探讨临床孤立综合征(CIS)和多发性硬化(MS)的富俱乐部组织,并描述其与身体残疾和认知障碍的关系。
我们在41CIS中构建了高分辨率白质(WM)结构网络,使用扩散MRI和确定性纤维束成像的32个MS和35个健康对照(HC)。富人俱乐部组织中的群体差异,研究了全球和本地网络指标。改变后的网络度量之间的关系,脑损伤和临床变量,包括EDSS,MMSE,PASAT,计算疾病持续时间。此外,使用不同的分割方案进行可重复性分析.
与HC相比,MS患者在所有类型的连接中表现出强度降低(富球杆:p<0.0001;喂食器:p=0.0004;和局部:p=0.0026)。CIS患者在MS患者和HC之间显示出中间值,并且在喂食器和局部连接中显示出强度降低(喂食器:p=0.019;局部:p=0.031),但在丰富的俱乐部连接中没有。与CIS患者相比,MS患者的富俱乐部连接显着减少(p=0.0004)。在MS组中,丰富的俱乐部和饲养者连接的强度降低与认知障碍相关。这些结果与病变分布无关,并且在不同的脑分割方案中可重复。
富人俱乐部组织在MS患者中被破坏,在CIS.MS的富俱乐部连通性中断与认知障碍相关。这些发现表明,受损的富俱乐部连通性是渐进结构网络破坏的基本特征,预示着MS临床残疾的发展。
To investigate the rich-club organization in clinically isolated syndrome (CIS) and multiple sclerosis (MS), and to characterize its relationships with physical disabilities and cognitive impairments.
We constructed high-resolution white matter (WM) structural networks in 41 CIS, 32 MS and 35 healthy controls (HCs) using diffusion MRI and deterministic tractography. Group differences in rich-club organization, global and local network metrics were investigated. The relationship between the altered network metrics, brain lesions and clinical variables including EDSS, MMSE, PASAT, disease duration were calculated. Additionally, reproducibility analysis was performed using different parcellation schemes.
Compared with HCs, MS patients exhibited a decreased strength in all types of connections (rich-club: p < 0.0001; feeder: p = 0.0004; and local: p = 0.0026). CIS patients showed intermediate values between MS patients and HCs and exhibited a decreased strength in feeder and local connections (feeder: p = 0.019; and local: p = 0.031) but not in rich-club connections. Compared with CIS patients, MS patients showed significant reductions in rich-club connections (p = 0.0004). The reduced strength of rich-club and feeder connections was correlated with cognitive impairments in the MS group. These results were independent of lesion distribution and reproducible across different brain parcellation schemes.
The rich-club organization was disrupted in MS patients and relatively preserved in CIS. The disrupted rich-club connectivity was correlated with cognitive impairment in MS. These findings suggest that impaired rich-club connectivity is an essential feature of progressive structural network disruption, heralding the development of clinical disability in MS.