Quantitative Susceptibility Mapping Values Quantification in Deep Gray Matter Structures for Relapsing-Remitting Multiple Sclerosis: A Systematic Review and Meta-Analysis

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES Brain and Behavior Pub Date : 2024-10-17 DOI:10.1002/brb3.70093

Sana Mohammadi, Sadegh Ghaderi, Farzad Fatehi

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Abstract

Background/Objectives

This systematic review and meta-analysis aimed to investigate the role of magnetic susceptibility (χ) in deep gray matter (DGM) structures, including the putamen (PUT), globus pallidus (GP), caudate nucleus (CN), and thalamus, in the most common types of multiple sclerosis (MS) and relapsing-remitting MS (RRMS), using quantitative susceptibility mapping (QSM).

Methods

The literature was systematically reviewed up to November 2023, adhering to PRISMA guidelines. This study was conducted using a random-effects model to calculate the standardized mean difference (SMD) in QSM values between patients with RRMS and healthy controls (HCs). Publication bias and risk of bias were also assessed.

Results

Nine studies involving 1074 RRMS patients with RRMS and 640 HCs were included in the meta-analysis. The results showed significantly higher QSM (χ) values in the PUT (SMD = 0.40, 95% confidence interval [CI] = 0.22–0.59, p = .000), GP (SMD = 0.60, 95% CI = 0.50–0.70, p = .00), and CN (SMD = 0.40, 95% CI = 0.15–0.66, p = .005) of RRMS patients compared to HCs. However, there were no significant differences in the QSM values in the thalamus between patients with RRMS and HCs (SMD = −0.33, 95% CI −0.67–0.01, p = .026). Age- and sex-based subgroup analysis demonstrated that younger patients (< 40 years) in the PUT, GP, and CN groups and larger male populations (> 25%) in the PUT and GP groups had more significant χ. Interestingly, thalamic QSM values were found to decrease in RRMS patients over 40 years of age and in higher male populations. Sex-based subgroup analysis indicated higher iron levels in the PUT and GP of RRMS patients regardless of sex. QSM values were higher in certain brain regions (PUT, GP, and CN) during the early stages (disease duration < 9.6 years) of RRMS, but lower in the thalamus during the later stages (disease duration > 9.6 years) than HCs.

Discussion/Conclusion

QSM may serve as a biomarker for understanding χ value alterations such as iron dysregulation and its contribution to neurodegeneration in RRMS, especially in the basal ganglia nuclei including PUT, GP, and CN.

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复发性多发性硬化症深灰质结构的定量易感性图谱数值定量：系统回顾与元分析

背景/目的本系统综述和荟萃分析旨在利用磁感应强度定量图谱（QSM）研究深部灰质（DGM）结构中磁感应强度（χ）的作用，这些结构包括最常见类型的多发性硬化症（MS）和复发缓解型多发性硬化症（RRMS）中的普妥门（PUT）、苍白球（GP）、尾状核（CN）和丘脑。方法按照PRISMA指南，系统回顾了截至2023年11月的文献。本研究采用随机效应模型计算 RRMS 患者与健康对照（HCs）之间 QSM 值的标准化平均差（SMD）。同时还评估了发表偏倚和偏倚风险。结果本次荟萃分析共纳入了9项研究，涉及1074名RRMS患者和640名健康对照者。结果显示，与健康人相比，RRMS 患者的 PUT（SMD = 0.40，95% 置信区间 [CI] = 0.22-0.59，p = .000）、GP（SMD = 0.60，95% CI = 0.50-0.70，p = .00）和 CN（SMD = 0.40，95% CI = 0.15-0.66，p = .005）的 QSM (χ) 值明显更高。然而，RRMS患者和HC患者丘脑的QSM值没有明显差异（SMD = -0.33，95% CI -0.67-0.01，p = .026）。基于年龄和性别的亚组分析表明，PUT 组、GP 组和 CN 组中较年轻的患者（< 40 岁）以及 PUT 组和 GP 组中较大的男性群体（> 25%）具有更显著的 χ。有趣的是，在年龄超过 40 岁的 RRMS 患者和较高的男性人群中，丘脑 QSM 值下降。基于性别的亚组分析表明，RRMS 患者的 PUT 和 GP 中的铁含量较高，与性别无关。在 RRMS 的早期阶段（病程为 9.6 年），某些脑区（PUT、GP 和 CN）的 QSM 值较高，但在后期阶段（病程为 9.6 年），丘脑的 QSM 值低于 HCs。讨论/结论 QSM可作为一种生物标记物，用于了解RRMS的χ值改变（如铁失调）及其对神经退行性变的贡献，尤其是在基底节核（包括PUT、GP和CN）中。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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