背景:多发性硬化皮质病变是脱髓鞘和神经轴突丢失的区域。视网膜层厚度,用光学相干断层扫描(OCT)测量,是神经轴突丢失的新兴生物标志物。研究已经报道了在确定的多发性硬化症中皮质病变和视网膜层变薄之间的相关性,暗示了一个共同的病理生理过程。这里,我们评估了多发性硬化症发作时皮质病变与OCT指标之间的相关性,检查,第一次,与身体或认知障碍有关。
目的:为了检查皮质病变之间的关系,视神经和视网膜层厚度,以及第一次脱髓鞘事件时的身体和认知障碍。
方法:39例患者和22例对照者接受了3T-MRI,光学相干层析成像,和临床试验。我们在相敏反转恢复序列上确定了皮质病变,包括枕骨皮质病变.我们测量了估计的颅内总体积和白质病变体积。OCT指标包括乳头周围视网膜神经纤维层(pRNFL),神经节细胞和内部丛状层(GCIPL)和内部核层(INL)的厚度。
结果:较高的总皮质和白质皮质病变体积与较薄的pRNFL相关(B=-0.0005,95%CI-0.0008至-0.0001,p=0.01;B=-0.0005,95%CI-0.0008至-0.0001,p=0.01)。白皮质病变数量与色觉缺陷相关(B=0.58,95CI0.039至1,11,p=0.036)。较小的GCIPL与较高的扩展残疾状态量表相关(B=-0.06,95%CI-1.1至-0.008,p=0.026)。MS诊断(n=18)与较高的皮质和白质皮质病变数量(p=0.004和p=0.003)相关,较薄的GCIPL(p=0.029)和INL(p=0.041)。
结论:皮质病变与视神经轴突损伤之间的关联加强了神经退行性过程在MS发病机制中的作用。
BACKGROUND: Multiple sclerosis cortical lesions are areas of demyelination and neuroaxonal loss. Retinal layer thickness, measured with optical coherence tomography (OCT), is an emerging biomarker of neuroaxonal loss. Studies have reported correlations between cortical lesions and retinal layer thinning in established multiple sclerosis, suggesting a shared pathophysiological process. Here, we assessed the correlation between cortical lesions and OCT metrics at the onset of multiple sclerosis, examining, for the first time, associations with physical or cognitive disability.
OBJECTIVE: To examine the relationship between cortical lesions, optic nerve and retinal layer thicknesses, and physical and cognitive disability at the first demyelinating event.
METHODS: Thirty-nine patients and 22 controls underwent 3T-MRI, optical coherence tomography, and clinical tests. We identified cortical lesions on phase-sensitive inversion recovery sequences, including occipital cortex lesions. We measured the estimated total intracranial volume and the white matter lesion volume. OCT metrics included peripapillary retinal nerve fibre layer (pRNFL), ganglion cell and inner plexiform layer (GCIPL) and inner nuclear layer (INL) thicknesses.
RESULTS: Higher total cortical and leukocortical lesion volumes correlated with thinner pRNFL (B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01; B = -0.0005, 95 % CI -0.0008 to -0.0001, p = 0.01, respectively). Leukocortical lesion number correlated with colour vision deficits (B = 0.58, 95 %CI 0.039 to 1,11, p = 0.036). Thinner GCIPL correlated with a higher Expanded Disability Status Scale (B = -0.06, 95 % CI -1.1 to -0.008, p = 0.026). MS diagnosis (n = 18) correlated with higher cortical and leukocortical lesion numbers (p = 0.004 and p = 0.003), thinner GCIPL (p = 0.029) and INL (p = 0.041).
CONCLUSIONS: The association between cortical lesions and axonal damage in the optic nerve reinforces the role of neurodegenerative processes in MS pathogenesis at onset.