Determinants of Cognitive Impairment in Patients with Multiple Sclerosis with and without Atrophy
Determinants of Cognitive Impairment in Patients with Multiple Sclerosis with and without Atrophy
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DOI：
10.1148/radiol.2018172808
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发表时间：
2018-08-01
期刊：
影响因子：
19.7
通讯作者：
Schoonheim, Menno M.
中科院分区：
文献类型：
--
作者：
Eijlers, Anand J. C.;Meijer, Kim A.;Schoonheim, Menno M.
目的：调查已经出现认知障碍的不伴有萎缩的多发性硬化症 (MS) 患者与保留认知功能的患有萎缩的多发性硬化症 (MS) 患者之间的差异。 材料和方法：这项回顾性影像学研究采用 2008 年至 2012 年期间获得的影像，包括 332 名 MS 患者（106 名男性和 226 名女性；平均年龄，48.1 岁；范围，23.0-72.5 岁）和 96 名健康对照参与者。认知障碍被定义为与对照组参与者在大于或等于两个认知领域的认知表现相比，z 小于-1.5。萎缩被定义为与对照组参与者相比，皮质和深层灰质体积 z 小于 -1.5。使用T2成像评估白质病变，使用扩散MRI评估束各向异性（即完整性），使用功能MRI评估区域中心性（即网络内的重要性）。在每个萎缩组中，对有认知障碍和保留认知功能的患者进行比较，并进行回归分析以预测认知障碍。 结果：328 名 MS 患者中，共有 132 名没有萎缩；其中，132 人中有 42 人（32%）患有认知障碍。通过教育水平预测无萎缩患者的认知障碍（Wald 检验，11.63；P
Purpose: To investigate the discrepancy between patients with multiple sclerosis (MS) without atrophy who have already developed cognitive impairment and patients with MS with atrophy who have preserved cognitive function.Materials and Methods: This retrospective imaging study, with imaging acquired between 2008 and 2012, included 332 patients with MS (106 men and 226 women; mean age, 48.1 years; range, 23.0-72.5 years) and 96 healthy control participants. Cognitive impairment was defined as cognitive performance of z less than -1.5 compared with that in control participants in greater than or equal to two cognitive domains. Atrophy was defined as cortical and deep gray matter volumes of z less than -1.5 compared with that in control participants. White matter lesions were assessed with T2-imaging, tract fractional anisotropy (ie, integrity) with diffusion MRI, and regional centrality (ie, importance within network) with functional MRI. Within each atrophy group, patients with cognitive impairment and preserved cognitive function were compared and regression analyses were performed to predict cognitive impairment.Results: A total of 132 of 328 patients with MS had no atrophy; of these, 42 of 132 (32%) had cognitive impairment. Cognitive impairment in patients without atrophy was predicted by level of education (Wald test, 11.63; P