Microstructural white matter abnormalities in multiple sclerosis and neuromyelitis optica spectrum disorders: Evaluation by advanced diffusion imaging
Microstructural white matter abnormalities in multiple sclerosis and neuromyelitis optica spectrum disorders: Evaluation by advanced diffusion imaging
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DOI：
10.1016/j.jns.2022.120205
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发表时间：
2022-03-05
影响因子：
4.4
通讯作者：
Aoki, Shigeki
中科院分区：
文献类型：
--
作者：
Kato, Shimpei;Hagiwara, Akifumi;Aoki, Shigeki
简介：尽管多发性硬化症（MS）和视神经脊髓炎谱系疾病（NMOSD）的发病机制和治疗存在差异，但仍然很难区分它们。在本研究中，我们旨在使用扩散张量成像 (DTI)、自由水 (FW) 成像以及神经突定向弥散和密度成像 (NODDI) 来区分 MS 和 NMOSD。 方法：30 名复发缓解型 (RR) MS 患者、18 名抗水通道蛋白 4 免疫球蛋白 G 血清反应呈阳性的 NMOSD 患者以及 20 名年龄和性别匹配的当前健康受试者接受了 MRI。使用基于束的空间统计（TBSS）和感兴趣区域（ROI）分析评估三组之间的DTI（分数各向异性[FA]、轴向扩散率[AD]、平均扩散率[MD]和径向扩散率[RD]）、FW和FW校正DTI和NODDI指数的差异。结果：病变的ROI分析表明，RRMS组的AD、MD、RD、ISO和FW 校正 AD 和 MD；且细胞内体积分数（ICVF）低于 NMOSD 组。 TBSS 分析显示，与 NMOSD 患者相比，RRMS 患者的水含量有所增加。与使用TBSS和ROI分析的健康对照（HC）相比，RRMS患者FW成像指数的变化比DTI的变化更有限。结论：FW成像和NODDI有助于识别RRMS和NMOSD患者神经退行性变和神经炎症相关微结构变化的病因。
Introduction: Despite differences in the pathogenesis and treatment of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), it remains difficult to distinguish them. In this study, we aimed to discriminate between MS and NMOSD using diffusion tensor imaging (DTI), free water (FW) imaging, and neurite orientation dispersion and density imaging (NODDI).Methods: Thirty patients with relapsing-remitting (RR) MS, 18 NMOSD patients with positive anti-aquaporin-4 immunoglobulin G seroreactivity, and 20 age-and sex-matched currently healthy subjects underwent MRI. The differences in the DTI (fractional anisotropy [FA], axial diffusivity [AD], mean diffusivity [MD], and radial diffusivity [RD]), FW and FW-corrected DTI, and NODDI indices between the three groups were evaluated using tract-based spatial statistics (TBSS) and region-of-interest (ROI) analyses.Results: The ROI analysis of lesions indicated that the RRMS group had significantly higher AD, MD, RD, ISO and FW-corrected AD, and MD; and lower intracellular volume fraction (ICVF) than the NMOSD group. TBSS analysis showed increased water content in RRMS patients compared to NMOSD patients. Compared with healthy controls (HCs) using TBSS and ROI analysis, the changes in FW imaging indices were more limited than those of in DTI in RRMS patients.Conclusion: FW imaging and NODDI were useful for identifying the etiology of neurodegeneration-and neuroinflammation-related microstructural changes in RRMS and NMOSD patients.