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.