Chronic active lesions preferentially localize in watershed territories in multiple sclerosis.

Autor: Toubasi AA; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Eisma JJ; Cognitive Division, Department of Neurology, VUMC, Nashville, Tennessee, USA., Wang J; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.; Department of Computer Science, School of Engineering, Vanderbilt University, Nashville, Tennessee, USA., Kazimuddin HF; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.; National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Health (NIH), Bethesda, Maryland, USA., Hernandez B; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.; Medical Scientist Program, VU School of Medicine, Nashville, Tennessee, USA.; Department of Biological Sciences, College of Science, University of Texas at El Paso, El Paso, Texas, USA.; Department of Biochemistry, VU School of Medicine, Nashville, Tennessee, USA., Vinarsky T; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Gheen C; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Rohm Z; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Koch C; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Clarke MA; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA., Cheek R; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.; Meharry Medical College, School of Medicine, Nashville, Tennessee, USA., Kramer J; Neuroimmunology Division, Department of Neurology, VUMC, Nashville, Tennessee, USA., Eaton J; Cognitive Division, Department of Neurology, VUMC, Nashville, Tennessee, USA.; Neuroimmunology Division, Department of Neurology, VUMC, Nashville, Tennessee, USA., Donahue MJ; Cognitive Division, Department of Neurology, VUMC, Nashville, Tennessee, USA.; Department of Psychiatry and Behavioral Science, VUMC, Nashville, Tennessee, USA., Bagnato F; Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.; Department of Neurology, VA Medical Center, TN Valley Healthcare System, Nashville, Tennessee, USA.
Jazyk: angličtina
Zdroj: Annals of clinical and translational neurology [Ann Clin Transl Neurol] 2024 Nov; Vol. 11 (11), pp. 2912-2922. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1002/acn3.52202
Abstrakt: Objective: Paramagnetic rim lesions (PRLs) are a biomarker of chronic active lesions (CALs), and an important driver of neurological disability in multiple sclerosis (MS). The reason subtending some acute lesions evolvement into CALs is not known. Here we ask whether a relatively lower oxygen content is linked to CALs.
Methods: In this prospective cross-sectional study, 64 people with multiple sclerosis (PwMS), clinically isolated syndrome and radiologically isolated syndrome underwent a 7.0 Tesla (7 T) brain magnetic resonance imaging (MRI). The scanning protocol included a T 2 -w fluid-attenuated inversion recovery (FLAIR), and a single echo gradient echo from which susceptibility-weighted imaging (SWI) was derived. WM lesions were identified on the T 2 -w-FLAIR whilst PRLs were identified on the SWI sequence. T 2 -lesions were classified as PRLs and rimless lesions (PRLs-). We registered a universal vascular atlas to each subject's T 2 -w-FLAIR and classified each T 2 -lesions according to its location into watershed- (ws), non-watershed- (nws), and mixed-lesion (m). Ws-lesions were defined as lesions that were fully located in a region between the territories of two major arteries.
Results: Out of 1,975 T 2 -lesions, 88 (4.5%) were PRLs. Ws-regions had a higher number (p = 0.005) and proportion (p < 0.001) of PRLs- compared to nws-regions. Ws-PRL- were larger compared to nws-ones (p = 0.009). The number (p = 0.043) and proportion (p < 0.001) of PRLs was higher in ws-regions compared to nws-ones. Ws-PRLs were not significantly larger than nws-ones (p = 0.195).
Interpretation: We propose the novel concept of a link between arterial vascularization and chronic activity in MS by demonstrating a preferential localization of CALs in ws-territories.
(© 2024 The Author(s). Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)
Databáze: MEDLINE
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