Brain and retinal atrophy in African-Americans versus Caucasian-Americans with multiple sclerosis: a longitudinal study
Brain and retinal atrophy in African-Americans versus Caucasian-Americans with multiple sclerosis: a longitudinal study
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患有多发性硬化症的非洲裔美国人与白人美国人的大脑和视网膜萎缩：一项纵向研究
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
P. Calabresi
中科院分区：
文献类型：
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作者：
Natalia Gonzalez Caldito;S. Saidha;E. Sotirchos;B. Dewey;Norah Cowley;J. Glaister;K. Fitzgerald;Omar Al;James Nguyen;Alissa Rothman;Esther Ogbuokiri;Nicholas Fioravante;S. Feldman;Ohemaa B Kwakyi;H. Risher;D. Kimbrough;T. Frohman;E. Frohman;L. Balcer;C. Crainiceanu;Peter C. M. van Zijl;E. Mowry;D. Reich;Jiwon Oh;D. Pham;Jerry L Prince;P. Calabresi
平均而言，与患有多发性硬化症的高加索美国人相比，患有多发性硬化症的非裔美国人表现出更高的炎症性疾病活跃度、更快的残疾积累、更大的视觉功能障碍、更明显的脑组织损伤和更高的病变体积负荷。神经退行性变是多发性硬化症的一个重要组成部分，这在一定程度上解释了这种疾病的临床异质性。脑萎缩似乎很普遍，尽管人们越来越多地认识到区域性亚结构萎缩可能具有更大的临床相关性。患者种族(在自我认同的祖先的限制内)被认为是一个重要的促成因素。然而，很少有研究考察非裔美国人与高加索裔美国人患者随着时间的推移在神经退行性变和脑亚结构体积方面的差异。光学相干断层扫描是一种测量视网膜结构改变的非侵入性和可靠的工具。最近的研究支持它在多发性硬化症体内追踪神经退行性变和疾病进展的效用。相对于高加索美国人，非裔美国人被发现在视网膜内层有更大的视网膜结构损伤。尽管RACE是否在这些变化中起作用，但基线时内核层厚度的增加和微囊样黄斑病变的存在可以预测临床和放射学炎症活动。同样，在多发性硬化症中，根据种族对视网膜外部变化的评估仍然不完全具有特征性。对22名非洲裔美国人和60名匹配的白人多发性硬化症患者进行了脑MRI检查，并对116名非洲裔美国人和116名匹配的白人多发性硬化症患者进行了光学相干断层扫描，平均持续时间为4.5年。统计分析采用混合效应线性回归模型。在非裔美国人中，灰质(-0.9%/年比-0.5%：P=0.02)、白质(-0.7%/年比-0.3%：P=0.04)和核丘脑(-1.5%/年比-0.7%/年：P=0.02)萎缩的速度大约是非裔美国人的两倍。非裔美国人也表现出更高比例的微囊状黄斑病变(12.1%对0.9%，P=0.001)。视网膜神经纤维层(-1.1%比-0.8%：P=0.02)和神经节细胞+内网状层(-0.7%/年比-0.4%/年：P=0.01)萎缩速度非洲裔美国人比高加索美国人快。平均而言，非洲裔美国人表现出比高加索美国人更快的神经退化，大脑和视网膜组织丢失的速度也明显更快。这些结果证实了据报道在多发性硬化症的非裔美国人中普遍出现的更快的临床进展，并支持了未来需要有非裔美国人参与的研究，以确定多发性硬化症治疗反应的个体差异。
On average, African Americans with multiple sclerosis demonstrate higher inflammatory disease activity, faster disability accumulation, greater visual dysfunction, more pronounced brain tissue damage and higher lesion volume loads compared to Caucasian Americans with multiple sclerosis. Neurodegeneration is an important component of multiple sclerosis, which in part accounts for the clinical heterogeneity of the disease. Brain atrophy appears to be widespread, although it is becoming increasingly recognized that regional substructure atrophy may be of greater clinical relevance. Patient race (within the limitations of self-identified ancestry) is regarded as an important contributing factor. However, there is a paucity of studies examining differences in neurodegeneration and brain substructure volumes over time in African Americans relative to Caucasian American patients. Optical coherence tomography is a non-invasive and reliable tool for measuring structural retinal changes. Recent studies support its utility for tracking neurodegeneration and disease progression in vivo in multiple sclerosis. Relative to Caucasian Americans, African American patients have been found to have greater retinal structural injury in the inner retinal layers. Increased thickness of the inner nuclear layer and the presence of microcystoid macular pathology at baseline predict clinical and radiological inflammatory activity, although whether race plays a role in these changes has not been investigated. Similarly, assessment of outer retinal changes according to race in multiple sclerosis remains incompletely characterized. Twenty-two African Americans and 60 matched Caucasian Americans with multiple sclerosis were evaluated with brain MRI, and 116 African Americans and 116 matched Caucasian Americans with multiple sclerosis were monitored with optical coherence tomography over a mean duration of 4.5 years. Mixed-effects linear regression models were used in statistical analyses. Grey matter (-0.9%/year versus -0.5%: P =0.02), white matter (-0.7%/year versus -0.3%: P =0.04) and nuclear thalamic (-1.5%/year versus -0.7%/year: P =0.02) atrophy rates were approximately twice as fast in African Americans. African Americans also exhibited higher proportions of microcystoid macular pathology (12.1% versus 0.9%, P =0.001). Retinal nerve fibre layer (-1.1% versus -0.8%: P =0.02) and ganglion cell+ inner plexiform layer (-0.7%/year versus -0.4%/year: P =0.01) atrophy rates were faster in African versus Caucasian Americans. African Americans on average exhibited more rapid neurodegeneration than Caucasian Americans and had significantly faster brain and retinal tissue loss. These results corroborate the more rapid clinical progression reported to occur, in general, in African Americans with multiple sclerosis and support the need for future studies involving African Americans in order to identify individual differences in treatment responses in multiple sclerosis.
影响因子：
14.5
作者：
Knier, Benjamin;Schmidt, Paul;Korn, Thomas
通讯作者：
Korn, Thomas
影响因子：
9.8
作者：
Oksenberg, JR;Barcellos, LF;Hauser, SL
通讯作者：
Hauser, SL