Investigating cortical hypoxia in multiple sclerosis via time-domain near-infrared spectroscopy

IF 4.4 2区医学 Q1 CLINICAL NEUROLOGY Annals of Clinical and Translational Neurology Pub Date : 2024-07-22 DOI:10.1002/acn3.52150

Thomas Williams, Frédéric Lange, Kenneth J. Smith, Ilias Tachtsidis, Jeremy Chataway

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Abstract

Objectives

Hypoperfusion and tissue hypoxia have been implicated as contributory mechanisms in the neuropathology of multiple sclerosis (MS). Our objective has been to study cortical oxygenation in vivo in patients with MS and age-matched controls.

Methods

A custom, multiwavelength time-domain near-infrared spectroscopy system was developed for assessing tissue hypoxia from the prefrontal cortex. A cross-sectional case–control study was undertaken assessing patients with secondary progressive MS (SPMS) and age-matched controls. Co-registered magnetic resonance imaging was used to verify the location from which near-infrared spectroscopy data were obtained through Monte Carlo simulations of photon propagation. Additional clinical assessments of MS disease severity were carried out by trained neurologists. Linear mixed effect models were used to compare cortical oxygenation between cases and controls, and against measures of MS severity.

Results

Thirty-three patients with secondary progressive MS (median expanded disability status scale 6 [IQR: 5–6.5]; median age 53.0 [IQR: 49–58]) and 20 age-matched controls were recruited. Modeling of photon propagation confirmed spectroscopy data were obtained from the prefrontal cortex. Patients with SPMS had significantly lower cortical hemoglobin oxygenation compared with controls (−6.0% [95% CI: −10.0 to −1.9], P = 0.004). There were no significant associations between cortical oxygenation and MS severity.

Interpretation

Using an advanced, multiwavelength time-domain near-infrared spectroscopy system, we demonstrate that patients with SPMS have lower cortical oxygenation compared with controls.

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通过时域近红外光谱仪研究多发性硬化症患者的皮质缺氧状况。

目的：低灌注和组织缺氧被认为是多发性硬化症（MS）神经病理学的促成机制。我们的目标是研究多发性硬化症患者和年龄匹配的对照组的体内皮质氧含量：方法：我们开发了一套定制的多波长时域近红外光谱仪系统，用于评估前额叶皮层组织缺氧情况。对继发性进行性多发性硬化症（SPMS）患者和年龄匹配的对照组进行了横断面病例对照研究。通过对光子传播进行蒙特卡洛模拟，使用共聚焦磁共振成像来验证获取近红外光谱数据的位置。训练有素的神经学家对多发性硬化症的疾病严重程度进行了额外的临床评估。线性混合效应模型用于比较病例与对照组之间的皮质氧合情况，以及与多发性硬化症严重程度的测量结果：结果：共招募了 33 名继发性进行性多发性硬化症患者（中位数扩展残疾状态量表 6 [IQR：5-6.5]；中位数年龄 53.0 [IQR：49-58]）和 20 名年龄匹配的对照组患者。光子传播模型证实了从前额叶皮层获得的光谱数据。与对照组相比，SPMS 患者的皮质血红蛋白含氧量明显较低（-6.0% [95% CI：-10.0 至-1.9]，P = 0.004）。皮质血红蛋白含氧量与多发性硬化症的严重程度无明显关联：我们利用先进的多波长时域近红外光谱仪系统证明，与对照组相比，SPMS 患者的皮质氧合较低。

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来源期刊

Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)

CiteScore

9.10

自引率

1.90%

发文量

218

审稿时长

8 weeks

期刊介绍： Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.