Microstructural Changes in the Striatum and Their Impact on Motor and Neuropsychological Performance in Patients with Multiple Sclerosis
Microstructural Changes in the Striatum and Their Impact on Motor and Neuropsychological Performance in Patients with Multiple Sclerosis
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DOI：
10.1371/journal.pone.0101199
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发表时间：
2014-07-21
期刊：
影响因子：
3.7
通讯作者：
Guttmann, Charles R. G.
中科院分区：
文献类型：
--
作者：
Cavallari, Michele;Ceccarelli, Antonia;Guttmann, Charles R. G.
灰质(GM)损害是多发性硬化症(MS)的临床相关特征，此前已通过弥散张量成像(DTI)进行评估。MS患者基底节和丘脑的各向异性分数(FA)可能增加，并与残疾评分相关。尽管纹状体和丘脑在运动控制、情绪和认知中的作用已经确定，但这些结构中DTI的变化对运动和神经心理表现的影响尚未在MS中具体讨论。我们研究了GM深核团的DTI测量及其与运动和神经心理功能的潜在关联。对30例MS患者和10例对照组的尾状核、壳核和丘脑进行了3T MRI的DTI测量。其中16名患者接受了神经心理测试。MS患者尾状核和壳核的FA明显高于对照组。尾状核FA与扩展的残疾状态量表评分、行走指数和抑郁症状的严重程度相关。壳核和丘脑FA与记忆测试中的缺陷相关。相比之下，脑白质(WM)损伤负荷与任何残疾、活动能力和心理测量学参数均无显著相关性。我们的发现支持了MS患者基底节FA改变的证据，以及GM参与了MS的残疾特征，包括行动和认知障碍。与西医损害负担相比，深GM FA似乎是一个更敏感的残疾相关性。
Grey matter (GM) damage is a clinically relevant feature of multiple sclerosis (MS) that has been previously assessed with diffusion tensor imaging (DTI). Fractional anisotropy (FA) of the basal ganglia and thalamus might be increased in MS patients, and correlates with disability scores. Despite the established role of the striatum and thalamus in motor control, mood and cognition, the impact of DTI changes within these structures on motor and neuropsychological performance has not yet been specifically addressed in MS. We investigated DTI metrics of deep GM nuclei and their potential association with mobility and neuropsychological function. DTI metrics from 3T MRI were assessed in the caudate, putamen, and thalamus of 30 MS patients and 10 controls. Sixteen of the patients underwent neuropsychological testing. FA of the caudate and putamen was higher in MS patients compared to controls. Caudate FA correlated with Expanded Disability Status Scale score, Ambulation Index, and severity of depressive symptomatology. Putamen and thalamus FA correlated with deficits in memory tests. In contrast, cerebral white matter (WM) lesion burden showed no significant correlation with any of the disability, mobility and psychometric parameters. Our findings support evidence of FA changes in the basal ganglia in MS patients, as well as deep GM involvement in disabling features of MS, including mobility and cognitive impairment. Deep GM FA appears to be a more sensitive correlate of disability than WM lesion burden.