ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2013-3-52-60ssmu-339Research ArticleМЕЖДИСЦИПЛИНАРНЫЕ ФУНДАМЕНТАЛЬНЫЕ ИССЛЕДОВАНИЯ В МЕДИЦИНЕNTERDISCIPLINARY BASIC RESEARCH IN MEDICINEВЛИЯНИЕ НЕЙРОДЕГЕНЕРАТИВНЫХ ИЗМЕНЕНИЙ В ГОЛОВНОМ МОЗГЕ НА ФОРМИРОВАНИЕ КЛИНИЧЕСКОЙ КАРТИНЫ ЗАБОЛЕВАНИЯ У БОЛЬНЫХ РАССЕЯННЫМ СКЛЕРОЗОМEFFECT OF NEURODEGENERATIVE CHANGES IN THE BRAIN ON THE FORMATION OF THE DISEASE CLINICAL PICTURE IN PATIENTS WITH MULTIPLE SCLEROSISПраховаЛ. Н.PrakhovaL. N.l.n.prakhova@hotmail.comМагоновЕ П.MagonovYe. P.l.n.prakhova@hotmail.comИльвесА. Г.IlvesA. G.

Ильвес Александр Геннадьевич – кандидат медицинских наук,  научный сотрудник лаборатории нейроиммунологии

l.n.prakhova@hotmail.comБогданА. А.BogdanA. A.l.n.prakhova@hotmail.comКатаеваГ. В.KataevaG. V.l.n.prakhova@hotmail.comМалаховаЕ. С.MalakhovaYe. S.l.n.prakhova@hotmail.comСавинцеваЖ. И.SavintsevaZh. I.l.n.prakhova@hotmail.comСтоляровИ. Д.StolyarovI. D.l.n.prakhova@hotmail.comТрофимоваТ. Н.TrofimovaT. N.

Трофимова Татьяна Николаевна –  доктор медицинских наук, профессор, главный  научный сотрудник 

l.n.prakhova@hotmail.comИнститут мозга человека имени Н.П. Бехтеревой РАН, Санкт-ПетербургРоссияInstitute of the Human Brain named after N.P. Bechtereva of the Russian Academy of Sciences, St. PetersburgRussian Federation2013280620131235260Copyright © Прахова Л.Н., Магонов Е.П., Ильвес А.Г., Богдан А.А., Катаева Г.В., Малахова Е.С., Савинцева Ж.И., Столяров И.Д., Трофимова Т.Н., 20132013Прахова Л.Н., Магонов Е.П., Ильвес А.Г., Богдан А.А., Катаева Г.В., Малахова Е.С., Савинцева Ж.И., Столяров И.Д., Трофимова Т.Н.Prakhova L.N., Magonov Y.P., Ilves A.G., Bogdan A.A., Kataeva G.V., Malakhova Y.S., Savintseva Z.I., Stolyarov I.D., Trofimova T.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/339

Целью исследования явилось определение взаимосвязи церебральной глобальной и региональной атрофии и объема очагов демиелинизации в головном мозге с клинической картиной у больных рассеянным склерозом (РС). Обследовано 55 больных с диагнозом РС. Группа контроля: 22 здоровых добровольца. Больные были разделены на группы согласно тяжести инвалидизации, типу течения и длительности заболевания. Оценка общей и регионарной атрофии осуществлялась путем постпроцессинговой  волюметрической  сегментации  данных  МРТ,  полученных  на  томографе Philips Achieva c напряженностью магнитного поля 3T, при помощи программного пакета FreeSurfer. Показано, что при РС наряду с демиелинизацией развивается атрофия головного мозга как за счет серого (включая кору и подкорковые структуры), так и за счет белого вещества. Глобальная и регионарная атрофия связаны с тяжестью инвалидизации больных по шкале EDSS, но не с длительностью и типом течения заболевания. Нейродегенеративные изменения мозговых структур развиваются с неодинаковой скоростью, имеют различную выраженность и определяют симптомокомплекс неврологических нарушений и тяжесть инвалидизации, что указывает на наличие определенных паттернов процесса атрофии в головном мозге, формирующих клиническую картину заболевания.

The aim of the study was to determine the relationship of global and regional cerebral atrophy and volume of demyelination lesions in the brain with a clinical picture in patients with multiple sclerosis (MS). The study involved 55 patients with MS. Control group included 22 healthy volunteers. Patients were divided into groups according to the severity of disability, the type and duration of disease. Assessment of general and regional atrophy was performed by post-process volumetric segmentation of MRI data, which was acquired at 3T Philips Achieva scanner. The post-processing was done with the FreeSurfer software. It is shown that in MS patients brain atrophy develops both by means of gray matter (including the cortex and subcortical structures), and white matter, along with demyelination. Global and regional atrophy is associated with the severity of disability of patients according to EDSS scale, but not with the duration and type of the disease. Neurodegenerative changes of brain structures evolve with different rates, have different intensity and determine the set of symptoms of neurological impairment and severity of disability, which indicates the presence of certain patterns of the process of atrophy in the brain, forming the clinical picture of the disease.

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The authors declare that there are no conflicts of interest present.