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Context-based morphometry of diseases affecting the cerebral white matter: Perfusion and its implications for brain parenchymal damage.

机译：影响脑白质的疾病的基于上下文的形态计量学：灌注及其对脑实质损害的影响。

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摘要

White matter hyperintensities (WMH), detected by T2-weighted magnetic resonance imaging (MRI), are common in many neurological diseases as well as in healthy older individuals. Despite a common appearance on MRI, these hyperintensities represent distinct pathological processes, for example inflammatory demyelination in multiple sclerosis (MS) and ischemic or hypoxic changes in healthy aging. Greater WMH burdens have been found in cerebral amyloid angiopathy (CAA), Alzheimer's disease (AD), and cardiovascular disease (CVD) as compared to healthy elderly. It is unclear whether the increased volume of WMH in these disorders is related to a shared etiology of the primary disease, an incidental secondary pathogenic process leading independently to WMH, or several pathogenic processes leading to different types of WM damage that appear indistinguishable on MRI.; This thesis explores the spatial and contextual distribution of cerebral white matter damage in MS, CAA, AD, CVD, and healthy aging. Context-based morphometry (CBM) is a novel approach in which analysis is performed in a feature space defined by a particular anatomical or physiological characteristic. CBM was used to examine the relationship of WMH to the cerebrovascular architecture and normal cerebral perfusion pattern, in order to address the hypothesis that these factors influence the distribution of white matter damage in the brain by influencing pathogenesis or modulating the tissue repair capacity.; While many of these studies found similar spatial distributions of WMH, CBM yielded important insight into relationships between focal white matter damage and the pattern of normal cerebral perfusion. We present indirect evidence that normal perfusion pattern influences the persistence of white matter lesions in MS, such that lesions occurring in regions of lower relative perfusion appear to persist into the chronic phases of the disease. In all disease groups and healthy older individuals, WMH occurred most often in regions of lower perfusion. This work supports the overall hypothesis that sustained tissue damage and therefore disability result from lesion development in regions of lower relative perfusion in which the environment may be restrictive or prohibitive to normal reparative processes, such that it is within these regions that lesions will tend to persist rather than repair and resolve.
机译：通过T2加权磁共振成像（MRI）检测到的白质高信号（WMH）在许多神经系统疾病以及健康的老年人中很常见。尽管在MRI上有常见现象，但这些高信号代表着独特的病理过程，例如多发性硬化症（MS）中的炎症性脱髓鞘以及健康衰老中的缺血性或缺氧性改变。与健康老年人相比，在脑淀粉样血管病（CAA），阿尔茨海默氏病（AD）和心血管疾病（CVD）中发现了更大的WMH负担。目前尚不清楚这些疾病中WMH量的增加是否与原发疾病的共同病因，独立导致WMH的偶然继发性致病过程或导致MRI上无法区分的不同类型WM损伤的几种致病过程有关。 ;本文探讨了MS，CAA，AD，CVD和健康衰老中脑白质损害的空间和背景分布。基于上下文的形态计量学（CBM）是一种新颖的方法，其中在由特定解剖或生理特征定义的特征空间中执行分析。 CBM用于检查WMH与脑血管结构和正常脑灌注模式的关系，以解决以下假设：这些因素通过影响发病机理或调节组织修复能力来影响脑内白质损伤的分布。尽管许多研究发现WMH的空间分布相似，但CBM对局灶性白质损害与正常脑灌注模式之间的关系提供了重要的见识。我们目前提供间接证据，表明正常的灌注方式会影响MS中白质病灶的持续性，从而使发生在相对灌注较低的区域的病灶似乎持续存在于疾病的慢性期。在所有疾病组和健康的老年人中，WMH最常发生在灌注较低的区域。这项工作支持总体假说，即在较低的相对灌注区域中病变发展会导致持续的组织损伤并因此导致残疾，在该区域中，环境可能会限制或禁止正常的修复过程，因此病变在这些区域内往往会持续存在而不是修理和解决。

著录项

  • 作者

    Holland, Christopher Michael.;

  • 作者单位

    Boston University.;

  • 授予单位 Boston University.;
  • 学科 Biology Neuroscience.
  • 学位 Ph.D.
  • 年度 2008
  • 页码 216 p.
  • 总页数 216
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 神经科学;
  • 关键词

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