| Abstrakt: |
Multiple sclerosis is an autoimmune disease, which characterized by CNS myelin lesion. The pathological changes include distinct demyelination foci well identified by MRI. However, because their volume and localizations weakly correlate with clinical appearances and progression of the disease, functional changes may exert a greater influence on disablement indices than regular MRI data. Positron emission tomography (PET), using a labeled native glucose analogue [18F] fluorinedesoxyglucose (FDG-PET) enables to evaluate cerebral glucose metabolism and specify an association between brain metabolism and clinical appearances. FDG-PET has been administered to 87 patients: 57 with valid MS, remitted course (group 1) and 30 with primary-, remitted- and secondary-progressive course (group 2). Besides, a patient's state was evaluated with EDSS and FS scales. A regional to global activity ratio was calculated according to ICVRglu indices. In both groups, significant negative correlation between glucose metabolism in the majority of the brain regions and MS duration was found, being more distinct in group 2. Also, cerebellum metabolism reverse correlated with FS 2 scale scores. In group 2, ICVRglu index in subcortical structures positively correlated with FS 1 scores. Positive correlation between ICVRglu in somatosensor area and EDSS and FS scores was detected. The associations with PET demonstrated a relationship between clinical syndromes, MS duration and cerebral metabolism level, being mostly pronounced in the group with progressive course. Both hypo- and hyper metabolism may be clinically significant. In the patients with progressive MS, hyper metabolism in sensomotor area is likely to be of compensatory importance. |
