Temporal and spatial evolution of grey matter atrophy in primary progressive multiple sclerosis.
Temporal and spatial evolution of grey matter atrophy in primary progressive multiple sclerosis.
复制标题
原发性多发性硬化症中灰质萎缩的时间和空间演变。
DOI：
10.1016/j.neuroimage.2013.09.059
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发表时间：
2014-02-01
期刊：
影响因子：
5.7
通讯作者：
Ciccarelli O
中科院分区：
文献类型：
--
作者：
Eshaghi A;Bodini B;Ridgway GR;García-Lorenzo D;Tozer DJ;Sahraian MA;Thompson AJ;Ciccarelli O
灰质（GM）萎缩发生在原发性进行性MS（PPMS）的早期，但尚不清楚其进展是否以不同的速率涉及不同的脑区域，如在其他神经退行性疾病中所见。我们的目的是调查5年内GM体积损失的时间和区域演变及其与早期PPMS残疾进展的关系。我们研究了36例发病5年内的PPMS患者和19例年龄和性别匹配的健康对照者，在研究开始时和每年3年，然后在5年进行临床和影像学评估。在每个时间点对患者进行扩展残疾状态量表（EDSS）和MS功能复合量表（MSFC）评分。一个无偏的纵向体素为基础的形态学方法，基于高维空间对齐的主题内，被施加到序列成像数据。比较两组之间每年局部（体素）体积变化率，并评估其与临床结局的关系。在5年的随访中，患者病情明显恶化。与健康对照组相比，患者在5年内双侧扣带皮层、丘脑、壳核、中央前回、小脑和小脑的GM体积下降幅度更大（p < 0.05，FWE校正），尽管体积损失率在整个大脑中各不相同，但扣带皮层的速度最快。与基线相比，3年时在患者的左前额叶、左楔前叶和右扣带回中检测到显著（p < 0.05，FWE校正）体积损失，而双侧壳核和左侧上级颞回在5年时显示体积损失。在患者中，双侧扣带回皮质体积丢失率较高与5年时MSFC测量的临床残疾程度较高之间存在相关性（Pearson r = 0.49，p = 0.003）。纵向VBM表明，PPMS中GM萎缩的进展在大脑的不同区域以不同的速率发生。扣带回皮质的受累发生在病程早期，在整个随访期间以稳定的速度持续，并与患者结局相关。这些发现为MS中整个大脑的GM萎缩特征提供了新的见解，并对选择脑萎缩作为神经保护临床试验中的结果测量具有潜在的影响。纵向VBM和TBM可用于多发性硬化的纵向研究。GM丢失是原发性进行性多发性硬化的一个动态过程。扣带回中GM减少率最高。GM萎缩可用作神经保护临床试验的结果测量。
Grey matter (GM) atrophy occurs early in primary progressive MS (PPMS), but it is unknown whether its progression involves different brain regions at different rates, as is seen in other neurodegenerative diseases. We aimed to investigate the temporal and regional evolution of GM volume loss over 5 years and its relationship with disability progression in early PPMS. We studied 36 patients with PPMS within five years from onset and 19 age and gender-matched healthy controls with clinical and imaging assessments at study entry and yearly for 3 years and then at 5 years. Patients were scored on the expanded disability status scale (EDSS) and MS Functional Composite (MSFC) at each time-point. An unbiased longitudinal voxel-based morphometry approach, based on high-dimensional spatial alignment within-subject, was applied to the serial imaging data. The rate of local (voxel-wise) volume change per year was compared between groups and its relationship with clinical outcomes was assessed. Patients deteriorated significantly during the five years follow-up. Patients showed a greater decline of GM volume (p < 0.05, FWE-corrected) bilaterally in the cingulate cortex, thalamus, putamen, precentral gyrus, insula and cerebellum when compared to healthy controls over five years, although the rate of volume loss varied across the brain, and was the fastest in the cingulate cortex. Significant (p < 0.05, FWE-corrected) volume loss was detected in the left insula, left precuneus, and right cingulate cortex in patients at three years, as compared to baseline, whilst the bilateral putamen and the left superior temporal gyrus showed volume loss at five years. In patients, there was a relationship between a higher rate of volume loss in the bilateral cingulate cortex and greater clinical disability, as measured by the MSFC, at five years (Pearson's r = 0.49, p = 0.003). Longitudinal VBM demonstrated that the progression of GM atrophy in PPMS occurs at different rates in different regions across the brain. The involvement of the cingulate cortex occurs early in the disease course, continues at a steady rate throughout the follow-up period and is associated with patient outcome. These findings provide new insights into the characteristics of GM atrophy across the brain in MS, and have potential consequences for the selection of brain atrophy as an outcome measure in neuroprotective clinical trials. Longitudinal VBM and TBM can be used in longitudinal studies in multiple sclerosis. GM loss is a dynamic process in primary progressive multiple sclerosis. The highest rate of GM reduction is seen in the cingulate gyri. GM atrophy may be used as an outcome measure for neuroprotective clinical trials.
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影响因子：
11
作者：
Hobbs, Nicola Z.;Henley, Susie M. D.;Tabrizi, Sarah J.
通讯作者：
Tabrizi, Sarah J.
影响因子：
4.8
作者：
Jernigan, TL;Gamst, AC;Ostergaard, AL
通讯作者：
Ostergaard, AL
DOI：
10.1093/jnen/62.7.723
发表时间：
2003-07-01
影响因子：
3.2
作者：
Bo, L;Vedeler, CA;Mork, SJ
通讯作者：
Mork, SJ
影响因子：
4.4
作者：
Battaglini, Marco;Giorgio, Antonio;De Stefano, Nicola
通讯作者：
De Stefano, Nicola
影响因子：
5.7
作者：
Griffa, Alessandra;Baumann, Philipp S.;Hagmann, Patric
通讯作者：
Hagmann, Patric