之间的关联。结果如下：与HCs相比，RRMS患者坐骨神经的MTR值显著降低，但RRMS患者腰丛的MTR无显著变化。RRMS患者的EDSS中位数为2.0（范围，0-3）。在该RRMS患者队列中研究的任何解剖部位，均未发现PNS和EDSS中MTR测量值之间的关系。结论：这项研究的结果表明，在RRMS患者中存在PNS损伤，并支持这些变化（提示脱髓鞘）可能独立发生在PNS内不同解剖位置的观点。进一步的调查，以确认这些发现，并澄清这些变化的病理生理基础是必要的。
Background: Multiple sclerosis (MS) has traditionally been regarded as a disease confined to the central nervous system (CNS). However, neuropathological, electrophysiological, and imaging studies have demonstrated that the peripheral nervous system (PNS) is also involved, with demyelination and, to a lesser extent, axonal degeneration representing the main pathophysiological mechanisms. Aim: The purpose of this study was to assess PNS damage at the lumbar plexus and sciatic nerve anatomical locations in people with relapsing-remitting MS (RRMS) and healthy controls (HCs) in vivo using magnetisation transfer ratio (MTR), which is a known imaging biomarker sensitive to alterations in myelin content in neural tissue, and not previously explored in the context of PNS damage in MS. Method: Eleven HCs (7 female, mean age 33.6 years, range 24-50) and 15 people with RRMS (12 female, mean age 38.5 years, range 30-56) were recruited for this study and underwent magnetic resonance imaging (MRI) investigations together with clinical assessments using the expanded disability status scale (EDSS). Magnetic resonance neurography (MRN) was first used for visualisation and identification of the lumbar plexus and the sciatic nerve and MTR imaging was subsequently performed using identical scan geometry to MRN, enabling straightforward co-registration of all data to obtain global and regional mean MTR measurements. Linear regression models were used to identify differences in MTR values between HCs and people with RRMS and to identify an association between MTR measures and EDSS. Results: MTR values in the sciatic nerve of people with RRMS were found to be significantly lower compared to HCs, but no significant MTR changes were identified in the lumbar plexus of people with RRMS. The median EDSS in people with RRMS was 2.0 (range, 0-3). No relationship between the MTR measures in the PNS and EDSS were identified at any of the anatomical locations studied in this cohort of people with RRMS. Conclusion: The results from this study demonstrate the presence of PNS damage in people with RRMS and support the notion that these changes, suggestive of demyelination, maybe occurring independently at different anatomical locations within the PNS. Further investigations to confirm these findings and to clarify the pathophysiological basis of these alterations are warranted.
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影响因子：
19.7
作者：
Jende, Johann M. E.;Groener, Jan B.;Kurz, Felix T.
通讯作者：
Kurz, Felix T.
影响因子：
4.4
作者：
Brambilla, L.;Sebastiano, D. Rossi;Confalonieri, P.
通讯作者：
Confalonieri, P.
影响因子：
--
作者：
LASSMANN, H;BUDKA, H;SCHNABERTH, G
通讯作者：
SCHNABERTH, G
影响因子：
2.2
作者：
SAITO, H;KOBAYASHI, K;ISHII, T
通讯作者：
ISHII, T
影响因子：
5.9
作者：
Chhabra, Avneesh;Belzberg, Allan J.;Carrino, John A.
通讯作者：
Carrino, John A.