关键词:

复发缓解型多发性硬化, 脑白质结构, 扩散张量成像, 静息态功能磁共振成像

Abstract:

Objective　To analyze the clinical features of white matter diffusion tensor imaging (DTI) and resting state functional magnetic resonance imaging (rs-fMRI) in patients with relapse-remitting multiple sclerosis (RRMS). Methods　One hundred and two patients with RRMS treated at Xi'an Qinhuang Hospital from March 2023 to March 2025 were selected as the research objects and set as an observation group, including 37 males and 65 females who were (38.25±18.36) years old. One hundred healthy individuals who underwent physical examination during the same period were selected as a control group, including 46 males and 54 females who were (37.45±17.78) years old. Both groups underwent DTI and rs-fMRI examinations. The parameters of DTI and rs-fMRI were analyzed, including the mean diffusivity (MD), fractional anisotropy (FA), and fMRI regional homogeneity (ReHo) of protein resting-state of the cingulum bundle (CCG), anterior limb of internal capsule (ALIC), posterior limb of internal capsule (PLIC), external capsule EC), superior longitudinal fasciculus (SLF), superior fronto-occipital fasciculus (SFOF), inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF), genu of corpus callosum (gCC), splenium of corpus callosum (sCC), etc.; the Expanded Disability Status Scale (EDSS) was used to quantify the degree of neurological impairment; the subjects' conditions were evaluated by the paced auditory serial addition test (PASAT) and the Modified Fatigue Impact Scale (MFIS). The Kolmogorov-Smirnov test was used to judge the data distribution. t test was used for the data of normal distribution. The independent-sample permutation test (5 000 permutations) was used to statistically analyze the data of brain function imaging. Results　The score of PASAT in the observation group was lower than that in the control group (87.44±12.37 vs. 100.43±8.54), with a statistical difference (P<0.05). The scores of EDSS and MFIS in the observation group were 87.44±12.37 and 100.43±8.54, and the scores in the control group 0 and 0, indicating that the observation group had obvious neurological function disorder and fatigue, while the control group were normal. The FA values of bilateral CCG, bilateral ALIC, bilateral PLIC, bilateral EC, bilateral SLF, bilateral SFOF, bilateral IFOF, bilateral ILF,  bilateral UF, gCC and sCC in the observation group were all lower than those in the control group; while the MD values of bilateral CCG, bilateral ALIC, bilateral PLIC, bilateral EC, bilateral SLF, bilateral SFOF, bilateral IFOF, bilateral ILF, bilateral UF, gCC and sCC in the observation group were all higher than those in the control group (all P < 0.05). The regional homogeneities (ReHo) of corpus callosum, internal capsule, radiative crown, pontine cross tract, and cingulate tract in the observation group were lower than those in the control group (all P<0.05). The global white matter network in the observation group showed compensatory increase in functional connection density. The nodal efficiency of specific fiber bundles (gCC and right upper longitudinal tract Ⅲ segment) in the observation group was lower than that in the control group (P<0.05). Conclusion　The combination of DTI and rs-fMRI can evaluate the structure and function of the white matter in patients with RRMS, and provide evidences for the early diagnosis and treatment of the disease.

Key words:

Relapsing-remitting multiple sclerosis, White matter structure of brain, Diffusion tensor imaging, Resting state functional magnetic resonance imaging