Erken Evre Multipl Skleroz'da Beyin Atrofi Ölçümü ve Klinik Parametrelerle İlişkisi
Küçük Resim Yok
Tarih
2016
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Multipl Skleroz (MS)'da aksonal kayıp ve nörodejenerasyon, hastalığın erken dönemlerinden itibaren oluşur ve kalıcı özürlülüğe yol açabilir. Bu çalışmada MS hastalarında beyin volüm kaybı ve klinik parametrelerle ilişkisi araştırılmıştır. Metod: 20 erken evre MS hastasında fiziksel ve kognitif değerlendirme Expanded Disability Status Scale(EDSS) ve Multiple Sclerosis Functional Composite (MSFC), Rey Auditory and Verbal Learning Test (RAVLT) ile yapılmıştır. Manyetik rezonans görüntüleme (MRG) sonrasında elde edilen veriler RIO (region of interest) tekniği ve JIM 4.0 software kullanarak işlenmiştir. BOS, gri, ve beyaz madde volümleri ve beyin parankimal fraksiyonu (BPF) hesaplanmıştır. Bulgular: MS hastalarında ortalama BPF değerleri normal kontrollerden anlamlı olarak düşük bulunmuştur. BPF değerleri hastalık süresi ile negatif orantılıdır. MS hastalarının %27.3 ünde sözel ve işitsel bellek süreçleri testinde anormallik saptanmıştır. BPF değerleri ile kognitif performans, MSFC/EDSS skorlarında anlamlı ilişki saptanmamıştır. Sonuç: BPF ölçümü beyin atrofisini değerlendirmede pratikte ve klinik çalışmalarda kullanılabilecek güvenilir bir metottur. Erken evrede saptanabilen beyin atrofisi klinik özürlülüğe yol açmayabilir. Kortikal reorganizasyon veya akson kaybının klinik özürlülük için bir eşik değerinin varlığı söz konusu olabilir. Beyin atrofisinin klinik öneminin anlaşılması için beyin volümü ölçümlerinin serial izlenmesi ve ayrıntılı nöropsikolojik testlere ihtiyaç vardır.
Objective Background: In multiple sclerosis (MS), axonal loss and neurodegeneration occurs early in disease course and may lead to irreversible neurological impairment. We aimed to investigate brain volume loss as an accurate measure of axonal loss and its clinical relevance in early MS. Methods: Twenty MS patients whose first symptoms beginning within the last 2 years were underwent a neurological examination included Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC). Cognitive status of patients was assessed with Paced Auditory Serial Addition Test (PASAT) and Rey Auditory Verbal Learning Test (RAVLT). For processing magnetic resonance imaging (MRI) data, region of interest technique (ROI) and JIM 4.0 software were established. Brain parenchymal fraction (BPF), cerebrospinal fluid (CSF) volume, gray and white matter volumes of brain was determined in MS patients and in control subjects. The relationship between MRI data and demographic, clinical variables was also evaluated. Results: In MS patients, the mean BPF value was significantly lower than controls. BPF also negatively correlated with the duration of disease. 27.3% of the patients have impairment by verbal memory processes tests. We didn't find significant correlation between BPF scores and cognitive performance, and also MSFC/EDSS scores. There was only significant correlation between PASAT scores and white matter volume. Conclusion: Measurement of BPF is a reliable method for brain atrophy that can be used in clinical practice and clinical trials. The atrophy beginning at the early phase of the disease might not cause clinical disability because of cortical reorganization and there might be individual threshold value of axon loss for clinical disability. In order to determine the clinical relevance of brain atrophy, longitudinal MRI studies with cognitive evaluation by comprehensive neurophysiological tests are needed.
Objective Background: In multiple sclerosis (MS), axonal loss and neurodegeneration occurs early in disease course and may lead to irreversible neurological impairment. We aimed to investigate brain volume loss as an accurate measure of axonal loss and its clinical relevance in early MS. Methods: Twenty MS patients whose first symptoms beginning within the last 2 years were underwent a neurological examination included Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC). Cognitive status of patients was assessed with Paced Auditory Serial Addition Test (PASAT) and Rey Auditory Verbal Learning Test (RAVLT). For processing magnetic resonance imaging (MRI) data, region of interest technique (ROI) and JIM 4.0 software were established. Brain parenchymal fraction (BPF), cerebrospinal fluid (CSF) volume, gray and white matter volumes of brain was determined in MS patients and in control subjects. The relationship between MRI data and demographic, clinical variables was also evaluated. Results: In MS patients, the mean BPF value was significantly lower than controls. BPF also negatively correlated with the duration of disease. 27.3% of the patients have impairment by verbal memory processes tests. We didn't find significant correlation between BPF scores and cognitive performance, and also MSFC/EDSS scores. There was only significant correlation between PASAT scores and white matter volume. Conclusion: Measurement of BPF is a reliable method for brain atrophy that can be used in clinical practice and clinical trials. The atrophy beginning at the early phase of the disease might not cause clinical disability because of cortical reorganization and there might be individual threshold value of axon loss for clinical disability. In order to determine the clinical relevance of brain atrophy, longitudinal MRI studies with cognitive evaluation by comprehensive neurophysiological tests are needed.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
Scopus Q Değeri
Cilt
33
Sayı
2
