Tract-Specific Spinal Cord Diffusion Tensor Imaging in Friedreich's Ataxia
Tract-Specific Spinal Cord Diffusion Tensor Imaging in Friedreich's Ataxia
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DOI：
10.1002/mds.28841
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发表时间：
2021-10-29
影响因子：
8.6
通讯作者：
Franca Jr, Marcondes C.
中科院分区：
文献类型：
--
作者：
Hernandez, Ana Luisa C. C.;Rezende, Thiago J. R.;Franca Jr, Marcondes C.
背景脊髓损伤是Friedreich‘s共济失调(FRDA)的一个特征。神经成像已经能够捕捉到SC的一些宏观变化，但还没有研究评估体内SC白质(WM)的微结构损伤。目的应用弥散张量成像(DTI)和自动分析管道技术，对FRDA患者的脊髓WM束的微结构完整性进行横断面研究。方法对30例患者和30例健康对照进行了3T磁共振成像(MRI)检查。我们获得了颈部SCT2和弥散加权成像(DWI)图像。使用4.3.0版脊髓工具箱对图像进行处理。对于C2-C5水平，我们测量了横截面面积(CSA)和WM DTI参数(轴向扩散系数[AD]、分数各向异性[FA]、径向扩散系数[RD]和平均扩散系数[MD])。还获得了年龄、病程和FARS评分。结果患者平均年龄31±10年，病程11±9年。所有水平的FRDA均有CSA降低。总白质(TWM)、背柱(DC)、股薄束(FG)、楔束(FC)和皮质脊髓束(CST)的FA、MD和RD在所有水平上都存在差异。TWM、DC、FC和CST的FA和RD与FARS评分相关，CST的FA和RD也与病程相关。结论DTI发现FRDA的SC-WM束存在异常，并与其临床特征相关。C2的CsA和CST FA与疾病严重程度的相关性最好，而DC FA对区分患者和健康对照的影响最大。SC-WM的微结构是一种潜在的神经影像生物标志物，在该病中有待进一步研究。(C)2021年国际帕金森病和运动障碍协会
Background Spinal cord (SC) damage is a hallmark in Friedreich's ataxia (FRDA). Neuroimaging has been able to capture some SC macroscopic changes, but no study has evaluated microstructural SC white matter (WM) damage in vivo. Objectives We designed a cross-sectional study to evaluate microstructural integrity in SC WM tracts of FRDA patients using diffusion tensor imaging (DTI) with an automated analysis pipeline. Methods Thirty patients and 30 matched healthy controls underwent 3 Tesla (T) magnetic resonance imaging (MRI). We obtained cervical SC T2 and diffusion-weighted imaging (DWI) acquisitions. Images were processed using the Spinal Cord Toolbox v.4.3.0. For levels C2-C5, we measured cross-sectional area (CSA) and WM DTI parameters (axial diffusivity [AD], fractional anisotropy [FA], radial diffusivity [RD], and mean diffusivity [MD]). Age, duration, and FARS scores were also obtained. Results Mean age and disease duration of patients were 31 +/- 10 and 11 +/- 9 years, respectively. There was CSA reduction in FRDA amongst all levels. Between-group differences in FA, MD, and RD in total white matter (TWM), dorsal columns (DC), fasciculus gracilis (FG), fasciculus cuneatus (FC), and corticospinal tracts (CST) were present in all levels. FA and RD from TWM, DC, FC, and CST correlated with FARS scores, and in CST they also correlated with disease duration. Conclusion DTI uncovered abnormalities in SC WM tracts, which correlated with clinical features in FRDA. CSA and CST FA in C2 correlated best with disease severity, whereas DC FA showed the largest effect size to differentiate patients and healthy controls. SC WM microstructure is a potential neuroimaging biomarker to be explored in the disease. (c) 2021 International Parkinson and Movement Disorder Society