Gray matter atrophy in multiple sclerosis: A longitudinal study
Gray matter atrophy in multiple sclerosis: A longitudinal study
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DOI：
10.1002/ana.21436
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发表时间：
2008-09-01
影响因子：
11.2
通讯作者：
Rudick, Richard A.
中科院分区：
文献类型：
--
作者：
Fisher, Elizabeth;Lee, Jar-Chi;Rudick, Richard A.
目的：确定多发性硬化症（MS）患者在疾病的各个阶段的灰质（GM）萎缩率，并确定GM atrophysics.Methods的预测和临床相关性：MS患者和健康对照组观察了4年以上的标准化磁共振成像（MRI）和神经系统检查。计算全脑、GM和白色物质萎缩率。受试者根据疾病状态和残疾进展进行分类，以确定萎缩的临床意义。结果：受试者包括17名健康对照者，7例临床孤立综合征患者，36例复发缓解型MS（RRMS）患者，27例继发进展型MS（SPMS）患者。以对照组的倍数增加表示，GM萎缩率随疾病分期而增加，从临床孤立综合征患者转化为RRMS的3.4倍正常值到SPMS的14倍正常值。相比之下，所有MS疾病阶段的白色萎缩率恒定在约3倍正常值。GM萎缩与残疾相关。MRI测量的局灶性和弥漫性组织损伤占62%的RRMS中GM萎缩的方差，但没有显着的预测GM萎缩SPMS.Interpretation：灰质组织损伤占主导地位的病理过程MS的进展，神经功能障碍的基础。灰质萎缩的影像学相关性表明RRMS和SPMS的机制不同。这些发现证明了灰质萎缩在MS中的临床相关性，并强调了了解其原因的必要性。
Objective: To determine gray matter (GM) atrophy rates in multiple sclerosis (MS) patients at all stages of disease, and to identify predictors and clinical correlates of GM atrophy.Methods: MS patients and healthy control subjects were observed over 4 years with standardized magnetic resonance imaging (MRI) and neurological examinations. Whole-brain, GM, and white matter atrophy rates were calculated. Subjects were categorized by disease status and disability progression to determine the clinical significance of atrophy. MRI predictors of atrophy were determined through multiple regression.Results: Subjects included 17 healthy control subjects, 7 patients with clinically isolated syndromes, 36 patients with relapsing-remitting MS (RRMS), and 27 patients with secondary progressive MS (SPMS). Expressed as fold increase from control subjects, GM atrophy rate increased with disease stage, from 3.4-fold normal in clinically isolated syndromes patients converting to RRMS to 14-fold normal in SPMS. In contrast, white matter atrophy rates were constant across all MS disease stages at approximately 3-fold normal. GM atrophy correlated with disability. MRI measures of focal and diffuse tissue damage accounted for 62% of the variance in GM atrophy in RRMS, but there were no significant predictors of GM atrophy in SPMS.Interpretation: Gray matter tissue damage dominates the pathological process as MS progresses, and underlies neurological disabillity. Imaging correlates of gray matter atrophy indicate that mechanisms differ in RRMS and SPMS. These findings demonstrate the clinical relevance of gray matter atrophy in MS, and underscore the need to understand its causes.