脊髓定量MRI诊断脊髓性肌萎缩症:疾病发展和治疗的敏感成像生物标志物。

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY
C Asteggiano, L Mazzocchi, L Farina, M Paoletti, L Barzaghi, E Caverzasi, S Parravicini, M I Dainesi, A Gardani, G Savini, N Bergsland, E Ballante, C A M Gandini Wheeler-Kingshott, A Berardinelli, A Pichiecchio
{"title":"脊髓定量MRI诊断脊髓性肌萎缩症:疾病发展和治疗的敏感成像生物标志物。","authors":"C Asteggiano, L Mazzocchi, L Farina, M Paoletti, L Barzaghi, E Caverzasi, S Parravicini, M I Dainesi, A Gardani, G Savini, N Bergsland, E Ballante, C A M Gandini Wheeler-Kingshott, A Berardinelli, A Pichiecchio","doi":"10.1007/s00415-025-13205-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Nusinersen is an approved disease-modifying therapy for spinal muscular atrophy (SMA), a rare neuromuscular disease characterized by degeneration of alpha motor neurons in the brainstem and spinal cord (SC), leading to progressive muscle atrophy and weakness. This exploratory study investigated the potential of quantitative SC magnetic resonance imaging (MRI) as a biomarker for monitoring treatment-related changes in pediatric and adult SMA patients treated with nusinersen at different disease stages.</p><p><strong>Methods: </strong>Five pediatric and three adult SMA patients underwent clinical assessments, including the Hammersmith Functional Motor Scale Expanded (HFMSE) and Revised Upper Limb Module (RULM), along with SC MRI at multiple time points (TPs) during nusinersen treatment. At each TP, total cross-sectional area (TCA), grey matter area (GM<sub>area</sub>), and magnetization transfer saturation (MT<sub>sat</sub>) were measured at multiple cervical SC levels.</p><p><strong>Results: </strong>All pediatric patients showed a progressive increase in SC TCA and GM<sub>area</sub> over time, paralleled by improvements in HFMSE and RULM scores. In contrast, adult patients exhibited stable SC MRI measures with modest functional gains. MT<sub>sat</sub> values remained largely stable across time points, with a mild decrease observed at TP5. TCA and GM<sub>area</sub> showed positive association trends with clinical scales.</p><p><strong>Conclusion: </strong>Nusinersen showed beneficial effects in both adult and pediatric SMA patients, with more marked improvements in children. Quantitative SC MRI metrics, especially TCA and GM<sub>area</sub>, reflected clinical trends and may serve as non-invasive biomarkers for monitoring treatment effects, pending validation in larger cohorts.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 7","pages":"475"},"PeriodicalIF":4.8000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187881/pdf/","citationCount":"0","resultStr":"{\"title\":\"Quantitative cervical cord MRI in spinal muscular atrophy: a sensitive imaging biomarker of disease evolution and treatment.\",\"authors\":\"C Asteggiano, L Mazzocchi, L Farina, M Paoletti, L Barzaghi, E Caverzasi, S Parravicini, M I Dainesi, A Gardani, G Savini, N Bergsland, E Ballante, C A M Gandini Wheeler-Kingshott, A Berardinelli, A Pichiecchio\",\"doi\":\"10.1007/s00415-025-13205-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Nusinersen is an approved disease-modifying therapy for spinal muscular atrophy (SMA), a rare neuromuscular disease characterized by degeneration of alpha motor neurons in the brainstem and spinal cord (SC), leading to progressive muscle atrophy and weakness. This exploratory study investigated the potential of quantitative SC magnetic resonance imaging (MRI) as a biomarker for monitoring treatment-related changes in pediatric and adult SMA patients treated with nusinersen at different disease stages.</p><p><strong>Methods: </strong>Five pediatric and three adult SMA patients underwent clinical assessments, including the Hammersmith Functional Motor Scale Expanded (HFMSE) and Revised Upper Limb Module (RULM), along with SC MRI at multiple time points (TPs) during nusinersen treatment. At each TP, total cross-sectional area (TCA), grey matter area (GM<sub>area</sub>), and magnetization transfer saturation (MT<sub>sat</sub>) were measured at multiple cervical SC levels.</p><p><strong>Results: </strong>All pediatric patients showed a progressive increase in SC TCA and GM<sub>area</sub> over time, paralleled by improvements in HFMSE and RULM scores. In contrast, adult patients exhibited stable SC MRI measures with modest functional gains. MT<sub>sat</sub> values remained largely stable across time points, with a mild decrease observed at TP5. TCA and GM<sub>area</sub> showed positive association trends with clinical scales.</p><p><strong>Conclusion: </strong>Nusinersen showed beneficial effects in both adult and pediatric SMA patients, with more marked improvements in children. Quantitative SC MRI metrics, especially TCA and GM<sub>area</sub>, reflected clinical trends and may serve as non-invasive biomarkers for monitoring treatment effects, pending validation in larger cohorts.</p>\",\"PeriodicalId\":16558,\"journal\":{\"name\":\"Journal of Neurology\",\"volume\":\"272 7\",\"pages\":\"475\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187881/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00415-025-13205-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-025-13205-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:Nusinersen是一种被批准用于治疗脊髓性肌萎缩症(SMA)的疾病改善疗法,脊髓性肌萎缩症是一种罕见的神经肌肉疾病,其特征是脑干和脊髓(SC)的α运动神经元变性,导致进行性肌肉萎缩和无力。本探索性研究探讨了定量SC磁共振成像(MRI)作为监测小儿和成人SMA患者在不同疾病阶段接受nusinersen治疗的治疗相关变化的生物标志物的潜力。方法:对5名儿童和3名成人SMA患者进行临床评估,包括Hammersmith功能运动量表扩展(HFMSE)和修订上肢模块(RULM),以及nusinersen治疗期间多个时间点(tp)的SC MRI。在每个TP,测量多个颈椎SC水平的总横截面积(TCA)、灰质面积(GMarea)和磁化转移饱和度(MTsat)。结果:随着时间的推移,所有儿科患者的SC TCA和GMarea都呈进行性增加,同时HFMSE和RULM评分也有所改善。相比之下,成年患者表现出稳定的SC MRI测量和适度的功能增益。MTsat值在各个时间点上基本保持稳定,TP5时观察到轻度下降。TCA和GMarea与临床量表呈显著正相关。结论:Nusinersen对成人和儿童SMA患者均有良好的疗效,其中对儿童的疗效更为显著。定量SC MRI指标,特别是TCA和GMarea,反映了临床趋势,可以作为监测治疗效果的非侵入性生物标志物,有待于在更大的队列中验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quantitative cervical cord MRI in spinal muscular atrophy: a sensitive imaging biomarker of disease evolution and treatment.

