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  1. 原著論文

Multiple sclerosis lesions in motor tracts from brain to cervical cord: spatial distribution and correlation with disability

https://repo.qst.go.jp/records/81480
https://repo.qst.go.jp/records/81480
eed79139-b54d-4e2a-8df4-918b36aa67d2
Item type 学術雑誌論文 / Journal Article(1)
公開日 2020-12-28
タイトル
タイトル Multiple sclerosis lesions in motor tracts from brain to cervical cord: spatial distribution and correlation with disability
言語
言語 eng
資源タイプ
資源タイプ識別子 http://purl.org/coar/resource_type/c_6501
資源タイプ journal article
アクセス権
アクセス権 metadata only access
アクセス権URI http://purl.org/coar/access_right/c_14cb
著者 Kerbrat, Anne

× Kerbrat, Anne

WEKO 1007116

Kerbrat, Anne

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Gros, Charley

× Gros, Charley

WEKO 1007117

Gros, Charley

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Badji, Atef

× Badji, Atef

WEKO 1007118

Badji, Atef

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Bannier, Elise

× Bannier, Elise

WEKO 1007119

Bannier, Elise

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Galassi, Francesca

× Galassi, Francesca

WEKO 1007120

Galassi, Francesca

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Benoit, Combès

× Benoit, Combès

WEKO 1007121

Benoit, Combès

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Raphaël, Chouteau

× Raphaël, Chouteau

WEKO 1007122

Raphaël, Chouteau

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Labauge, Pierre

× Labauge, Pierre

WEKO 1007123

Labauge, Pierre

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Ayrignac, Xavier

× Ayrignac, Xavier

WEKO 1007124

Ayrignac, Xavier

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Tachibana, Yasuhiko

× Tachibana, Yasuhiko

WEKO 1007125

Tachibana, Yasuhiko

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Others

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WEKO 1007126

Others

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Yasuhiko, Tachibana

× Yasuhiko, Tachibana

WEKO 1007127

en Yasuhiko, Tachibana

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抄録
内容記述タイプ Abstract
内容記述 Despite important efforts to solve the clinico-radiological paradox, correlation between lesion load and physical disability in patients with multiple sclerosis remains modest. One hypothesis could be that lesion location in corticospinal tracts plays a key role in explaining motor impairment. In this study, we describe the distribution of lesions along the corticospinal tracts from the cortex to the cervical spinal cord in patients with various disease phenotypes and disability status. We also assess the link between lesion load and location within corticospinal tracts, and disability at baseline and 2-year follow-up. We retrospectively included 290 patients (22 clinically isolated syndrome, 198 relapsing remitting, 39 secondary progressive, 31 primary progressive multiple sclerosis) from eight sites. Lesions were segmented on both brain (T2-FLAIR or T2-weighted) and cervical (axial T2- or T2*-weighted) MRI scans. Data were processed using an automated and publicly available pipeline. Brain, brainstem and spinal cord portions of the corticospinal tracts were identified using probabilistic atlases to measure the lesion volume fraction. Lesion frequency maps were produced for each phenotype and disability scores assessed with Expanded Disability Status Scale score and pyramidal functional system score. Results show that lesions were not homogeneously distributed along the corticospinal tracts, with the highest lesion frequency in the corona radiata and between C2 and C4 vertebral levels. The lesion volume fraction in the corticospinal tracts was higher in secondary and primary progressive patients (mean = 3.6 ± 2.7% and 2.9 ± 2.4%), compared to relapsing-remitting patients (1.6 ± 2.1%, both P < 0.0001). Voxel-wise analyses confirmed that lesion frequency was higher in progressive compared to relapsing-remitting patients, with significant bilateral clusters in the spinal cord corticospinal tracts (P < 0.01). The baseline Expanded Disability Status Scale score was associated with lesion volume fraction within the brain (r = 0.31, P < 0.0001), brainstem (r = 0.45, P < 0.0001) and spinal cord (r = 0.57, P < 0.0001) corticospinal tracts. The spinal cord corticospinal tracts lesion volume fraction remained the strongest factor in the multiple linear regression model, independently from cord atrophy. Baseline spinal cord corticospinal tracts lesion volume fraction was also associated with disability progression at 2-year follow-up (P = 0.003). Our results suggest a cumulative effect of lesions within the corticospinal tracts along the brain, brainstem and spinal cord portions to explain physical disability in multiple sclerosis patients, with a predominant impact of intramedullary lesions.
書誌情報 Brain

巻 143, 号 7, p. 2089-2105, 発行日 2020-12
出版者
出版者 Oxford University Press
ISSN
収録物識別子タイプ ISSN
収録物識別子 0006-8950
DOI
識別子タイプ DOI
関連識別子 10.1093/brain/awaa162
関連サイト
識別子タイプ URI
関連識別子 https://academic.oup.com/brain/article-abstract/143/7/2089/5861019?redirectedFrom=fulltext
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