ATROPHY OF ISTHMUS AND BODY OF THE CORPUS CALLOSUM AS INDEPENDENT MARKER OF SEVERITY AND PROGRESSION OF MUL- TIPLE SCLEROSIS

The corpus callosum (CC) volume loss in patients with multiple sclerosis (MS) is a long been known phenomenon, considered by many authors as an indicator of disease severity. Meanwhile the relationship between CC atrophy and disease severity in MS patients not always found in studies, which may be due to the features of somatotopical CC structure. The aim of our study was to determine the relationship of atrophy in different parts of CC with the severity of clinical manifestations in MS patients to clarify the pathogenesis of these disorders and find opportunities for the development of tools for control and correction. The article presents results of morphometric analysis of 117 patients with different types of MS and 25 healthy volunteers. The original MRI image postprocessing algorithm is used. The initial parameters used for the statistical analysis were: age, duration of disease, the type of the disease, numerical score of FS and EDSS scales, the results of morphometry. Correlation analysis showed that the volume of the CC isthmus and corpus inversely correlated with disease duration and severity of a pyramidal, cerebellar, sensory, pelvic disorders and degree of disability. Analysis of variance in groups of patients with different types and severity of MS showed that atrophy of the CC isthmus and corpus is associated not only with the degree of disability, but also with the disease type. The study results confirm the important role of the atrophy of certain brain regions in the development of clinical picture and types of MS. It is shown that changes in the volume of the CC isthmus and corpus are independent markers of the development stage and severity of the disease, and their measurement can be an instrumental tool for objective assessment of the effectiveness of personalized neurorehabilitation techniques in patients with demyelinating diseases of the central nervous system.

мозолистое тело, рассеянный склероз, магнитно-резонансная томография, воксельная морфометрия, атрофия, corpus callosum, multiple sclerosis, MRI, voxel-based morphometry, atrophy

1. Barnard R. O., Trigg M. Corpus callosum in multiple sclerosis // J. Neurol Neurosurg Psychiatry.- 1974.- Vol. 37.- Р 1259-1264.

2. Simon J. H., Schiffer R. B., Rudick R. A. et al. Quantitative determination of MS induced corpus callosum atrophy in vivo using MR imaging // Am. J. Neuroradiol.- 1987.- Vol. 8.- Р 599-604.

3. Dietemann J. L., Beigelman C., Rumbach L. et al. Multiple sclerosis and corpus callosum atrophy: relationship of MRI findings to clinical data // Neuroradiology.- 1988.- Vol. 30.- Р 478-480.

4. Wahl M., Lauterbach-Soon B., Hattingen E. et al. Human motor corpus callosum: topography, somatotopy, and link between microstructure and function // J. Neurosci.- 2007.- Vol. 27.- Р 12132-12138.

5. Llufriu S., Blanco Y., Martinez-Heras E. et al. Influence of corpus callosum damage on cognition and physical disability in multiple sclerosis: a multimodal study // PLoS One.- 2012.- Vol. 7 (5).- e37167.

6. Fabri M., Pierpaoli C., Barbaresi P. et al. Functional topography of the corpus callosum investigated by DTI and fMRI // World J. Radiol.- 2014.- Vol. 6.- Р 895-906.

7. Gean-Marton A. D., Vezina L. G., Marton K. I. et al. Abnormal corpus callosum: a sensitive and specific indicator of multiple sclerosis // Radiology.- 1991.- Vol. 180.- Р 215-221.

8. Pelletier J., Suchet L., Witjas T. et al. Alongitudinal study of callosal atrophy and interhemispheric dysfunction in relapsing-remitting multiple sclerosis // Arch Neurol.- 2001.- Vol. 58.- Р 105-111.

9. Yaldizli O., Atefy R., Gass A. et al. Corpus callosum index and long-term disability in multiple sclerosis patients // J. Neurol.- 2010.- Vol. 257.- P 1256-1264.

10. Ozturk A., Smith S. A., Gordon-Lipkin E. M. et al. MRI of the corpus callosum in multiple sclerosis: association with disability // Mult Scler.- 2010.- Vol. 16.- Р 166-177.

11. Lin X., Tench C. R., Morgan P. S. et al. Use of combined conventional and quantitative MRI to quantify pathology related to cognitive impairment in multiple sclerosis // J. Neurol Neurosurg Psychiatry - 2008 - Vol. 79.- Р 437-441.

12. Трофимова Т. Н., Магонов Е. П., Назинкина Ю. В. Построцессинговая обработка при структурном анализе МР-изображения головного мозга // Профессор В. М. Бехтерев и наше время (155 лет со дня рождения) / Под ред. А. А. Скоромна, М. М. Одинака, Н. Г. Незнанова, М. А. Акименко.- СПб.: Политехника, 2015.- С. 405-417. [Электронный ресурс] http://www.student-library.ru/documents/ISBN9785732510201-SCN0003.html.

13. Магонов Е. П., Прахова Л. Н., Ильвес А. Г., Катаева Г. В., Трофимова Т. Н. Автоматическая сегментация МРТ-изображений головного мозга: методы и программное обеспечение // ВИЧ-инфекция и иммуносупрессии.- 2014.- Т. 6, № 3.- С. 73-77.

14. Прахова Л. Н., Ильвес А. Г., Магонов Е. П. и др. Атрофия коры головного мозга при рассеянном склерозе // Журнал неврологии и психиатрии им. С. С. Корсакова.- 2014.- Т. 10.- С. 43-49.

15. Прахова Л. Н., Магонов Е. П., Ильвес А. Г. и др. Влияние нейродегенеративных изменений в головном мозге на формирование клинической картины заболевания у больных рассеянным склерозом // Бюллетень сибирской медицины.- 2013.- Т. 12, № 3.- С. 52-60.

16. Прахова Л. Н., Богдан А. А., Ильвес А. Г., Магонов Е. П.,. Савинцева Ж. И., Трофимова Т. Н. Особенности развития нейродегенерации таламуса у больных рассеянным склерозом // Лучевая диагностика и терапия.- 2015.- Т. 6, № 4.- С. 35-41