Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability
Evidence of axonal damage in the early stages of multiple sclerosis and its relevance to disability
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DOI：
10.1001/archneur.58.1.65
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发表时间：
2001-01-01
影响因子：
--
通讯作者：
Arnold, DL
中科院分区：
文献类型：
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作者：
De Stefano, N;Narayanan, S;Arnold, DL
目的：评估多发性硬化症（MS）不同阶段的轴突损伤及其对残疾的影响。背景：最近的体内成像和原位病理学研究表明，大量的轴突损伤伴随着MS的炎性病变。然而，轴突损伤与MS持续时间的关系及其对疾病不同阶段残疾的影响仍然很难确定。设计：我们对88名具有广泛临床残疾和疾病持续时间的患者进行了质子磁共振光谱成像，以测量N-乙酰天冬氨酸：（NAA，轴突完整性指数）相对于大中央脑体积中的肌酸（Cr），其中包括磁共振成像上大部分正常外观的白色物质。结果：我们观察到MS早期NAA/Cr值异常低，甚至在临床上明显残疾（使用扩展残疾状态量表[EDSS]测量）之前，并且EDSS评分较低时比EDSS评分较高时下降更快（P
Objective: To assess axonal damage and its contribution to disability at different stages of multiple sclerosis (MS).Background: Recent in a vivo imaging and in situ pathologic studies have demonstrated that substantial axonal damage accompanies the inflammatory lesions of MS. However, the relation of axonal damage to the duration of MS and its contribution to disability at different stages of the disease remain poorly defined.Design: We performed proton magnetic resonance spectroscopic imaging in 88 patients with a wide range of clinical disability and disease duration to measure N-acetylaspartate: (NAA, an index of axonal integrity) relative to creatine (Cr) in a large central brain volume that included mostly normal-appearing white matter on magnetic resonance imaging.Results: We observed that the NAA/Cr values were abnormally low in the early stages of MS, even before significant disability (measured using the Expanded Disability Status Scale [EDSS]) was evident clinically, and declined more rapidly with respect to EDSS at lower than at higher EDSS scores (P