Neurology:多发性硬化疾病活动 与GCIP厚度加速减退相关
2013-01-09 Neurology CMT 程蓓 编译
一项美国和加拿大联合研究显示,伴临床和(或)影像学非眼部病变活动征象的多发性硬化症(MS)患者(尤其是在病程早期),其神经节细胞/内丛状层(GCIP)厚度呈加速减退趋势。论文发表于《神经病学》[Neurology 2013,80(1):47]杂志。 研究者对于MS组(n=164)和健康对照组(n=59)每6个月进行一次频域光学相干断层成像扫描,在基线和每年度实施增强脑部磁共振检
一项美国和加拿大联合研究显示,伴临床和(或)影像学非眼部病变活动征象的多发性硬化症(MS)患者(尤其是在病程早期),其神经节细胞/内丛状层(GCIP)厚度呈加速减退趋势。论文发表于《神经病学》[Neurology 2013,80(1):47]杂志。
研究者对于MS组(n=164)和健康对照组(n=59)每6个月进行一次频域光学相干断层成像扫描,在基线和每年度实施增强脑部磁共振检查。结果显示,在随访期间,出现残疾进展患者的年度GCIP厚度减退增快37%;与病程>5年者相比,病程<5年者的年度GCIP厚度减退增快43%(P=0.003)。同时伴有新发钆增强病变、新发T2病变和病程<5年三种特征患者的年度GCIP厚度减退率最高(P<0.001)。
Objective: To determine the effect of clinical and radiologic disease activity on the rate of thinning of the ganglion cell/inner plexiform (GCIP) layer and the retinal nerve fiber layer in patients with multiple sclerosis (MS) using optical coherence tomography (OCT).
Methods: One hundred sixty-four patients with MS and 59 healthy controls underwent spectral-domain OCT scans every 6 months for a mean follow-up period of 21.1 months. Baseline and annual contrast-enhanced brain MRIs were performed. Patients who developed optic neuritis during follow-up were excluded from analysis.
Results: Patients with the following features of disease activity during follow-up had faster rates of annualized GCIP thinning: relapses (42% faster, p = 0.007), new gadolinium-enhancing lesions (54% faster, p < 0.001), and new T2 lesions (36% faster, p = 0.02). Annual GCIP thinning was 37% faster in those with disability progression during follow-up, and 43% faster in those with disease duration <5 years vs >5 years (p = 0.003). Annual rates of GCIP thinning were highest in patients exhibiting combinations of new gadolinium-enhancing lesions, new T2 lesions, and disease duration <5 years (70% faster in patients with vs without all 3 characteristics,p < 0.001).
Conclusions: MS patients with clinical and/or radiologic nonocular disease activity, particularly early in the disease course, exhibit accelerated GCIP thinning. Our findings suggest that retinal changes in MS reflect global CNS processes, and that OCT-derived GCIP thickness measures may have utility as an outcome measure for assessing neuroprotective agents, particularly in early, active MS.
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#多发性#
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#疾病活动#
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