Anatomical Distribution of Pathology in MS

MS 病理学的解剖分布

• 批准号: 7234046
• 负责人: CHRISTOPHER MICHAEL HOLLAND
• 金额: $ 4.87万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-17 至 2009-04-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7234046
• 关键词: Acute; Address; Area; Atlases; Benign; Brain; Brain region; Cerebrum; Clinical; Clinical Course of Disease; Cognitive; Data; Data Set; Databases; Deterioration; Development; Diffuse; Disease; Disease Progression; Environment; Fellowship; Frequencies; Healed; Hypoxia; Individual; Inflammation; Inflammatory; Lesion; Magnetic Resonance Imaging; Maps; Multiple Sclerosis; Multiple Sclerosis Lesions; Names; Neuraxis; Newly Diagnosed; Pathology; Patients; Pattern; Perfusion; Personal Satisfaction; Phase; Physiological; Population; Predisposition; Prevalence; Process; Progressive Disease; Recovery; Regional Perfusion; Relapse; Relative (related person); Research Proposals; Resolution; Role; Scanning; Secondary Progressive Multiple Sclerosis; Secondary to; Site; Spatial Distribution; Specificity; Staging; Statistically Significant; Subgroup; System; Testing; Thinking; Tissues; Translating; Work; burden of illness; cohort; disability; healing; healthy volunteer; in vivo; outcome forecast; repaired; response; size; spinal cord white matter; white matter; white matter damage

DESCRIPTION (provided by applicant): This research proposal aims to investigate the role of cerebral perfusion in the development of lesion burden and disease progression in multiple sclerosis (MS). Are well perfused regions of the brain are more likely to recover from inflammatory and/or demyelinating activity? Would such propensity translate into an anatomical prevalence of lesion persistence? The clinical disease course, prognosis, and response to treatment in patients with multiple sclerosis (MS) are highly variable and difficult to predict. The clinical subtypes of relapsing-remitting (RR) and secondary progressive (SP) are considered the early and late phases respectively of the MS disease course. Yet progression within these phases and conversion between them can vary greatly among individuals, and the pathological differences are poorly characterized. We hypothesize that sustained tissue damage results from lesion development in regions of anatomical and physiological susceptibility in which the environment is restrictive or prohibitive to normal reparative processes (e.g. resolution of inflammation, remyelination). We will specifically test if well perfused regions of the brain are more likely to recover from MS damage and therefore result in fewer persistent lesions over the course of disease progression. To this end, we will compare the spatial distribution of lesions in early (RR) and late (SP) MS patients and characterize lesion distribution in these two groups as a function of normal cerebral perfusion. The proposed work will be carried out on a retrospective dataset of a large cohort of MS patients stratified by clinical subtype (n = 1,607 RR, n = 495 SP). This project will provide important information regarding the spatial specificity of white matter lesions in the early and late stages of MS and how these distributions relate to the normal pattern of healthy perfusion.

描述（由申请人提供）： 本研究计划旨在研究脑灌注在多发性硬化症（MS）病变负荷发展和疾病进展中的作用。大脑灌注良好的区域是否更有可能从炎症和/或脱髓鞘活动中恢复？这种倾向会转化为病变持续存在的解剖学普遍性吗？多发性硬化症 (MS) 患者的临床病程、预后和治疗反应变化很大且难以预测。复发缓解型 (RR) 和继发进展型 (SP) 临床亚型分别被认为是 MS 病程的早期和晚期。然而，这些阶段内的进展以及它们之间的转换在个体之间可能存在很大差异，并且病理差异的特征很少。我们假设持续的组织损伤是由于解剖和生理易感区域的病变发展造成的，这些区域的环境限制或禁止正常的修复过程（例如炎症的消退、髓鞘再生）。我们将专门测试灌注良好的大脑区域是否更有可能从多发性硬化症损伤中恢复，从而在疾病进展过程中减少持续性病变。为此，我们将比较早期 (RR) 和晚期 (SP) MS 患者病变的空间分布，并将这两组患者的病变分布特征描述为正常脑灌注的函数。拟议的工作将在按临床亚型分层的大量 MS 患者的回顾性数据集上进行（n = 1,607 RR，n = 495 SP）。该项目将提供有关多发性硬化症早期和晚期白质病变空间特异性的重要信息，以及这些分布与正常健康灌注模式的关系。