OBJECTIVE: To identify neuroimaging and molecular biomarker characteristics that distinguish SD/SN from DDM-CD progressive pwMS.
METHODS: This study was carried at SN facility and at a tertiary MS center. The study collected clinical, molecular (serum neurofilament light chain, sNfL and glial acidic fibrillary protein, sGFAP) and MRI quantitative lesion-, brain volume-, and tissue integrity-derived measures. Statistical analyses were controlled for multiple comparisons.
RESULTS: 42 SD/SN and 42 DDM-CD were enrolled. SD/SN pwMS showed significantly lower cortical volume (CV) (p < 0.001, d = 1.375) and thalamic volume (p < 0.001, d = 0.972) compared to DDM-CD pwMS. In a logistic stepwise regression model, the SD/SN pwMS were best differentiated from the DDM-CD pwMS by lower CV (p < 0.001) as the only significant predictor, with the accuracy of 82.3%. No significant differences between the two groups were observed for medulla oblongata volume, a proxy for spinal cord atrophy and white matter lesion burden, while there was a statistical trend for numerically higher sGFAP in SD/SN pwMS.
CONCLUSIONS: The CASA-MS study showed significantly more gray matter atrophy in severe compared to less-severe progressive MS.
目的:确定区分SD/SN和DDM-CD进行性pwMS的神经影像学和分子生物学特征。
方法:本研究在SN机构和三级MS中心进行。这项研究收集了临床,分子(血清神经丝轻链,sNfL和胶质酸性原纤维蛋白,sGFAP)和MRI定量病变-,大脑容量-,和组织完整性衍生的措施。对统计分析进行多重比较。
结果:纳入42SD/SN和42DDM-CD。与DDM-CDpwMS相比,SD/SNpwMS显示出明显较低的皮质体积(CV)(p<0.001,d=1.375)和丘脑体积(p<0.001,d=0.972)。在逻辑逐步回归模型中,SD/SNpwMS与DDM-CDpwMS的最佳区别在于较低的CV(p<0.001)作为唯一显著的预测因子,准确率为82.3%。两组延髓体积无显著差异,脊髓萎缩和白质病变负担的代表,而SD/SNpwMS中sGFAP数值较高存在统计趋势。
结论:CASA-MS研究显示,与不太严重的进行性MS相比,重度患者的灰质萎缩明显更多。