Regional cerebellar atrophy related to disability and cognitive progression in multiple sclerosis

IF 3.4 2区医学 Q2 NEUROIMAGING

Neuroimage-Clinical Pub Date : 2025-01-01 DOI:10.1016/j.nicl.2025.103792

Myrte Strik , Iris Dekker , Aurélie Ruet , Hanneke Hulst , Mike P. Wattjes , Frederik Barkhof , Bernard Uitdehaag , Joep Killestein , Menno Schoonheim

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引用次数: 0

Abstract

Objective

The implications of cerebellar pathology on clinical disease progression in multiple sclerosis (MS) remain unclear. This study investigated regional cerebellar atrophy related to physical disability and cognitive impairment progression.

Methods

We included 331 MS patients and 95 controls (Amsterdam MS Cohort, 229 patients and 58 controls re-evaluated after 5 years). Assessments included baseline MRI, and disability and cognition at baseline and follow up. Cerebellar (sub)cortex was parcellated, volumetric data were determined and related to baseline disability and cognition. Longitudinal progression was explored only for regions with significant baseline correlations.

Results

At baseline, patients had mild disability (median EDSS 3.0) and 46% showing mild-to-severe cognitive impairment. At follow-up, 34.5% showed EDSS progression and 26.6% cognitive decline. All global and most regional volumes showed atrophy. Cross-sectionally, atrophy of several regions encompassing both anterior and posterior lobes correlated with both disability and cognition, while some correlated with EDSS only. Additionally, cerebellar nuclei only correlated with cognition. Cerebellar volumes were mainly related to information processing speed, working and verbal memory. Longitudinally, atrophy in the posterior lobe, lobule VI and VIIIb, and vermis VI, correlated with cognitive decline, while no variables correlated with disability progression.

Conclusion

Regional cerebellar atrophy in both anterior and posterior lobes correlated with disability and cognitive impairment. Posterior regional atrophy was correlated with longitudinal cognitive decline, but none correlated with disability progression. Further research is required to elucidate these relationships.

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局部小脑萎缩与多发性硬化症的残疾和认知进展有关

目的小脑病理学对多发性硬化症（MS）临床疾病进展的影响仍不清楚。本研究调查了与身体残疾和认知障碍进展相关的区域性小脑萎缩。方法我们纳入了331名多发性硬化症患者和95名对照组患者（阿姆斯特丹多发性硬化症队列，229名患者和58名对照组患者在5年后接受了重新评估）。评估包括基线磁共振成像、基线和随访时的残疾和认知情况。对小脑（亚）皮层进行切片，确定容积数据，并将其与基线残疾和认知能力联系起来。结果基线时，患者有轻度残疾（EDSS 中位数为 3.0），46% 的患者有轻度至重度认知障碍。在随访中，34.5%的患者出现 EDSS 进展，26.6%的患者出现认知功能下降。所有整体和大部分区域体积均出现萎缩。从横断面来看，包括前叶和后叶在内的多个区域的萎缩与残疾和认知能力均有关联，而有些区域的萎缩仅与EDSS相关。此外，小脑核只与认知能力相关。小脑体积主要与信息处理速度、工作记忆和言语记忆有关。纵向来看，小脑后叶、第VI小叶和第VIIIb小叶以及第VI蚓部的萎缩与认知能力下降相关，而没有变量与残疾进展相关。后叶区域性萎缩与纵向认知能力下降相关，但与残疾进展无相关性。要阐明这些关系，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.