视神经脊髓炎谱系障碍与多发性硬化症脊髓白质、灰质扩散异常无差异(P4.151)

摘要

目的:探讨视神经脊髓炎谱系障碍(NMOSD)患者脊髓灰质(GM)和白质(WM)的微观结构变化，并与多发性硬化症(MS)患者进行比较。背景:NMOSD和MS对脊髓的影响可能不同。弥散张量成像(Diffusion tensor imaging, DTI)可以在体内反映脊髓的病理受累情况。方法:我们招募了18例NMOSD患者(除2例外均为aqp4抗体阳性)，18例复发缓解型MS患者和22例健康对照(hc)。平均年龄(NMOSD=52岁[±11]，MS=42岁[±10]，HCs=34岁[±10])。平均病程(NMOSD=8.9年[±6.5]，MS=8.8[±7.1])。所有受试者均行3T MRI，测量脊髓横截面积(CCA)和DTI指标(FA:扩散各向异性;AD/RD:沿神经纤维的扩散量;MD: GM和WM(后柱和侧柱)的平均扩散量)。使用扩展残疾状态量表、9孔钉测试(HPT)、时间-25英尺行走测试、握力和振动感知评估身体残疾。 We used ANOVA to compare imaging measures and Spearman-correlation (r) to explore association between DTI and clinical measures. Statistics with p-values<0.05 were reported as significant. RESULTS: We detected: smaller CCA in NMOSD than HCs (mean=75.6 mm²[±11.4] vs. 85.8[±11.4]) and in MS than HCs (76.5mm²[±11] vs. 85.8[±11.4]), with no significant difference between patient groups; CCA reduced with longer disease-duration (r=-0.58) in NMOSD, and with worse disability (9-HPT test r=-0.51, handgrip-strength r=0.47) in MS. Compared to HCs, NMOSD patients showed reduced FA in GM and posterior-WM; higher RD in posterior-WM and AD in lateral-WM. MS patients had lower FA in the lateral-WM than HC. No difference in diffusion measures between patient groups was seen. In NMOSD, FA and RD of the posterior-WM were associated with worse vibration-perception (r=-0.63 and 0.52, respectively). CONCLUSION: Pathological involvement of spinal cord, as reflected by DTI, does not differ between NMOSD and MS. In NMOSD patients diffusion abnormalities in the posterior-WM may contribute to physical disability.

披露:科尔特斯医生没什么可说的。马诺莱医生没什么好说的。德·安吉利斯医生没什么好说的。埃沙吉医生没什么可透露的。格鲁苏博士没什么可透露的。普拉多斯医生没什么好说的。乌尔瑟林医生没什么可透露的。伊安纳卡斯医生没什么可透露的。迪斯索医生没什么可透露的。米勒医生没什么可说的。 Dr. Gandini Wheeler-Kingshott has nothing to disclose. Dr. Ciccarelli has received personal compensation for activities with Novartis, Biogen and GE as a consultant.