Novel fMRI working memory paradigm accurately detects cognitive impairment in multiple sclerosis.
Novel fMRI working memory paradigm accurately detects cognitive impairment in multiple sclerosis.
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DOI：
10.1177/1352458516666186
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发表时间：
2017-05
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影响因子：
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通讯作者：
Steinberg JL
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作者：
Nelson F;Akhtar MA;Zúñiga E;Perez CA;Hasan KM;Wilken J;Wolinsky JS;Narayana PA;Steinberg JL
认知障碍（CI）不能通过MRI诊断。功能磁共振成像（fMRI）范式，如即时/延迟记忆任务（I/DMT），检测不同程度的工作记忆。使用I/DMT的初步结果显示，受损（MSCI, n=12）和未受损（MSNI, n=9） MS患者的血氧水平依赖性（BOLD）激活存在差异。在更大的MS患者队列中确认基于I/DMT的BOLD激活的CI检测。T2病变体积（LV）和EDSS在BOLD信号大小中的作用也被寻求。50例患者[EDSS平均值(m) = 3.2, DD m =12岁，年龄m =40岁]。进行了MS认知功能最小评估（MACFIMS）和I/DMT。工作记忆激活（WMa）表示DMT期间的BOLD信号和IMT期间的负信号。CI基于MACFIMS。MSNI患者10例，MSCI患者30例，边缘患者4例纳入分析。方差分析显示，MSNI组左(L)前额皮质和L辅助运动区WMa显著高于MSCI组（p = 0.032）。回归分析显示WMa与相似部位T2 LV/EDSS呈显著负相关（p分别为0.005、0.004）。基于I/ dmt的BOLD激活检测MS中的CI，需要更大规模的研究来证实这些发现。
Cognitive impairment (CI) cannot be diagnosed by MRI. Functional MRI (fMRI) paradigms such as the immediate/delayed memory task (I/DMT), detect varying degrees of working memory. Preliminary findings using I/DMT, showed differences in Blood Oxygenation Level Dependent (BOLD) activation between impaired (MSCI, n=12) and non-impaired (MSNI, n=9) MS patients. To confirm CI detection based on I/DMT’ BOLD activation in a larger cohort of MS patients. The role of T2 lesion volume (LV) and EDSS in magnitude of BOLD signal were also sought. Fifty patients [EDSS mean (m) = 3.2, DD m =12 yr., age m =40yr.] underwent the Minimal Assessment of Cognitive Function in MS (MACFIMS) and the I/DMT. Working-memory activation (WMa) represents BOLD signal during DMT minus signal during IMT. CI was based on MACFIMS. 10 MSNI, 30 MSCI and 4 borderline patients were included in analyses. ANOVA showed MSNI had significantly greater WMa than MSCI, in the left (L) prefrontal cortex and L supplementary motor area (p = 0.032). Regression analysis showed significant inverse correlations between WMa and T2 LV/EDSS in similar areas (p = 0.005, 0.004 respectively). I/DMT-based BOLD activation detects CI in MS, larger studies are needed to confirm these findings.