423 多发性硬化症患者护理的创新:将认知健康与髓鞘完整性联系起来

IF 2.1 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Journal of Clinical and Translational Science Pub Date : 2024-04-03 DOI:10.1017/cts.2024.365
Ashley Pike, GA James, ML Calvert, CD Kilts, RL Archer, T Wolfe
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引用次数: 0

摘要

目的/目标:我们的目标是开发一款方便患者使用的应用程序,以解决多发性硬化症(MS)患者认知障碍发展的问题。这一举措旨在通过为每位患者生成认知健康脑图,加强对多发性硬化症这一主要合并症的个性化护理和精确管理。方法/研究对象:我们正在使用 UAMS COMS 数据库(该数据库具有高分辨率多对比 MRI)以及全面的临床、行为和人口学数据集,开发一种基于分层学习的软件工具,以计算大脑结构-功能和个人认知功能的相关图谱。我们的磁共振成像分析采用了三室模型(NNLS>0.96)。功能评分是根据个体在改良信息处理速度任务(如 m-SDMT)中的准确性来定义的。我们利用贝叶斯分类器与组织分类的明确皮尔逊相关性(BF10>100)来计算整个脑组织与认知障碍相关的可能性指数。结果/预期结果:这种方法使我们能够揭示细微的认知变化及其与髓鞘完整性的潜在联系,为疾病的进展和管理提供重要的见解。m-SDMT与标准SDMT有很强的相关性(r=0.79,p<0.001),证实了在临床和研究中作为认知评估工具的可靠性。对COMS数据集的分析强调了精细髓鞘结构在多发性硬化症患者认知功能中的作用。我们的研究结果提高了髓鞘完整性在保护认知能力方面的关键意义,并确定髓鞘合成和平衡的破坏是导致认知能力下降的主要因素。这一发现强调了受髓鞘完整性影响的特化脑通路在多发性硬化症病理学中的关键作用。讨论/意义:这一进展将先进的神经成像技术与实际临床应用结合起来,强调了髓鞘完整性在多发性硬化症相关认知障碍中的微妙作用。我们的研究结果主张采用多学科方法来管理多发性硬化症,这就要求在转化科学方面开展合作性人才培养和教育。
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423 Innovation in MS Patient Care: Linking Cognitive Health and Myelin Integrity
OBJECTIVES/GOALS: Our objective is to develop a patient-friendly application addressing the progression of cognitive impairments in multiple sclerosis (MS) patients. This initiative aims to augment individualized care and precision management of a major MS comorbidity by generating a cognitive health brain map for each patient. METHODS/STUDY POPULATION: Using the UAMS COMS Database, featuring high-resolution multi-contrast MRIs, and a comprehensive clinical, behavioral, and demographic dataset, we are developing a hierarchical learning-based software tool to compute maps correlating brain structure-function and individual cognitive function. Our MRI analysis employs a three-compartment model (NNLS>0.96). Functional scores are defined by individualized accuracy during the modified information processing speed task (e.g., m-SDMT). We utilize a Bayesian classifier with explicit Pearson’s correlation for tissue classification (BF10>100) to compute an index of the likelihood of correlation with cognitive impairment throughout brain tissue. RESULTS/ANTICIPATED RESULTS: This approach allows us to reveal subtle cognitive changes and their potential links to myelin integrity, offering vital insights into disease progression and management. The m-SDMT strongly correlates with the standard SDMT (r=0.79, p<0.001), confirming reliability as a cognitive assessment tool in clinical and research contexts. Analysis of the COMS dataset emphasized insights into the role of fine myelin structure in MS patients' cognitive functionality. Our findings heightened the pivotal significance of myelin integrity in preserving cognitive abilities and identify disruptions in myelin synthesis and homeostasis as primary contributors to cognitive decline. This discovery stresses the critical role that specialized brain pathways, influenced by myelin integrity, play in the pathology of MS. DISCUSSION/SIGNIFICANCE: This development bridges advanced neuroimaging techniques with practical clinical applications, emphasizing the nuanced role of myelin integrity in MS-related cognitive deficits. Our findings advocate for a multidisciplinary approach to MS management, demanding collaborative workforce development and education in translational science.
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来源期刊
Journal of Clinical and Translational Science
Journal of Clinical and Translational Science MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.80
自引率
26.90%
发文量
437
审稿时长
18 weeks
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