Spontaneous remyelination in lesions protects the integrity of surrounding tissues over time in multiple sclerosis.

Autor: Ricigliano VAG; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Neurology Department, St Antoine Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France., Tonietto M; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Alternative Energies and Atomic Energy Commission (CEA), National Center for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), BioMaps, Frédéric Joliot Hospital Service, Paris-Saclay University, Orsay, France., Hamzaoui M; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France., Poirion É; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Medical Imaging Service, Adolphe de Rothschild Hospital Service, Paris, France., Lazzarotto A; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Neurology Department, St Antoine Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France., Bottlaender M; Alternative Energies and Atomic Energy Commission (CEA), National Center for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), BioMaps, Frédéric Joliot Hospital Service, Paris-Saclay University, Orsay, France., Gervais P; Alternative Energies and Atomic Energy Commission (CEA), National Center for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), BioMaps, Frédéric Joliot Hospital Service, Paris-Saclay University, Orsay, France., Maillart E; Neurology Department, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France., Stankoff B; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Neurology Department, St Antoine Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France., Bodini B; Paris Brain Institute (ICM), National Center of Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (Inserm), Sorbonne University, Paris, France.; Neurology Department, St Antoine Hospital, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2022 Jun; Vol. 29 (6), pp. 1719-1729. Date of Electronic Publication: 2022 Feb 25.
DOI: 10.1111/ene.15285
Abstrakt: Background and Purpose: Lesion remyelination preserves axonal integrity in animal models of multiple sclerosis (MS), but an in vivo demonstration of its protective effect on surrounding tissues in humans is lacking.
Methods: Nineteen persons with MS were enrolled in a cohort study and underwent two positron emission tomography (PET)/magnetic resonance imaging (MRI) scans 1-4 months apart. Voxelwise maps of Pittsburgh compound B distribution volume ratio, reflecting myelin content, were used to calculate an index of baseline demyelination, and of dynamic demyelination and remyelination over the follow-up in 549 single white matter lesions. Changes in fractional anisotropy and mean diffusivity, reflecting microstructural damage, were calculated in the proximal and distal 3-mm-thick rings surrounding each lesion, and used to classify perilesional microstructure as "preserved" or "worsening" over the follow-up. Mixed-effect linear models and logistic regressions were employed to investigate whether PET-derived lesional indices were associated with changes in MRI metrics in perilesions, and to identify which of them best predicted the microstructural evolution of perilesions over time.
Results: A higher index of remyelination, and a lower index of baseline and dynamic demyelination in lesions were associated with a less severe microstructural deterioration of the corresponding proximal and distal perilesions over time (p-value range: <0.001-0.012), but the index of remyelination was the best predicting variable of perilesional fate. For every extra 1% of remyelination within each lesion, the probability of the corresponding perilesional microstructure remaining preserved over time increased by 39% (odds ratio = 6.62, 95% confidence interval = 2.16-20.32, p < 0.001).
Conclusions: Intralesional remyelination is associated with the microstructural preservation of surrounding tissues, possibly preventing neuroaxonal damage resulting from Wallerian degeneration.
(© 2022 European Academy of Neurology.)
Databáze: MEDLINE
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