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Detecting neurodegenerative pathology in multiple sclerosis before irreversible brain tissue loss sets in

Translational Neurodegeneration 2019年第1期8卷 466-482页

作者： Jeroen Van Schependom kaat guldolf Marie Béatrice D’hooghe Guy Nagels Miguel D’haeseleer Neurology Department Universitair Ziekenhuis BrusselCenter for NeurosciencesVrije Universiteit BrusselLaarbeeklaan 1011090 BrusselBelgium Radiology Department Universitair Ziekenhuis Brussel BrusselsBelgium Nationaal Multiple Sclerose Centrum MelsbroekBelgium

Background:Multiple sclerosis(MS)is a complex chronic inflammatory and degenerative disorder of the central nervous *** brain volume loss,or also termed atrophy,is currently emerging as a popular imaging marker of neurodegeneration in affected patients,but,unfortunately,can only be reliably interpreted at the time when irreversible tissue damage likely has already *** of treatment decisions based on brain atrophy may therefore be viewed as *** body:This Narrative Review focuses on alternative techniques with the potential of detecting neurodegenerative events in the brain of subjects with MS prior to the atrophic ***,metabolic and molecular imaging provide the opportunity to identify early subcellular changes associated with energy dysfunction,which is an assumed core mechanism of axonal degeneration in ***,cerebral hypoperfusion has been observed throughout the entire clinical spectrum of the disorder but it remains an open question whether this serves as an alternative marker of reduced metabolic activity,or exists as an independent contributing process,mediated by endothelin-1 ***,both metabolic and perfusion alterations may lead to repercussions at the level of network performance and structural connectivity,respectively assessable by functional and diffusion tensor *** and finally,elevated body fluid levels of neurofilaments are gaining interest as a biochemical mirror of axonal damage in a wide range of neurological conditions,with early rises in patients with MS appearing to be predictive of future brain ***:Recent findings from the fields of advanced neuroradiology and neurochemistry provide the promising prospect of demonstrating degenerative brain pathology in patients with MS before atrophy has *** the overall level of evidence on the presented topic is still preliminary,this Review may pave the way for further longitudinal and multimodal studi

关键词： Brain atrophy magnetic resonance imaging multiple sclerosis neurodegeneration neurofilaments

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