A longitudinal study of cerebral glucose metabolism, MRI, and disability in patients with MS
A longitudinal study of cerebral glucose metabolism, MRI, and disability in patients with MS
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DOI：
10.1212/wnl.53.1.149
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发表时间：
1999-07-13
期刊：
影响因子：
9.9
通讯作者：
Sorensen, PS
中科院分区：
文献类型：
--
作者：
Blinkenberg, M;Jensen, CV;Sorensen, PS
目的：研究多发性硬化症患者脑葡萄糖代谢率（CMRglc）的时间相关性变化及其与MRI病变负荷和残疾变化的相关性。背景：在MS患者的纵向研究中，MRI损伤负荷和神经功能障碍的测量被广泛用于监测疾病进展，但对脑神经功能的相关变化知之甚少。方法：作者研究了10例临床明确的MS患者，他们在大约2年的时间里（3次检查）进行了CMRglc、MRI t2加权总病变面积（TLA）和残疾临床评估（扩展残疾状态量表[EDSS]）的一系列测量。用PET和18-氟脱氧葡萄糖（FDG）计算CMRglc。结果：皮层CMRglc随时间的延长而降低（p < 0.001），其中额叶和顶叶皮层CMRglc降低最为明显。在研究期间，残疾（p < 0.01）和TLA （p < 0.05）测量值均有统计学意义的增加，但CMRglc的变化与TLA和EDSS的变化无相关性。结论：在2年的观察期内，MS患者的整体皮质脑代谢显著降低，表明皮质活动随着疾病进展而恶化。皮质CMRglc的时间相关变化在统计学上强于TLA测量和神经功能障碍的变化，可能是治疗效果的有用的次要指标。
Objective: To study the time-related changes in cerebral metabolic rate of glucose (CMRglc) in MS patients and to correlate these with changes in MRI lesion load and disability. Background: Measurements of MRI lesion load and neurologic disability are used widely to monitor disease progression in longitudinal studies of MS patients, but little is known about the associated changes in cerebral neural function. Methods: The authors studied 10 patients with clinically definite MS who underwent serial measurements of CMRglc, MRI T2-weighted total lesion area (TLA), and clinical evaluation of disability (Expanded Disability Status Scale [EDSS]) over a period of approximately 2 years (three examinations). CMRglc was calculated using PET and 18-fluorodeoxyglucose (FDG). Results: The global cortical CMRglc decreased with time (p < 0.001) and the most pronounced reductions of CMRglc were detected in frontal and parietal cortical areas. There was a statistically significant increase of disability (p < 0.01) and TLA (p < 0.05) measurements during the study, but changes in CMRglc were not correlated to changes in TLA and EDSS. Conclusions: Global cortical cerebral metabolism in MS is decreased significantly during a 2-year observation period, suggesting a deterioration of cortical activity with disease progression. The time-related changes of cortical CMRglc are statistically stronger than changes in TLA measurements and neurologic disability, and might be a useful secondary measure of treatment efficacy.