Axonal injury or loss in the internal capsule and motor impairment in multiple sclerosis
Axonal injury or loss in the internal capsule and motor impairment in multiple sclerosis
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DOI：
10.1001/archneur.57.1.65
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发表时间：
2000-01-01
影响因子：
--
通讯作者：
Matthews, PM
中科院分区：
文献类型：
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作者：
Lee, MA;Blamire, AM;Matthews, PM
目的：通过比较多发性硬化症（MS）和持续性不对称运动缺陷患者内囊内双侧N-乙酰天冬氨酸（NAA）浓度与运动损伤侧化，检验轴突损伤扩展到主要表现正常的白色物质的假设在临床上是重要的。设计：我们对内囊进行了磁共振波谱和T2加权成像，计算了中枢运动传导时间，并将这些结果与12名MS患者的运动功能不对称性测量相关联。结果：MS患者内囊外观正常的白色物质中的NAA水平显着低于对照组（P = 0.05）。MS患者NAA水平的侧对侧差异也显著大于对照组（P = 0.01）。左右肢体运动功能不对称与内囊NAA浓度不对称之间存在相关性（r = 0.60; P = 0.04）。当单独考虑手臂和手部运动不对称性的测试时，这种相关性似乎稍强。大多数MS患者的中枢运动传导时间异常，并表现出与运动功能不对称相关的侧对侧差异。我们证明了在主要正常范围内NAA浓度之间的分级关联-出现白色物质的一个特定的道和功能障碍，可与该道表明，轴突病理远离宏观病变可能是残疾的一个重要决定因素，女士
Objective: To test the hypothesis that axonal damage extending into primarily normal-appearing white matter is clinically important by comparing the concentrations of N-acetylaspartate (NAA) bilaterally within the internal capsule with lateralization of motor impairment in patients with multiple sclerosis (MS) and persistent asymmetrical motor deficit.Design: We performed magnetic resonance spectroscopy and T2-weighted imaging of the internal capsule, calculated central motor conduction times, and related these results to measures of motor function asymmetry in 12 patients with MS.Results: Levels of NAA from normal-appearing white matter of the internal capsule in patients with MS were significantly lower than those in control subjects (P = .05). Side-to-side differences in NAA levels were also significantly greater in patients with MS than in controls (P = .01). There was a correlation between asymmetry in motor function for the left and right limbs and asymmetry of internal capsule NAA concentrations (r = 0.60; P = .04). This correlation seemed slightly stronger when tests specifically of arm and hand motor asymmetry were considered alone. Central motor conduction times were abnormal in most patients with MS and showed a side-to-side difference that also correlated with asymmetry in motor function.Conclusion: Our demonstration of a graded association between NAA concentrations within primarily normal-appearing white matter of a specific tract and functional impairments referable to that tract suggests that axonal pathology distant from macroscopic lesions might be an important determinant of disability in MS.