Iron-Insensitive Quantitative Assessment of Subcortical Gray Matter Demyelination in Multiple Sclerosis Using the Macromolecular Proton Fraction.
Iron-Insensitive Quantitative Assessment of Subcortical Gray Matter Demyelination in Multiple Sclerosis Using the Macromolecular Proton Fraction.
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DOI：
10.3174/ajnr.a5542
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发表时间：
2018-04
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影响因子：
--
通讯作者：
Bowen JD
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文献类型：
--
作者：
Yarnykh VL;Krutenkova EP;Aitmagambetova G;Repovic P;Mayadev A;Qian P;Jung Henson LK;Gangadharan B;Bowen JD
快速大分子质子分数（MPF）成像是一种新的定量MRI髓鞘评估方法。本研究的目的是评估MPF作为多发性硬化症（MS）皮质下灰质（GM）结构脱髓鞘的一种测量方法，并使用MPF和T2 * 图评估脱髓鞘和过量铁沉积之间的潜在关系。使用3T MRI从12名健康对照、18名复发缓解型MS（RRMS）和12名继发进展型MS（SPMS）患者中获得MPF和T2 * 图。比较各组尾状核、苍白球、壳核、黑质和丘脑的参数值，并与临床数据相关。 研究结果：MPF在所有皮质下结构和T2 * 在苍白球，壳核，尾状核表现出显着的单调下降，从控制到RRMS和从RRMS SPMS。所有皮质下结构中的MPF与扩展残疾状态量表和MS功能复合评分显著相关，绝对Pearson相关系数（r）值在0.4 - 0.6范围内。MPF和9孔栓试验之间也存在显著相关性（r =-0.4--0.6），表明与黑质纹状体通路损伤存在潜在关系。在T2 * 值中，仅在壳核中发现与临床变量的弱显著相关性。MPF与T2 * 在任何研究的解剖结构没有相关性。MPF提供脱髓鞘的铁不敏感测量。多发性硬化患者皮质下GM结构中的髓鞘丢失与过量铁沉积无关。皮质下GM脱髓鞘与疾病表型和残疾的关系比铁超载更密切。
Fast macromolecular proton fraction (MPF) mapping is a recent quantitative MRI method for myelin assessment. The objectives of this study were to evaluate MPF as a measure demyelination in subcortical gray matter (GM) structures in multiple sclerosis (MS) and asses a potential relationship between demyelination and excess iron deposition using MPF and T2* mapping. MPF and T2* maps were obtained from 12 healthy controls, 18 relapsing-remitting MS (RRMS), and 12 secondary-progressive MS (SPMS) patients using 3T MRI. Parameter values in the caudate nucleus, globus pallidus, putamen, substantia nigra, and thalamus were compared between groups and correlated to clinical data. RESULTS: MPF in all subcortical structures and T2* in the globus pallidus, putamen, and caudate nucleus demonstrated a significant monotonic decrease from controls to RRMS and from RRMS to SPMS. MPF in all subcortical structures significantly correlated with Expanded Disability Status Scale and MS Functional Composite scores with absolute Pearson correlation coefficient (r) values in a range 0.4-0.6. Significant correlations (r=-0.4--0.6) were also identified between MPF and the 9-hole peg test indicating a potential relationship with nigrostriatal pathway damage. Among T2* values, weak significant correlations with clinical variables were found only in the putamen. MPF did not correlate with T2* in any of the studied anatomic structures. MPF provides an iron-insensitive measure of demyelination. Myelin loss in subcortical GM structures in MS is unrelated to excess iron deposition. Subcortical GM demyelination is more closely associated with the disease phenotype and disability than iron overload.