Myelin water imaging reflects clinical variability in multiple sclerosis.
Myelin water imaging reflects clinical variability in multiple sclerosis.
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DOI：
10.1016/j.neuroimage.2011.11.070
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发表时间：
2012-03
期刊：
影响因子：
5.7
通讯作者：
Palace, Jackie
中科院分区：
文献类型：
--
作者：
Kolind, Shannon;Matthews, Lucy;Johansen-Berg, Heidi;Leite, M. Isabel;Williams, Steven C. R.;Deoni, Sean;Palace, Jackie
关键词：
虽然MRI常规用于多发性硬化症的评估和诊断，但原发性进展性多发性硬化症（PPMS）患者的临床残疾与疾病活动的常规MRI标志物（例如，增强病变的数量）。由于PPMS患者表现为弥漫性和全局性髓鞘丢失，本研究的目的是评价全脑髓鞘水分数（MWF）成像在PPMS中的疗效。具体而言，我们试图使用全脑分析技术：1）确定PPMS脑中MWF估计值的重现性; 2）将PPMS脑中的MWF值与健康对照组进行比较; 3）在整个脑中建立区域和全球MWF与临床残疾之间的关系。17例PPMS患者和17例年龄匹配的对照组使用全脑多成分弛豫成像技术进行成像，以测量MWF。在三个空间水平上进行MWF减少的分析：1）直方图; 2）白色物质骨架;和3）在单个受试者水平上的体素方式。从直方图分析，PPMS患者与对照组相比具有显著降低的总体正常外观白色物质MWF（6%，p=0.04）。在对照组（61%，p<0.001）和患者组（59%，p<0.001）中，局灶性病变的MWF值低于白色物质。沿着白色物质骨架，MWF在整个PPMS大脑中弥漫性降低，通过扩展残疾状态量表测量，在胼胝体和额叶、颞叶、顶叶和枕叶白色物质中，MWF降低与临床残疾增加（更严重的症状）之间存在显著相关性。与更具体的精神和感觉功能系统评分的相关性局限于临床雄辩的位置：MWF降低与前部区域的精神评分增加显著相关（即，额叶和胼胝体的胼胝体），并增加更靠近感觉皮层的后部区域的感觉评分。还将个体患者MWF图与标准人群图谱进行了比较，该图谱突出显示了个体患者与人群平均值之间的统计学差异。MWF显著减少的体积与临床残疾之间存在显著相关性（p=0.008，R = 0.58）。我们的研究结果表明，临床残疾反映在特定区域的大脑白色物质是一致的科目之间，并说明了一种方法来检查整个大脑的个别患者的组织改变。这些结果强烈支持使用MWF成像来评估PPMS中的疾病活动。
Whilst MRI is routinely used for the assessment and diagnosis of multiple sclerosis, there is poor correspondence between clinical disability in primary progressive multiple sclerosis (PPMS) patients and conventional MRI markers of disease activity (e.g., number of enhancing lesions). As PPMS patients show diffuse and global myelin loss, the aim of this study was to evaluate the efficacy of whole-brain myelin water fraction (MWF) imaging in PPMS. Specifically, we sought to use full-brain analysis techniques to: 1) determine the reproducibility of MWF estimates in PPMS brain; 2) compare MWF values in PPMS brain to healthy controls; and 3) establish the relationship between MWF and clinical disability, regionally and globally throughout the brain. Seventeen PPMS patients and seventeen age-matched controls were imaged using a whole-brain multi-component relaxation imaging technique to measure MWF. Analysis of MWF reduction was performed on three spatial levels: 1) histogram; 2) white matter skeleton; and 3) voxel-wise at the single-subject level. From histogram analysis, PPMS patients had significantly reduced global normal appearing white matter MWF (6%, p=0.04) compared to controls. Focal lesions showed lower MWF values than white matter in controls (61%, p<0.001) and patients (59%, p<0.001). Along the white matter skeleton, MWF was diffusely reduced throughout the PPMS brain, with significant correlations between reduced MWF and increased clinical disability (more severe symptoms), as measured by the Expanded Disability Status Scale, within the corpus callosum and frontal, temporal, parietal and occipital white matter. Correlations with the more specific mental and sensory functional system scores were localized to clinically eloquent locations: reduced MWF was significantly associated with increased mental scores in anterior regions (i.e., frontal lobes and genu of the corpus callosum), and increased sensory scores in more posterior regions closer to the sensory cortex. Individual patient MWF maps were also compared to a normative population atlas, which highlighted areas of statistical difference between the individual patient and the population mean. A significant correlation was found between the volume of significantly reduced MWF and clinical disability (p=0.008, R = 0.58). Our results show that clinical disability is reflected in particular regions of cerebral white matter that are consistent between subjects, and illustrates a method to examine tissue alteration throughout the brain of individual patients. These results strongly support the use of MWF imaging to evaluate disease activity in PPMS.
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影响因子：
1.3
作者：
COLLINS, DL;NEELIN, P;EVANS, AC
通讯作者：
EVANS, AC
影响因子：
5.7
作者：
Jenkinson, M;Bannister, P;Smith, S
通讯作者：
Smith, S
DOI：
10.1002/jmri.22062
发表时间：
2010-03
期刊：
Journal of magnetic resonance imaging : JMRI
影响因子：
--
作者：
Giorgio A;Palace J;Johansen-Berg H;Smith SM;Ropele S;Fuchs S;Wallner-Blazek M;Enzinger C;Fazekas F
通讯作者：
Fazekas F
影响因子：
2.5
作者：
Grenier, D;Pelletier, D;Majumdar, S
通讯作者：
Majumdar, S
影响因子：
3.3
作者：
Deoni, Sean C. L.;Rutt, Brian K.;Jones, Derek K.
通讯作者：
Jones, Derek K.