Chronic active lesions preferentially localize in watershed territories in multiple sclerosis.

IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Annals of Clinical and Translational Neurology Pub Date : 2024-10-24 DOI:10.1002/acn3.52202
Ahmad A Toubasi, Jarrod J Eisma, Jiacheng Wang, Habeeb F Kazimuddin, Bryan Hernandez, Taegan Vinarsky, Caroline Gheen, Zachary Rohm, Carynn Koch, Margareta A Clarke, Rachael Cheek, John Kramer, James Eaton, Manus J Donahue, Francesca Bagnato
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Abstract

Objective: Paramagnetic rim lesions (PRLs) are a biomarker of chronic active lesions (CALs), and an important driver of neurological disability in multiple sclerosis (MS). The reason subtending some acute lesions evolvement into CALs is not known. Here we ask whether a relatively lower oxygen content is linked to CALs.

Methods: In this prospective cross-sectional study, 64 people with multiple sclerosis (PwMS), clinically isolated syndrome and radiologically isolated syndrome underwent a 7.0 Tesla (7 T) brain magnetic resonance imaging (MRI). The scanning protocol included a T2-w fluid-attenuated inversion recovery (FLAIR), and a single echo gradient echo from which susceptibility-weighted imaging (SWI) was derived. WM lesions were identified on the T2-w-FLAIR whilst PRLs were identified on the SWI sequence. T2-lesions were classified as PRLs and rimless lesions (PRLs-). We registered a universal vascular atlas to each subject's T2-w-FLAIR and classified each T2-lesions according to its location into watershed- (ws), non-watershed- (nws), and mixed-lesion (m). Ws-lesions were defined as lesions that were fully located in a region between the territories of two major arteries.

Results: Out of 1,975 T2-lesions, 88 (4.5%) were PRLs. Ws-regions had a higher number (p = 0.005) and proportion (p < 0.001) of PRLs- compared to nws-regions. Ws-PRL- were larger compared to nws-ones (p = 0.009). The number (p = 0.043) and proportion (p < 0.001) of PRLs was higher in ws-regions compared to nws-ones. Ws-PRLs were not significantly larger than nws-ones (p = 0.195).

Interpretation: We propose the novel concept of a link between arterial vascularization and chronic activity in MS by demonstrating a preferential localization of CALs in ws-territories.

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多发性硬化症患者的慢性活动性病灶优先分布在分水岭区域。
目的:顺磁边缘病变(PRLs)是慢性活动性病变(CALs)的生物标志物,也是多发性硬化症(MS)神经残疾的重要驱动因素。一些急性病变演变为慢性活动性病变的原因尚不清楚。在此,我们想知道相对较低的氧含量是否与 CALs 有关:在这项前瞻性横断面研究中,64 名患有多发性硬化症(PwMS)、临床孤立综合征和放射学孤立综合征的患者接受了 7.0 特斯拉(7 T)脑磁共振成像(MRI)检查。扫描方案包括 T2-w 液体衰减反转恢复(FLAIR)和单回波梯度回波,并由此得出感度加权成像(SWI)。在T2-w-FLAIR上确定WM病变,而在SWI序列上确定PRL。T2 病变分为 PRLs 和无缘病变(PRLs-)。我们将通用血管图谱登记到每个受试者的 T2-w-FLAIR 上,并根据每个 T2- 病变的位置将其分为分水岭病变 (ws)、非分水岭病变 (nws) 和混合病变 (m)。Ws病变被定义为病变完全位于两条主要动脉区域之间的区域:在1,975个T2病变中,88个(4.5%)是PRL。Ws-区域的数量(p = 0.005)和比例(p)均较高:我们提出了一个新概念,即动脉血管化与多发性硬化症的慢性活动之间存在联系,并证明了CALs在Ws-区域的优先定位。
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来源期刊
Annals of Clinical and Translational Neurology
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.
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