Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis
Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis
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DOI：
10.1212/01.wnl.0000201238.93586.d9
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发表时间：
2006-03-14
期刊：
影响因子：
9.9
通讯作者：
Bakshi, R
中科院分区：
文献类型：
--
作者：
Sanfilipo, MP;Benedict, RHB;Bakshi, R
背景资料：多发性硬化症（MS）中灰质和白色萎缩与神经心理和神经精神损害的关系尚未研究。研究方法：在40名MS患者和15名年龄/性别匹配的正常对照中，作者使用SPM 99获得全脑标准化的灰色和白色物质体积，以及测量的常规病变负荷（总T1低信号和FLAIR高信号病变体积）。针对与MS脑病变相关的错误分类校正了全脑分割。为了比较灰质、白色物质和病变体积对脑行为关系的影响，对MS组（病程= 11.2 +/- 8.8年; EDSS评分= 3.3 +/- 1.9）进行了神经心理学评估，并与年龄/性别匹配的独立的较大组正常对照组（n = 83）进行了比较。结果如下：多发性硬化组有较小的灰色（p = 0.009）和白色物质体积（p = 0.018），认知能力受损（言语记忆、视觉记忆、处理速度和工作记忆）（所有P < 0.0001），和更大的神经精神症状（抑郁，p < 0.0001;烦躁，p < 0.0001;易怒，p <0.0001;焦虑，p <0.0001;欣快，p = 0.006;激越，p = 0.02;冷漠，p = 0.02;和去抑制，p = 0.11）与对照相比。分层逐步回归分析显示，在解释认知能力和神经精神症状方面，全灰和白色物质体积比病变负荷解释更大的方差。白色物质体积是心理加工速度和工作记忆的最佳预测因子，而灰质体积则预测了言语记忆、欣快和去抑制。结论：灰色和白色脑组织萎缩均导致多发性硬化的神经心理学缺陷。
Background: The relationship of gray and white matter atrophy in multiple sclerosis ( MS) to neuropsychological and neuropsychiatric impairment has not been examined. Methods: In 40 patients with MS and 15 age-/sex-matched normal controls, the authors used SPM99 to obtain whole brain normalized volumes of gray and white matter, as well as measured conventional lesion burden (total T1 hypointense and FLAIR hyperintense lesion volume). The whole brain segmentation was corrected for misclassification related to MS brain lesions. To compare the effects of gray matter, white matter, and lesion volumes with respect to brain-behavior relationships, the MS group (disease duration = 11.2 +/- 8.8 years; EDSS score = 3.3 +/- 1.9) underwent neuropsychological assessment, and was compared to a separate, larger group of age-/sex-matched normal controls (n = 83). Results: The MS group had smaller gray (p = 0.009) and white matter volume (p = 0.018), impaired cognitive performance ( verbal memory, visual memory, processing speed, and working memory) (all p < 0.0001), and greater neuropsychiatric symptoms (depression, p < 0.0001; dysphoria, p < 0.0001; irritability, p < 0.0001; anxiety, p < 0.0001; euphoria, p = 0.006; agitation, p = 0.02; apathy, p = 0.02; and disinhibition, p = 0.11) vs controls. Hierarchical stepwise regression analysis revealed that whole gray and white matter volumes accounted for greater variance than lesion burden in explaining cognitive performance and neuropsychiatric symptoms. White matter volume was the best predictor of mental processing speed and working memory, whereas gray matter volume predicted verbal memory, euphoria, and disinhibition. Conclusion: Both gray and white brain matter atrophy contribute to neuropsychological deficits in multiple sclerosis.