Associations Between Findings From Myelin Water Imaging and Cognitive Performance Among Individuals With Multiple Sclerosis.

作者: Nathalie Ackermans , Jillian Chan , Helen Cross , Cornelia Laule , Adam Dvorak

DOI: 10.1001/JAMANETWORKOPEN.2020.14220

关键词:

摘要: Importance Cognitive impairment is a debilitating symptom of multiple sclerosis (MS) that affects up to 70% patients. An improved understanding the underlying pathology MS-related cognitive would provide considerable benefit patients and clinicians. Objective To determine whether there an association between myelin damage in tissue appears completely normal on standard clinical imaging, but can be detected by water imaging (MWI), with performance MS. Design, Setting, Participants In this cross-sectional study, participants MS controls underwent testing magnetic resonance (MRI) from August 23, 2017, February 20, 2019. were recruited through University British Columbia Hospital clinic via online recruitment advertisements local health authority websites. was performed clinic, MRI at adjacent academic research neuroimaging center. Seventy-three clinically definite fulfilling 2017 revised McDonald criteria for diagnosis 22 age-, sex-, education-matched healthy volunteers without neurological disease included study. Data analysis March November Exposures MWI 3 T 48-echo, 3-dimensional, gradient spin-echo (GRASE) sequence. assessments drawn batteries validated use Main Outcomes Measures The measures, measurement T2 relaxation signal bilayers providing specific marker myelin, test scores assessed using Pearson correlation. Three white matter regions interest-the cingulum, superior longitudinal fasciculus (SLF), corpus callosum-were selected priori according their known involvement impairment. Results For 95 total participants, mean (SD) age 49.33 (11.44) years. 50.2 (10.7) years 73 46.4 (13.5) controls. Forty-eight (66%) 14 (64%) women. education 14.7 (2.2) 15.8 (2.5) MS, significant associations observed measures Symbol Digit Modalities Test (SLF, r = -0.490; 95% CI, -0.697 -0.284; P < .001; callosum, r = -0.471; -0.680 -0.262; r = -0.419; -0.634 -0.205; P < .001), Selective Reminding r = -0.444; -0.660 -0.217; r = -0.411; -0.630 -0.181; P = .001; r = -0.361; -0.602 -0.130; P = .003), Controlled Oral Word Association r = -0.317; -0.549 -0.078; P = .01; r = -0.335; -0.658 -0.113; P = .006). No found Conclusions Relevance This study used demonstrate otherwise normal-appearing brain diffusely damaged findings suggest are associated performance. offers vivo biomarker feasible trials investigating cognition, means monitoring changes myelination its worsening or improvement.

参考文章(49)
M. Inglese, Maxim Bester, Diffusion imaging in multiple sclerosis: research and clinical implications NMR in Biomedicine. ,vol. 23, pp. 865- 872 ,(2010) , 10.1002/NBM.1515
C. Thomsen, O. Henriksen, P. Ring, In Vivo Measurement of Water Self Diffusion in the Human Brain by Magnetic Resonance Imaging Acta Radiologica. ,vol. 28, pp. 353- 361 ,(1987) , 10.1177/028418518702800324
Aurélie Ruet, Mathilde Deloire, Delphine Hamel, Jean-Christophe Ouallet, Klaus Petry, Bruno Brochet, Cognitive impairment, health-related quality of life and vocational status at early stages of multiple sclerosis: a 7-year longitudinal study. Journal of Neurology. ,vol. 260, pp. 776- 784 ,(2013) , 10.1007/S00415-012-6705-1
Thomas Prasloski, Burkhard Mädler, Qing-San Xiang, Alex MacKay, Craig Jones, Applications of stimulated echo correction to multicomponent T2 analysis Magnetic Resonance in Medicine. ,vol. 67, pp. 1803- 1814 ,(2012) , 10.1002/MRM.23157
Bertrand Audoin, Jean-Philippe Ranjeva, Patrick Viout, Irina Malikova, Sylviane Confort-Gouny, Patrick Cozzone, My Van Au Duong, Elisabeth Soulier, Danielle Ibarrola, Jean Pelletier, André Ali-Chérif, Local Tissue Damage Assessed with Statistical Mapping Analysis of Brain Magnetization Transfer Ratio: Relationship with Functional Status of Patients in the Earliest Stage of Multiple Sclerosis American Journal of Neuroradiology. ,vol. 26, pp. 119- 127 ,(2005)
Ralph H.B. Benedict, Jill S. Fischer, Cate J. Archibald, Peter A. Arnett, William W. Beatty, Julie Bobholz, Gordon J. Chelune, John D. Fisk, Dawn W. Langdon, Lauren Caruso, Fred Foley, Nicholas G. LaRocca, Lindsey Vowels, Amy Weinstein, John DeLuca, Stephen M. Rao, Frederick Munschauer, Minimal Neuropsychological Assessment of MS Patients: A Consensus Approach The Clinical Neuropsychologist. ,vol. 16, pp. 381- 397 ,(2002) , 10.1076/CLIN.16.3.381.13859
Lauren Strober, Nancy Chiaravalloti, Nancy Moore, John DeLuca, Unemployment in multiple sclerosis (MS): utility of the MS Functional Composite and cognitive testing Multiple Sclerosis Journal. ,vol. 20, pp. 112- 115 ,(2014) , 10.1177/1352458513488235
Derek K. Jones, Thomas R. Knösche, Robert Turner, White matter integrity, fiber count, and other fallacies: The do's and don'ts of diffusion MRI NeuroImage. ,vol. 73, pp. 239- 254 ,(2013) , 10.1016/J.NEUROIMAGE.2012.06.081
Nancy D Chiaravalloti, John DeLuca, Cognitive impairment in multiple sclerosis Lancet Neurology. ,vol. 7, pp. 1139- 1151 ,(2008) , 10.1016/S1474-4422(08)70259-X