Lack of correlation between cortical demyelination and white matter pathologic changes in multiple sclerosis
Lack of correlation between cortical demyelination and white matter pathologic changes in multiple sclerosis
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DOI：
10.1001/archneur.64.1.76
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发表时间：
2007-01-01
影响因子：
--
通讯作者：
Barkhof, Frederik
中科院分区：
文献类型：
--
作者：
Bo, Lars;Geurts, Jeroen J. G.;Barkhof, Frederik
背景资料：组织病理学研究表明慢性多发性硬化（chronic multiple sclerosis，MS）患者广泛存在软膜下皮质脱髓鞘病变，目的：探讨MS患者软膜下皮质脱髓鞘病变与局灶性或弥漫性白色物质（white matter，WM）MRI病理特征的关系设计：死后MR成像结果与组织病理学结果的比较。设置：来自普通社区的脑捐赠。患者：从MS尸检数据集中选择了3例伴有广泛皮质脱髓鞘的MS患者和3例伴有轻微皮质脱髓鞘的患者。对患者的死后MR成像和组织病理学数据进行了比较。主要结果测量：两名观察者对彼此的结果不知情，通过MR成像和组织病理学评估了WM中局灶性和弥漫性病理变化的存在、程度和分布。广泛的软膜下脱髓鞘与Luxol Fast评估的局灶性和弥漫性WM病理改变面积的显著增加无关蓝色组织化学或通过MR成像或与存在或范围的apertacortically异常的MR imaging. Conclusions：缺乏关联的MS灰质脱髓鞘与弥漫性或局灶性WM的变化表明，灰质脱髓鞘在MS发生在很大程度上独立于WM的病理变化。WM异常的程度或分布不能用于在临床环境中识别广泛的皮质脱髓鞘。
Background: Histopathologic studies have shown that subpial cortical demyelination is extensive in chronic multiple sclerosis (MS).Objective: To study whether subpial cortical demyelination in MS is associated with focal or diffuse white matter (WM) pathologic features on magnetic resonance imaging (MR imaging).Design: Comparison of postmortem MR imaging findings with histopathologic findings.Setting: Brain donations from a general community.Patients: Three patients with MS with extensive cortical demyelination and 3 patients with minor cortical demyelination were selected from an MS autopsy data set. The postmortem MR imaging and histopathologic data of the patients were compared.Main Outcome Measures: Two observers blinded to the results of each other assessed the presence, extent, and distribution of focal and diffuse pathologic changes in WM by MR imaging and by histopathology.Results: Extensive subpial demyelination was not associated with a significant increase in the area of focal and diffuse WM pathologic changes as assessed by Luxol fast blue histochemistry or by MR imaging or with the presence or extent of juxtacortical abnormalities on MR imaging.Conclusions: The lack of association of MS gray matter demyelination with diffuse or focal WM changes indicates that gray matter demyelination in MS occurs largely independent of WM pathologic changes. The extent or distribution of WM abnormalities cannot be used to identify extensive cortical demyelination in the clinical setting.