期刊
MULTIPLE SCLEROSIS JOURNAL
卷 27, 期 4, 页码 528-538出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458520921362
关键词
Multiple sclerosis; energy dysfunction; diffusion-weighted spectroscopy; diffusion tensor imaging; tractography; neurodegeneration
资金
- ARSEP
- Institut des neuro-sciences translationnelle [ANR-10-IAIHU-06]
- Infrastructure d'avenir en Biologie Sante [ANR-11-INBS-0006]
The study demonstrates that reduced thalamic ADC(tCr) is associated with damage to thalamo-cortical tracts in multiple sclerosis (MS) patients, indicating a correlation between pathological changes in thalamic energy metabolism and structural degeneration of connected fibers.
Background: Diffusion-weighted(1)H magnetic resonance spectroscopy (DW-MRS) allows to quantify creatine-phosphocreatine brain diffusivity (ADC(tCr)), whose reduction in multiple sclerosis (MS) has been proposed as a proxy of energy dysfunction. Objective: To investigate whether thalamic ADC(tCr) changes are associated with thalamo-cortical tract damage in MS. Methods: Twenty patients with MS and 13 healthy controls (HC) were enrolled in a DW-MRS and DW imaging (DWI) study. From DW-MRS, ADC(tCr) and total N-acetyl-aspartate diffusivity (ADC(tNAA)) were extracted in the thalami. Three thalamo-cortical tracts and one non-thalamic control tract were reconstructed from DWI. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD), reflecting microstructural integrity, were extracted for each tract. Associations between thalamic ADC(tCr) and tract metrics were assessed using linear regression models adjusting for age, sex, thalamic volume, thalamic ADC(tNAA), and tract-specific lesion load. Results: Lower thalamic ADC(tCr) was associated with higher MD and RD of thalamo-cortical projections in MS (MD:p = 0.029; RD:p = 0.017), but not in HC (MD:p = 0.625, interaction term between thalamic ADC(tCr) and group = 0.019; RD:p = 0.320, interaction term = 0.05). Thalamic ADC(tCr) was not associated with microstructural changes of the control tract. Conclusion: Reduced thalamic ADC(tCr) correlates with thalamo-cortical tract damage in MS, showing that pathologic changes in thalamic energy metabolism are associated with structural degeneration of connected fibers.
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