Anatomical Distribution of Pathology in MS

本研究旨在探讨脑血流灌注在病变负荷发展过程中的作用。 多发性硬化症(MS)的疾病进展。大脑中血流良好的区域更有可能从 炎症和/或脱髓鞘活动？这种倾向会转化为解剖学上的病变流行吗？ 坚持不懈？多发性硬化症患者的临床病程、预后和治疗反应 变数很大，很难预测。复发缓解型和继发性进展型的临床亚型 (SP)分别被认为是MS病程的早期和晚期。然而，在这些方面取得进展 不同个体之间的时相和转换可能有很大差异，而且病理差异很小。 特色化的。我们假设，持续的组织损伤是由于解剖区域的病变发展造成的。 和生理敏感性，即环境对正常的修复过程是限制性的或禁止的(例如 炎症消退、髓鞘再生)。我们将专门测试大脑中血流良好的区域是否更有可能 从多发性硬化症的损害中恢复，因此在疾病进展过程中减少持续性损害。至 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 病变在这两组中的分布是正常脑血流灌注的函数。将开展拟议的工作 根据大量MS患者按临床亚型分层的回顾性数据集(n=1,607 RR，n=495 SP)。这 该项目将提供关于早期和晚期白质病变的空间特异性的重要信息 多发性硬化症的分期以及这些分布与正常的健康血流模式之间的关系。

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.