Differential Associations of Mobility With Fronto-Striatal Integrity and Lesion Load in Older Adults With and Without Multiple Sclerosis.
Differential Associations of Mobility With Fronto-Striatal Integrity and Lesion Load in Older Adults With and Without Multiple Sclerosis.
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DOI：
10.1177/15459683231164787
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发表时间：
2023-04
影响因子：
4.2
通讯作者：
Holtzer, Roee
中科院分区：
文献类型：
--
作者：
Wagshul, Mark E.;Foley, Frederick W.;Chaudhary, Kapil;Lipton, Michael L.;Motl, Robert W.;Izzetoglu, Meltem;Hernandez, Manuel E.;Picone, Mary Ann;Holtzer, Roee
关键词：
运动障碍在MS老年人中很常见，并进一步加剧了与年龄相关的一般运动能力下降，但其潜在的大脑基质知之甚少。检查额-纹状体白色物质（WM）的完整性和损伤负荷，作为老年MS患者和非MS患者活动性结局的成像相关性。（年龄64.9 ± 3.7岁，29名女性）和50名健康、匹配的对照组（66.2 ± 3.2岁，24名女性）参与了研究，包括身体和认知测试组合和3 T MRI成像会话。主要影像学指标为各向异性分数（FA）和WM病变负荷。采用分层逻辑回归模型评估了使用经验证的短期体能测试（SPPB）临界评分定义的活动障碍与神经影像学指标之间的关系。从六个额-纹状体回路（左/右）中提取FA：背侧纹状体（dStr）-前背外侧前额叶皮层（aDLPFC）、dStr-后DLPFC和腹侧纹状体（vStr）-腹内侧前额叶皮层（VMPFC）。对于完全校正的回归模型，在健康对照组中，活动性障碍与两个回路（左dStr-aDLPFC（p = 0.003）和左vStr-VMPFC（p = 0.004））中的FA降低显著相关，但在MS患者中则不相关（p > 0.20）。相反，在MS患者中，而不是在健康对照组中，活动障碍与更大的病变体积显著相关（p < 0.02）。比较老年人与非MS，我们提供了令人信服的证据，一个双重分离之间的存在的流动性障碍和两个神经影像学标志物的白色物质的完整性，额-纹状体各向异性分数和全脑病变负荷。
Mobility impairment is common in older persons with MS, and further compounded by general age-related mobility decline but its underlying brain substrates are poorly understood. Examine fronto-striatal white matter (WM) integrity and lesion load as imaging correlates of mobility outcomes in older persons with and without MS. Fifty-one older MS patients (age 64.9 ± 3.7 years, 29 women) and 50 healthy, matched controls (66.2 ± 3.2 years, 24 women), participated in the study, which included physical and cognitive test batteries and 3T MRI imaging session. Primary imaging measures were fractional anisotropy (FA) and WM lesion load. The relationship between mobility impairment, defined using a validated short physical performance battery (SPPB) cutoff score, and neuroimaging measures was assessed with stratified logistic regression models. FA was extracted from six fronto-striatal circuits (left/right): dorsal striatum (dStr)-to-anterior dorsolateral prefrontal cortex (aDLPFC), dStr-to-posterior DLPFC, and ventral striatum (vStr)-to-ventromedial prefrontal cortex (VMPFC). Mobility impairment was significantly associated with lower FA in two circuits, left dStr-aDLPFC (p = 0.003) and left vStr-VMPFC (p = 0.004), in healthy controls but not in MS patients (p > 0.20), for fully adjusted regression models. Conversely, in MS patients but not in healthy controls, mobility impairment was significantly associated with greater lesion volume (p < 0.02). Comparing older persons with and without MS, we provide compelling evidence of a double dissociation between the presence of mobility impairment and two neuroimaging markers of white matter integrity, fronto-striatal fractional anisotropy and whole brain lesion load.
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