基于病变的断连组解释多发性硬化症的认知结果

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Jonadab dos Santos Silva, Claudia C. F. Vasconcelos, Carina T. Spedo, Carolina Alvarez Azevedo, Larissa C. S. Lopes, Francesco La Rosa, Carolina B. Moura, Osvaldo Nascimento, Fernanda Cristina Rueda Lopes
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引用次数: 0

摘要

背景和目的认知障碍在多发性硬化症(MS)中是常见和致残的,但很难用病变负担来解释。本研究旨在确定通过断连体量化的病变的间接影响是否比病变负荷更有效地解释多域认知缺陷,并确定这些缺陷背后的特定白质束。方法30例成人多发性硬化症患者完成多发性硬化症国际简易认知测试,包括加工速度(符号数字模态测试;SDMT)、言语记忆(加州言语学习测试- ii)和视觉空间记忆(视觉空间记忆简易测试修订;BVMT-R)。使用3张特斯拉流体衰减反演恢复图像对病变进行分割,并用于估计特定于束的断开,并生成体素方向的断开组图。通道特异性和体素分析用于识别与认知表现相关的断开模式。结果所有领域的认知功能受损(p < 0.001)。断连体体积是认知表现的重要独立决定因素(β = -0.41, p = 0.004),而病变体积则不是。通道特异性分析显示了明显的断开模式:较慢的SDMT与左后扣带相关(β = - 0.310, 95%可信区间[CI] [- 0.599, - 0.021]);较差的CVLT-II伴左弓状束(β = - 0.232, 95% CI [- 0.435, - 0.030]);右侧后扣带BVMT-R较低(β = - 0.218, 95% CI[- 0.383, - 0.054])。体素分析确定了断开体和认知表现之间最强关联的位置。结论病变驱动的断开连接是多发性硬化症认知障碍的一个更强大的决定因素,而断开连接组的定位可能有助于了解多发性硬化症认知障碍的间接网络水平机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Lesion-Based Disconnectome Explains Cognitive Outcomes in Multiple Sclerosis

Lesion-Based Disconnectome Explains Cognitive Outcomes in Multiple Sclerosis

Background and Purpose

Cognitive impairment is common and disabling in multiple sclerosis (MS), yet poorly explained by lesion burden. This study aimed to determine whether the indirect impact of lesions, quantified through disconnectomes, explains multidomain cognitive deficits more effectively than lesion load, and to identify specific white matter tracts underlying these deficits.

Methods

Thirty adults with MS completed the Brief International Cognitive Assessment for MS, covering processing speed (Symbol Digit Modalities Test; SDMT), verbal memory (California Verbal Learning Test-II; CVLT-II), and visuospatial memory (Brief Visuospatial Memory Test–Revised; BVMT-R). Lesions were segmented using 3 Tesla fluid-attenuated inversion recovery images and used to estimate tract-specific disconnections and generate voxel-wise disconnectome maps. Tract-specific and voxel-wise analyses were used to identify disconnection patterns associated with cognitive performance.

Results

Cognition was impaired across all domains (all p < 0.001). Disconnectome volume was a significant independent determinant of cognitive performance (β = –0.41, p = 0.004), whereas lesion volume was not. Tract-specific analyses revealed distinct disconnection patterns: slower SDMT was associated with left cingulum posterior (β = −0.310, 95% confidence interval [CI] [−0.599, −0.021]); poorer CVLT-II with left arcuate fasciculus (β = −0.232, 95% CI [−0.435, −0.030]); and lower BVMT-R with right cingulum posterior (β = −0.218, 95% CI [−0.383, −0.054]). Voxel-wise analyses identified where the strongest associations between disconnectomes and cognitive performance were located.

Conclusion

Lesion-driven disconnection is a more robust determinant of cognitive impairment in MS than lesion burden alone, and disconnectome mapping may help understand the indirect network-level mechanisms underlying cognitive deficits in MS.

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来源期刊
Journal of Neuroimaging
Journal of Neuroimaging 医学-核医学
CiteScore
4.70
自引率
0.00%
发文量
117
审稿时长
6-12 weeks
期刊介绍: Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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