Spinal Cord Atrophy Predicts Progressive Disease in Relapsing Multiple Sclerosis.
Spinal Cord Atrophy Predicts Progressive Disease in Relapsing Multiple Sclerosis.
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DOI：
10.1002/ana.26281
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发表时间：
2022-03
影响因子：
11.2
通讯作者：
Henry RG
中科院分区：
文献类型：
--
作者：
Bischof A;Papinutto N;Keshavan A;Rajesh A;Kirkish G;Zhang X;Mallott JM;Asteggiano C;Sacco S;Gundel TJ;Zhao C;Stern WA;Caverzasi E;Zhou Y;Gomez R;Ragan NR;Santaniello A;Zhu AH;Juwono J;Bevan CJ;Bove RM;Crabtree E;Gelfand JM;Goodin DS;Graves JS;Green AJ;Oksenberg JR;Waubant E;Wilson MR;Zamvil SS;University of California, San Francisco MS-EPIC Team;Cree BAC;Hauser SL;Henry RG
多发性硬化症（MS）研究的一个主要挑战是对无症状进展和进展性MS的理解。我们使用一种新方法从遗留脑MRI扫描中准确捕获上颈髓区域，旨在研究脊髓和脑萎缩对无症状进展和继发性进展性疾病（SPMS）转化的作用。在一项单中心观察性研究中，对所有RRMS（n = 360）和SPMS（n = 47）患者以及80例匹配对照进行了评价。在12年观察期内，分别将转化为SPMS（n = 54）或无症状进展（n = 159）的RRMS患者亚组与临床匹配的RRMS患者（保持RRMS（n = 54）或稳定（n = 147））进行比较。通过脑MRI，我们评估了脑和脊髓测量对预测无症状进展和SPMS转换的价值。发生SPMS的患者在转换前至少4年的脊髓萎缩率（-2.19%/年）比RRMS匹配者（-0.88%/年，p < 0.001）更快。转换后的脊髓萎缩率（-1.63%/年，p = 0.010）与研究入组时的SPMS患者（-1.04%）相比有所下降。脊髓萎缩率每增加1%，至无症状进展和SPMS转换的时间分别缩短69%（p <0.0001）和53%（p < 0.0001）。无症状进展和继发性疾病进展主要与颈髓萎缩有关。这种萎缩通常存在于最早的疾病阶段，并预测沉默进展和转化为进行性MS的速度。SPMS的诊断是对这种神经退行性过程的晚期认识，而不是一个独特的疾病阶段。神经网络2022;91：268-281
A major challenge in multiple sclerosis (MS) research is the understanding of silent progression and Progressive MS. Using a novel method to accurately capture upper cervical cord area from legacy brain MRI scans we aimed to study the role of spinal cord and brain atrophy for silent progression and conversion to secondary progressive disease (SPMS). From a single‐center observational study, all RRMS (n = 360) and SPMS (n = 47) patients and 80 matched controls were evaluated. RRMS patient subsets who converted to SPMS (n = 54) or silently progressed (n = 159), respectively, during the 12‐year observation period were compared to clinically matched RRMS patients remaining RRMS (n = 54) or stable (n = 147), respectively. From brain MRI, we assessed the value of brain and spinal cord measures to predict silent progression and SPMS conversion. Patients who developed SPMS showed faster cord atrophy rates (−2.19%/yr) at least 4 years before conversion compared to their RRMS matches (−0.88%/yr, p < 0.001). Spinal cord atrophy rates decelerated after conversion (−1.63%/yr, p = 0.010) towards those of SPMS patients from study entry (−1.04%). Each 1% faster spinal cord atrophy rate was associated with 69% (p < 0.0001) and 53% (p < 0.0001) shorter time to silent progression and SPMS conversion, respectively. Silent progression and conversion to secondary progressive disease are predominantly related to cervical cord atrophy. This atrophy is often present from the earliest disease stages and predicts the speed of silent progression and conversion to Progressive MS. Diagnosis of SPMS is rather a late recognition of this neurodegenerative process than a distinct disease phase. ANN NEUROL 2022;91:268–281
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影响因子：
2.7
作者：
Dupuy SL;Khalid F;Healy BC;Bakshi S;Neema M;Tauhid S;Bakshi R
通讯作者：
Bakshi R
影响因子：
16.6
作者：
Eshaghi A;Young AL;Wijeratne PA;Prados F;Arnold DL;Narayanan S;Guttmann CRG;Barkhof F;Alexander DC;Thompson AJ;Chard D;Ciccarelli O
通讯作者：
Ciccarelli O
影响因子：
--
作者：
Krishnan, Chitra;Kaplin, Adam I.;Kerr, Douglas A.
通讯作者：
Kerr, Douglas A.
影响因子：
4
作者：
Liu, Zheng;Yaldizli, Ozgur;Chard, Declan T.
通讯作者：
Chard, Declan T.
影响因子：
11.2
作者：
Cree, Bruce A. C.;Gourraud, Pierre-Antoine;Hauser, Stephen L.
通讯作者：
Hauser, Stephen L.