Combining tractography and cortical measures to test system-specific hypotheses in multiple sclerosis.
Combining tractography and cortical measures to test system-specific hypotheses in multiple sclerosis.
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DOI：
10.1177/1352458510362440
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Ciccarelli O
中科院分区：
文献类型：
--
作者：
Gorgoraptis N;Wheeler-Kingshott CA;Jenkins TM;Altmann DR;Miller DH;Thompson AJ;Ciccarelli O
目的是测试多发性硬化症患者的三个运动系统特异性假设：（i）多发性硬化症患者和对照组之间的皮质脊髓束和初级运动皮层成像测量结果不同； (ii) 在患者中，这些指标与残疾相关； (iii) 在患者中，皮质脊髓束测量值与同侧初级运动皮层的测量值相关。研究人员对 11 名有因对侧皮质脊髓束病变导致的偏瘫病史的多发性硬化症患者和 12 名对照者进行了研究。我们使用了两种先进的成像技术：（i）基于扩散的概率纤维束成像，以获得皮质脊髓束的连通性和分数各向异性； (ii) FreeSurfer，用于测量中央前和旁中央皮质的体积、厚度、表面积和曲率。研究了患者和对照之间这些测量值的差异，以及彼此之间以及与临床评分的关系。与对照组相比，患者的皮质脊髓束各向异性分数较低，中央前回的体积和表面积较小。在患者中，随着残疾程度的增加，皮质脊髓束的连通性和旁中央皮质体积、表面积和曲率降低；受影响的皮质脊髓束的连通性较低与同侧旁中央皮质表面积较大有关。皮质脊髓束连接性和初级运动皮层的新测量（例如表面积和曲率）反映了导致残疾的潜在白质和灰质损伤。受影响的皮质脊髓束的较低连通性与同侧旁中央皮质较大表面积之间的相关性表明皮质适应的可能性。纤维束成像和皮质测量相结合是检验多发性硬化症临床相关功能系统特定假设的有效方法，并且可应用于其他神经系统疾病。
The objective was to test three motor system-specific hypotheses in multiple sclerosis patients: (i) corticospinal tract and primary motor cortex imaging measures differ between multiple sclerosis patients and controls; (ii) in patients, these measures correlate with disability; (iii) in patients, corticospinal tract measures correlate with measures of the ipsilateral primary motor cortex. Eleven multiple sclerosis patients with a history of hemiparesis attributable to a lesion within the contralateral corticospinal tract, and 12 controls were studied. We used two advanced imaging techniques: (i) diffusion-based probabilistic tractography, to obtain connectivity and fractional anisotropy of the corticospinal tract; and (ii) FreeSurfer, to measure volume, thickness, surface area, and curvature of precentral and paracentral cortices. Differences in these measures between patients and controls, and relationships between each other and to clinical scores, were investigated. Patients showed lower corticospinal tract fractional anisotropy and smaller volume and surface area of the precentral gyrus than controls. In patients, corticospinal tract connectivity and paracentral cortical volume, surface area, and curvature were lower with increasing disability; lower connectivity of the affected corticospinal tract was associated with greater surface area of the ipsilateral paracentral cortex. Corticospinal tract connectivity and new measures of the primary motor cortex, such as surface area and curvature, reflect the underlying white and grey matter damage that contributes to disability. The correlation between lower connectivity of the affected corticospinal tract and greater surface area of the ipsilateral paracentral cortex suggests the possibility of cortical adaptation. Combining tractography and cortical measures is a useful approach in testing hypotheses which are specific to clinically relevant functional systems in multiple sclerosis, and can be applied to other neurological diseases.
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