Eight-year follow-up study of brain atrophy in patients with MS
Eight-year follow-up study of brain atrophy in patients with MS
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DOI：
10.1212/01.wnl.0000036271.49066.06
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发表时间：
2002-11-12
期刊：
影响因子：
9.9
通讯作者：
Simonian, NA
中科院分区：
文献类型：
--
作者：
Fisher, E;Rudick, RA;Simonian, NA
目的：描述复发缓解型MS（RRMS）患者8年内全脑萎缩的特征。本研究的具体目标是确定脑萎缩是否与随后的残疾状态有关，并确定MRI与萎缩进展的相关性。方法：进行了一项随访研究，以重新评估随机分组后8年的干扰素β-1a（IFN β-1a）III期试验的患者。在原始试验中随访超过2年的172例患者的临床和MRI数据用作基线数据。获得了160例患者的随访数据，其中134例患者进行了随访MRI检查。通过自动计算脑实质分数来估计脑萎缩。确定了原始试验期间萎缩与随访时残疾状态之间的关系。还确定了原始试验的病变测量值与随访时脑实质分数之间的相关性。结果：脑萎缩与随后的残疾状态相关。原始试验期间的萎缩率是随访时残疾状态的最重要MRI预测因子。随访时的脑萎缩与原始试验期间测量的病变体积相关。结论：萎缩进展与随后的神经功能障碍状态之间的关系表明，RRMS期间的萎缩进展具有临床相关性。因此，萎缩进展可能是临床试验中疾病进展的有用标志物。病变和随后的萎缩之间的关系表明，脑萎缩可能与早期的局灶性组织损伤有关，但导致萎缩的重要诱因或其他因素仍不明确。
Objective: To characterize whole-brain atrophy in relapsing-remitting MS (RRMS) patients over an 8-year period. The specific goals of this study were to determine if brain atrophy is related to subsequent disability status and to identify MRI correlates of atrophy progression. Methods: A follow-up study was conducted to reassess patients from a phase III trial of interferon beta-1a (IFNbeta-1a) 8 years after randomization. Clinical and MRI data from 172 patients followed over 2 years in the original trial were used as baseline data. Follow-up data were obtained on 160 patients, including 134 patients with follow-up MRI examinations. Brain atrophy was estimated by automated calculation of brain parenchymal fraction. The relation between atrophy during the original trial and disability status at follow-up was determined. Correlations were also determined between lesion measurements from the original trial and the brain parenchymal fraction at follow-up. Results: Brain atrophy was correlated with subsequent disability status. Atrophy rate during the original trial was the most significant MRI predictor of disability status at follow-up. Brain atrophy at follow-up was related to lesion volumes measured during the original trial. Conclusions: The relation between atrophy progression and subsequent neurologic disability status suggests that atrophy progression during RRMS is clinically relevant. Therefore, atrophy progression may be a useful marker for disease progression in clinical trials. The relation between lesions and subsequent atrophy indicates that brain atrophy may be related to focal tissue damage at earlier points in time, but important predisposing or other factors contributing to atrophy remain undefined.