Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS
Use of the brain parenchymal fraction to measure whole brain atrophy in relapsing-remitting MS
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DOI：
10.1212/wnl.53.8.1698
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发表时间：
1999-11-10
期刊：
影响因子：
9.9
通讯作者：
Jacobs, L
中科院分区：
文献类型：
--
作者：
Rudick, RA;Fisher, E;Jacobs, L
背景资料：在MS的早期阶段CNS中的发作性炎症导致数年后的进行性残疾，推测是由于髓鞘和轴突损伤。MRI显示在疾病早期阶段持续的疾病活动，即使在一些临床稳定的患者中。然而，对于破坏性病理过程的最佳MRI测量是不确定的。研究方法：在这项事后研究中，对参与干扰素β-1a安慰剂对照试验的复发性MS患者的MRI扫描进行了分析。脑实质分数（定义为脑实质体积与脑表面轮廓内总体积的比值）用于测量全脑萎缩。确定疾病特征与脑萎缩的关系以及干扰素β-1a的作用。结果：MS患者有明显的脑萎缩，在2年的观察期间每年都恶化。在许多患者中，脑萎缩恶化而无临床疾病活动。基线临床和MRI异常与随后2年的脑萎缩率没有强相关性。在临床试验的第二年，干扰素β-1a治疗导致脑萎缩进展减少。结论：复发缓解型MS患者每年都有可测量的全脑萎缩，大多数情况下没有临床表现。脑实质分数是复发性MS患者中正在进行的破坏性病理过程的标志物，并且在对照临床试验中显示治疗效果方面似乎是有用的。
Background: Episodic inflammation in the CNS during the early stages of MS results in progressive disability years later, presumably due to myelin and axonal injury. MRI demonstrates ongoing disease activity during the early disease stage, even in some patients who are stable clinically. The optimal MRI measure for the destructive pathologic process is uncertain, however. Methods: In this post-hoc study, MRI scans were analyzed from patients with relapsing MS participating in a placebo-controlled trial of interferon beta-1a The brain parenchymal fraction, defined as the ratio of brain parenchymal volume to the total volume within the brain surface contour, was used to measure whole brain atrophy. The relationship between disease features and brain atrophy and effect of interferon beta-1a were determined. Results: MS patients had significant brain atrophy that worsened during each of 2 years of observation. In many patients, brain atrophy worsened without clinical disease activity. Baseline clinical and MRI abnormalities were not strongly related to the rate of brain atrophy during the subsequent 2 years. Treatment with interferon beta-1a resulted in a reduction in brain atrophy progression during the second year of the clinical trial. Conclusions: Patients with relapsing-remitting MS have measurable amounts of whole brain atrophy that worsens yearly, in most cases without clinical manifestations. The brain parenchymal fraction is a marker for destructive pathologic processes ongoing in relapsing MS patients, and appears useful in demonstrating treatment effects in controlled clinical trials.