Paolo Preziosa, Elisabetta Pagani, Alessandro Meani, Monica Margoni, Martina Rubin, Federica Esposito, Marco Palombo, Massimo Filippi, Maria A Rocca
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Using SANDI, the fractions of neurite (f<sub>neurite</sub>) and soma (f<sub>soma</sub>) and size of soma (r<sub>soma</sub>) were quantified in PRLs (including their core and rim separately), and core-sign lesions identified on SWI-phase.</p><p><strong>Results: </strong>Among 1811 WMLs, 122 (6.7%) core-sign lesions and 97 (5.4%) PRLs were identified. Compared to HC and MS normal-appearing white matter, all MS WML showed significantly lower f<sub>neurite</sub> and f<sub>soma</sub> and higher r<sub>soma</sub> (FDR-p < 0.001). Compared to SWI-isointense WML, core-sign lesions showed a significantly higher f<sub>neurite</sub>, and lower f<sub>soma</sub> and r<sub>soma</sub> (FDR-p ≤ 0.005). Compared to SWI-isointense WML and core-sign lesions, PRLs showed a significantly lower f<sub>neurite</sub>, higher f<sub>soma,</sub> and higher r<sub>soma</sub> (FDR-p ≤ 0.001). The PRL-core showed significantly lower f<sub>neurite</sub>, and higher r<sub>soma</sub> than PRL-rim (FDR-p < 0.001). Lower PRL f<sub>neurite</sub> (β ≤ -0.006, FDR-p ≤ 0.015) and higher r<sub>soma</sub> (β ≥ 0.032, FDR-p ≤ 0.024) were significantly associated with a longer disease duration and more severe disability.</p><p><strong>Conclusions: </strong>In PRLs, the significant and clinically relevant neurite loss and increased soma fraction and size possibly reflect increased astrogliosis and activated microglia. 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Using SANDI, the fractions of neurite (f<sub>neurite</sub>) and soma (f<sub>soma</sub>) and size of soma (r<sub>soma</sub>) were quantified in PRLs (including their core and rim separately), and core-sign lesions identified on SWI-phase.</p><p><strong>Results: </strong>Among 1811 WMLs, 122 (6.7%) core-sign lesions and 97 (5.4%) PRLs were identified. Compared to HC and MS normal-appearing white matter, all MS WML showed significantly lower f<sub>neurite</sub> and f<sub>soma</sub> and higher r<sub>soma</sub> (FDR-p < 0.001). Compared to SWI-isointense WML, core-sign lesions showed a significantly higher f<sub>neurite</sub>, and lower f<sub>soma</sub> and r<sub>soma</sub> (FDR-p ≤ 0.005). Compared to SWI-isointense WML and core-sign lesions, PRLs showed a significantly lower f<sub>neurite</sub>, higher f<sub>soma,</sub> and higher r<sub>soma</sub> (FDR-p ≤ 0.001). The PRL-core showed significantly lower f<sub>neurite</sub>, and higher r<sub>soma</sub> than PRL-rim (FDR-p < 0.001). 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引用次数: 0
摘要
背景：在多发性硬化症（MS）中，敏感性加权成像（SWI）可显示具有顺磁边缘的白质病变（“顺磁边缘病变”[PRLs]）或弥漫性低密度病变（“核心征病变”），反映WML发展的不同阶段。目的：利用弥散加权磁共振成像（MRI）的soma and neurite density imaging （SANDI）模型，对MS prl和核心征象病变的显微结构异常及其临床意义进行分析。方法：40例MS患者和20例健康对照（HC）行3t脑MRI检查。利用SANDI定量prl（分别包括其核心和边缘）中神经突（fneurite）和躯体（fsoma）的组成和躯体（rsoma）的大小，并在wi - fi期识别核心征病变。结果：在1811例wml中，鉴定出122例（6.7%）核心征象病变，97例（5.4%）prl病变。与HC和MS正常白质相比，所有MS WML的神经突和fsoma均明显降低，rsoma较高（FDR-p神经突，FDR-p≤0.005）。与wi - fi等强度WML和核心征病变相比，prl表现出明显较低的神经鞘突、较高的fsoma和较高的rsoma （FDR-p≤0.001）。PRL-core的神经突突明显低于PRL-rim， rsoma高于PRL-rim (FDR-p神经突（β≤-0.006,FDR-p≤0.015）和rsoma较高（β≥0.032,FDR-p≤0.024）与病程延长和残疾加重相关。结论：在prl中，显著的和临床相关的神经突丢失和体细胞分数和大小的增加可能反映了星形胶质细胞增生和激活的小胶质细胞。核心征病变表现为较轻的轴突丧失、小胶质细胞密度和星形胶质增生，支持其破坏性较小的性质。
Soma and neurite density abnormalities of paramagnetic rim lesions and core-sign lesions in multiple sclerosis.
Background: In multiple sclerosis (MS), susceptibility-weighted imaging (SWI) may reveal white matter lesions (WML) with a paramagnetic rim ("paramagnetic rim lesions" [PRLs]) or diffuse hypointensity ("core-sign lesions"), reflecting different stages of WML evolution.
Objective: Using the soma and neurite density imaging (SANDI) model on diffusion-weighted magnetic resonance imaging (MRI), we characterized microstructural abnormalities of MS PRLs and core-sign lesions and their clinical relevance.
Methods: Forty MS patients and 20 healthy controls (HC) underwent a 3 T brain MRI. Using SANDI, the fractions of neurite (fneurite) and soma (fsoma) and size of soma (rsoma) were quantified in PRLs (including their core and rim separately), and core-sign lesions identified on SWI-phase.
Results: Among 1811 WMLs, 122 (6.7%) core-sign lesions and 97 (5.4%) PRLs were identified. Compared to HC and MS normal-appearing white matter, all MS WML showed significantly lower fneurite and fsoma and higher rsoma (FDR-p < 0.001). Compared to SWI-isointense WML, core-sign lesions showed a significantly higher fneurite, and lower fsoma and rsoma (FDR-p ≤ 0.005). Compared to SWI-isointense WML and core-sign lesions, PRLs showed a significantly lower fneurite, higher fsoma, and higher rsoma (FDR-p ≤ 0.001). The PRL-core showed significantly lower fneurite, and higher rsoma than PRL-rim (FDR-p < 0.001). Lower PRL fneurite (β ≤ -0.006, FDR-p ≤ 0.015) and higher rsoma (β ≥ 0.032, FDR-p ≤ 0.024) were significantly associated with a longer disease duration and more severe disability.
Conclusions: In PRLs, the significant and clinically relevant neurite loss and increased soma fraction and size possibly reflect increased astrogliosis and activated microglia. Core-sign lesions exhibit milder axonal loss, microglia density and astrogliosis, supporting their less destructive nature.
期刊介绍：
The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field.
In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials.
Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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