Background: Nusinersen is an approved disease-modifying therapy for spinal muscular atrophy (SMA), a rare neuromuscular disease characterized by degeneration of alpha motor neurons in the brainstem and spinal cord (SC), leading to progressive muscle atrophy and weakness. This exploratory study investigated the potential of quantitative SC magnetic resonance imaging (MRI) as a biomarker for monitoring treatment-related changes in pediatric and adult SMA patients treated with nusinersen at different disease stages.

Methods: Five pediatric and three adult SMA patients underwent clinical assessments, including the Hammersmith Functional Motor Scale Expanded (HFMSE) and Revised Upper Limb Module (RULM), along with SC MRI at multiple time points (TPs) during nusinersen treatment. At each TP, total cross-sectional area (TCA), grey matter area (GMarea), and magnetization transfer saturation (MTsat) were measured at multiple cervical SC levels.

Results: All pediatric patients showed a progressive increase in SC TCA and GMarea over time, paralleled by improvements in HFMSE and RULM scores. In contrast, adult patients exhibited stable SC MRI measures with modest functional gains. MTsat values remained largely stable across time points, with a mild decrease observed at TP5. TCA and GMarea showed positive association trends with clinical scales.

Conclusion: Nusinersen showed beneficial effects in both adult and pediatric SMA patients, with more marked improvements in children. Quantitative SC MRI metrics, especially TCA and GMarea, reflected clinical trends and may serve as non-invasive biomarkers for monitoring treatment effects, pending validation in larger cohorts.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信