Focal cortical atrophy in multiple sclerosis: Relation to lesion load and disability
Focal cortical atrophy in multiple sclerosis: Relation to lesion load and disability
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DOI：
10.1016/j.neuroimage.2006.10.006
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发表时间：
2007-01-15
期刊：
影响因子：
5.7
通讯作者：
Evans, Alan C.
中科院分区：
文献类型：
--
作者：
Charil, Arnaud;Dagher, Alain;Evans, Alan C.
多发性硬化（MS）被认为主要影响白色物质（WM）。然而，最近，也有报道称皮质灰质丢失。关于MS皮质萎缩的原因知之甚少，它是否发生在病程的早期，以及它是否同样影响所有皮质区域，或者是否存在局灶性皮质萎缩的优先模式。一种自动化的方法被用来计算在425个早期复发缓解型MS患者的大脑皮质表面的每个顶点的厚度。我们将皮质厚度与WM损伤负荷和扩展残疾状态量表评分相关联。平均皮质厚度与WM损伤负荷和残疾相关。皮质厚度与总损伤负荷和功能障碍的相关性在扣带回、颞叶和相关皮质区域最为显著。相反，初级感觉、视觉和运动区域显示出不太显著的关系。每个病变体积或残疾量表单位的萎缩量最高的是前扣带皮层。这项研究证实了皮质萎缩，WM病变负荷，并在MS残疾之间的关系，并表明，皮质萎缩发生在MS患者只有轻度残疾。最有趣的是，我们显示了一个特定的区域模式，局灶性萎缩的MS是明显不同的，从一个在正常老化。与其他脑区高度互连的区域的萎缩过程的偏好表明，MS斑块中断WM束至少部分地导致皮质萎缩的发展。(c)2006年爱思唯尔公司All rights reserved.
Multiple sclerosis (MS) is thought to predominantly affect white matter (WM). Recently, however, loss of cortical gray matter has also been described. Little is known about the cause of cortical atrophy in MS, whether it occurs early in the disease course, and whether it affects all cortical regions equally or if there is a preferential pattern of focal cortical atrophy. An automated method was used to compute the thickness at every vertex of the cortical surface of the brains of 425 early relapsing-remitting MS patients. We correlated cortical thickness with the WM lesion load and the Expanded Disability Status Scale score. Mean cortical thickness correlated with WM lesion load and disability. The correlations of cortical thickness with total lesion load and disability were most significant in cingulate gyrus, insula, and associative cortical regions. Conversely, primary sensory, visual, and motor areas showed a less significant relationship. The highest amount of atrophy per lesion volume or disability scale unit was in the anterior cingulate cortex. This study confirms the relation between cortical atrophy, WM lesion load, and disability in MS, and suggests that cortical atrophy occurs even in MS patients with only mild disability. Most interestingly, we show a specific regional pattern of focal atrophy in MS that is distinctively different from the one in normal aging. The predilection of the atrophic process for areas that are heavily interconnected with other brain regions suggests that interruption of WM tracts by MS plaques contributes, at least in part, to the development of cortical atrophy. (c) 2006 Elsevier Inc. All rights reserved.