학술논문
Cortical lesion hotspots and association of subpial lesions with disability in multiple sclerosis.
Document Type
Article
Author
Beck, Erin S; Maranzano, Josefina; Luciano, Nicholas J; Parvathaneni, Prasanna; Filippini, Stefano; Morrison, Mark; Suto, Daniel J; Wu, Tianxia; van Gelderen, Peter; de Zwart, Jacco A; Antel, Samson; Fetco, Dumitru; Ohayon, Joan; Andrada, Frances; Mina, Yair; Thomas, Chevaz; Jacobson, Steve; Duyn, Jeff; Cortese, Irene; Narayanan, Sridar
Source
Subject
*DISABILITIES
*MULTIPLE sclerosis
*WHITE matter (Nerve tissue)
*MAGNETIC resonance imaging
*SPINAL cord
*PEOPLE with disabilities
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Language
ISSN
1352-4585
Abstract
Background: Dramatic improvements in visualization of cortical (especially subpial) multiple sclerosis (MS) lesions allow assessment of impact on clinical course. Objective: Characterize cortical lesions by 7 tesla (T) T2*-/T1-weighted magnetic resonance imaging (MRI); determine relationship with other MS pathology and contribution to disability. Methods: Sixty-four adults with MS (45 relapsing–remitting/19 progressive) underwent 3 T brain/spine MRI, 7 T brain MRI, and clinical testing. Results: Cortical lesions were found in 94% (progressive: median 56/range 2–203; relapsing–remitting: 15/0–168; p = 0.004). Lesion distribution across 50 cortical regions was nonuniform (p = 0.006), with highest lesion burden in supplementary motor cortex and highest prevalence in superior frontal gyrus. Leukocortical and white matter lesion volumes were strongly correlated (r = 0.58, p < 0.0001), while subpial and white matter lesion volumes were moderately correlated (r = 0.30, p = 0.002). Leukocortical (p = 0.02) but not subpial lesions (p = 0.40) were correlated with paramagnetic rim lesions; both were correlated with spinal cord lesions (p = 0.01). Cortical lesion volumes (total and subtypes) were correlated with expanded disability status scale, 25-foot timed walk, nine-hole peg test, and symbol digit modality test scores. Conclusion: Cortical lesions are highly prevalent and are associated with disability and progressive disease. Subpial lesion burden is not strongly correlated with white matter lesions, suggesting differences in inflammation and repair mechanisms. [ABSTRACT FROM AUTHOR]