Increasing cord atrophy in early relapsing-remitting multiple sclerosis: a 3 year study
Increasing cord atrophy in early relapsing-remitting multiple sclerosis: a 3 year study
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DOI：
10.1136/jnnp.2005.068338
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发表时间：
2006-01-01
影响因子：
11
通讯作者：
Miller, DH
中科院分区：
文献类型：
--
作者：
Rashid, W;Davies, GR;Miller, DH
目的：以往的研究表明，上颈髓萎缩（UCCA）发生在多发性硬化症（MS），特别是在那些残疾和原发性或继发性疾病进展。目前尚不清楚如何早期可以检测到复发缓解型（RR）MS，以及早期脊髓萎缩是否涉及到同期或未来的临床course.Methods：27 RR MS患者（中位病程1.7年，在所有情况下，3年发病）被招募沿着与20名对照。他们随访长达3年，每年评估UCCA和临床功能，通过扩展残疾状态量表（EDSS）和MS功能综合评分（MSFC）测量。研究了临床和MRI相关性。统计模型调整的协变量，包括总颅内volume.Results：纵向分析显示，UCCA在患者队列（p< 0.001），并与对照组（p = 0.001）相比，患者显着下降。EDSS显著增加（p = 0.008），但MSFC无显著变化。UCCA丢失率与临床变化或脑体积变化无关。结论：总之，连续UCCA测量可检测临床早期RR MS中脊髓萎缩的发展。
Objectives: Previous studies have shown that upper cervical cord atrophy ( UCCA) occurs in multiple sclerosis ( MS), particularly in those disabled and with primary or secondary progressive disease. It is less clear how early it can be detected in relapsing-remitting (RR) MS, and whether early cord atrophy relates to the concurrent or future clinical course.Methods: Twenty seven RR MS patients ( median disease duration 1.7 years, in all cases,3 years from onset) were recruited along with 20 controls. They were followed for up to 3 years with a yearly assessment of UCCA and clinical function measured by the Expanded Disability Status Scale (EDSS) and MS Functional Composite Score (MSFC). Clinical and MRI correlations were investigated. Statistical models adjusted for covariates including total intracranial volume.Results: Longitudinal analysis showed a significant decrease in UCCA in patients both within the patient cohort ( p< 0.001) and in comparison with controls ( p = 0.001). There was a significant increase in EDSS ( p = 0.008) but no significant change in MSFC. The rate of UCCA loss did not correlate with clinical change or with change in brain volume.Conclusions: In summary, serial UCCA measurement detects the development of spinal cord atrophy in clinically early RR MS.