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Authors
Abstract(s)
A Esclerose Múltipla (EM) é uma doença neurodegenerativa caracterizada pela presença de lesões que provocam danos na bainha de mielina, afetando diversas regiões do sistema nervoso central (SNC). A Ressonância Magnética (RM) ´e o método de eleição para o diagnóstico da EM, pois permite detetar a presença de lesões e quantificar a atrofia encefálica, ajudando na monitorização da progressão da doença. Avaliar a atrofia do cerebelo, através de métodos de segmentação e quantificação automáticos, que recorrem a imagens de RM, e obter a sua relação com a disfunção cognitiva e motora, tem sido alvo de investigação. O objetivo principal do presente trabalho consiste em analisar a performance cognitiva e motora e verificar a sua relação com o grau de atrofia do cerebelo, em pacientes com EM Surto-Remissão (EM-SR), com e sem disfunção clínica do cerebelo.
Para concretização do objetivo, foram recolhidos dados clínico-demográficos e resultados dos testes cognitivos e motores, em 44 indivíduos com EM-SR. As imagens de RM de cada indivíduo da amostra foram processadas recorrendo a métodos de segmentação e quantificação automáticos, como o FreeSurfer, volBrain e CERES, para obtenção dos dados volumétricos do cerebelo (regional e lobular).
Obtiveram-se diferenças significativas entre os pacientes com e sem disfunção clínica do cerebelo nos resultados do teste cognitivo e no volume total do cerebelo (VTC) e dos lóbulos Crus II e VIIb. Observaram-se também correlações significativas entre os resultados dos testes cognitivos e o VTC, volume da substância branca do cerebelo (VSBC) e volume dos lóbulos IV, Crus II e VIIb.
Em conclusão, os pacientes com sinais de disfunção clínica do cerebelo apresentaram mais alterações cognitivas e um maior grau de atrofia no VTC e lóbulos Crus II e VIIb. Para a performance cognitiva concluiu-se que está correlacionada com o grau de atrofia do VTC, VSBC e lóbulos Crus II e VIIb.
Multiple sclerosis (MS) is a neurodegenerative disease characterized by the presence of lesions that cause damage to the myelin sheath, affecting several regions of the central nervous system. Magnetic Resonance (MR) is the method of choice for the diagnosis of MS, as it allows the detection of the presence of lesions and the quantification of brain atrophy, helping to monitor the progression of the disease. Evaluating cerebellar atrophy, using automatic segmentation and quantification methods that use NMR images, and obtaining it’s relationship with cognitive and motor dysfunction, has been a potential target for investigation. The main objective of the present work is to analyze the cognitive and motor performance and to verify its relation with the degree of cerebellar atrophy, in patients with Relapsing-Remitting MS (RRMS), with and without clinical cerebellar dysfunction. To achieve the objective, clinical-demographic data and results of cognitive and motor tests were collected from 44 individuals with RRMS. The NMR images of the sample were subjected to processing by automatic segmentation and quantification methods, such as FreeSurfer, volBrain and CERES, to obtain cerebellar volumetric data (regional and lobular). Significant differences were obtained between patients with and without clinical dysfunction of the cerebellum in the results of the cognitive test and in the total cerebellum volume (TCV) and lobes Crus II and VIIb. There were also significant correlations between the results of the cognitive tests and the TCV, cerebellum white matter volume (CWMV) and volume of the lobes IV, Crus II and VIIb. In conclusion, patients with clinical dysfunction of the cerebellum showed more cognitive changes and a greater degree of atrophy in the TCV and lobes Crus II and VIIb. For the cognitive performance it was concluded that it is correlated with the degree of atrophy of the TCV, CWMV and Crus II and VIIb lobes.
Multiple sclerosis (MS) is a neurodegenerative disease characterized by the presence of lesions that cause damage to the myelin sheath, affecting several regions of the central nervous system. Magnetic Resonance (MR) is the method of choice for the diagnosis of MS, as it allows the detection of the presence of lesions and the quantification of brain atrophy, helping to monitor the progression of the disease. Evaluating cerebellar atrophy, using automatic segmentation and quantification methods that use NMR images, and obtaining it’s relationship with cognitive and motor dysfunction, has been a potential target for investigation. The main objective of the present work is to analyze the cognitive and motor performance and to verify its relation with the degree of cerebellar atrophy, in patients with Relapsing-Remitting MS (RRMS), with and without clinical cerebellar dysfunction. To achieve the objective, clinical-demographic data and results of cognitive and motor tests were collected from 44 individuals with RRMS. The NMR images of the sample were subjected to processing by automatic segmentation and quantification methods, such as FreeSurfer, volBrain and CERES, to obtain cerebellar volumetric data (regional and lobular). Significant differences were obtained between patients with and without clinical dysfunction of the cerebellum in the results of the cognitive test and in the total cerebellum volume (TCV) and lobes Crus II and VIIb. There were also significant correlations between the results of the cognitive tests and the TCV, cerebellum white matter volume (CWMV) and volume of the lobes IV, Crus II and VIIb. In conclusion, patients with clinical dysfunction of the cerebellum showed more cognitive changes and a greater degree of atrophy in the TCV and lobes Crus II and VIIb. For the cognitive performance it was concluded that it is correlated with the degree of atrophy of the TCV, CWMV and Crus II and VIIb lobes.
Description
Trabalho final de mestrado para obtenção do grau de Mestre em Engenharia Biomédica
Keywords
Esclerose múltipla surto-remissão Relapsing-Remitting Multiple Sclerosis, Cerebellum Atrophy, Magnetic Ressonance, Automatic Segmentation and Quantification, Cognitive and Motor Dysfunction Atrofia do cerebelo Cerebellum atrophy Ressonância magnética Magnetic ressonance Segmentação e quantificação automática Automatic segmentation and quantification Disfunção mognitiva e motora Cognitive and motor dysfunction
Citation
GRAÇA, Ana Filipa Batista - Análise do desempenho cognitivo e motor e sua relação com a atrofia do cerebelo em pacientes com esclerose múltipla surto-remissão. Lisboa: Instituto Superior de Engenharia de Lisboa - Escola Superior de Tecnologia da Saúde de Lisboa, 2020. Dissertação de mestrado.
Publisher
Instituto Superior de Engenharia de Lisboa - Escola Superior de Tecnologia da Saúde de Lisboa