Normal-appearing white matter demyelination in neuromyelitis optica spectrum disorder
Normal-appearing white matter demyelination in neuromyelitis optica spectrum disorder
复制标题
DOI：
10.1111/ene.13266
复制
发表时间：
2017-04-01
影响因子：
5.1
通讯作者：
Kim, H. J.
中科院分区：
文献类型：
--
作者：
Jeong, I. H.;Choi, J. Y.;Kim, H. J.
背景和目的：越来越多的证据表明，视神经脊髓炎谱系障碍（NMOSD）患者的正常白质（NAWM）中存在脱髓鞘。目的是使用髓磷脂水成像 (MWI) 确定 NMOSD 患者 NAWM 中是否存在亚临床脱髓鞘。方法：对 28 名 NMOSD 患者和 18 名健康对照者的 NAWM 进行全脑和感兴趣区域 (ROI) 分析，包括半卵圆中心、放射冠、胼胝体膝部和压部以及视放射 (HC) 使用两种 MWI 模式：传统 MWI 和短横向弛豫时间分量 (ViSTa) MWI 直接可视化。结果：NMOSD 患者整体 NAWM 和三个 ROI（半卵圆中心、放射冠和胼胝体膝部）的传统髓磷脂水分数 (MWF) 略低于 HC，但没有统计学意义。另一方面，NMOSD 患者的整体 NAWM 和除胼胝体膝部外的所有 ROI 的 ViSTa MWF 值均显着低于 HC。特别是，在两种 MWI 方法中，NMOSD 患者的视辐射中的 MWF 相对于 HC 显着降低，即使在没有脑部受累的患者中也是如此。此外，视神经炎患者的 MWF 低于无视神经炎患者，并且视辐射的 MWF 与视功能系统评分呈负相关。 结论：本研究发现 NMOSD 患者的 NAWM 中存在广泛的脱髓鞘，并强调视辐射是明显脱髓鞘的部位。
Background and purpose: Increasing evidence suggests the presence of demyelination in the normal-appearing white matter (NAWM) of patients with neuromyelitis optica spectrum disorder (NMOSD). The objective was to determine the presence of subclinical demyelination in the NAWM of patients with NMOSD using myelin water imaging (MWI).Methods: Whole brain and regions-of-interest (ROIs) analyses, including the centrum semiovale, corona radiata, genu and splenium of the corpus callosum, and optic radiation, were conducted in the NAWM of 28 NMOSD patients and 18 healthy controls (HCs) using two MWI modalities: conventional MWI and direct visualization of short transverse relaxation time component (ViSTa) MWI.Results: Conventional myelin water fractions (MWFs) of the global NAWM and three ROIs (centrum semiovale, corona radiata, and genu of the corpus callosum) were slightly lower in NMOSD patients than in HCs, although not statistically significant. On the other hand, ViSTa MWF values of the global NAWM and all ROIs except the genu of the corpus callosum were significantly lower in NMOSD patients relative to HCs. In particular, the MWF in the optic radiation was significantly reduced in NMOSD patients relative to HCs in both MWI methods, even in patients who had no brain involvement. Additionally, patients with optic neuritis showed lower MWF than patients without optic neuritis and a negative correlation was identified between the MWF of the optic radiation and visual functional system score.Conclusions: This study identified the presence of widespread demyelination in the NAWM of NMOSD patients and highlighted the optic radiation as a site of marked demyelination.