Abnormalities of cerebral perfusion in multiple sclerosis

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2004-09, Vol.75 (9), p.1288-1293
• Main Authors: Rashid, W, Parkes, L M, Ingle, G T, Chard, D T, Toosy, A T, Altmann, D R, Symms, M R, Tofts, P S, Thompson, A J, Miller, D H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Alzheimer's disease; arterial spin labelling; ASL; Axons - pathology; Biological and medical sciences; Blood; Brain - metabolism; Brain research; CASL; Cohort Studies; continuous arterial spin labelling; Dementia; Disabled Persons; Disease Progression; echo planar imaging; echo time; EPI; Female; field of view; FOV; grey matter; Humans; Immunologic Factors - therapeutic use; Interferon-beta - therapeutic use; Labeling; Magnetic Resonance Angiography; Male; Medical imaging; Medical sciences; Metabolism; Middle Aged; MRI; MS Functional Composite; MSFC; Multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - drug therapy; Multiple Sclerosis - pathology; Nervous system; Neurology; NMR; Noise; Nuclear magnetic resonance; perfusion; PET; positron emission tomography; proton density; repetition time; Severity of Illness Index; single photon emission computed tomography; SPECT; SPM; statistical parametric mapping; Studies; Tomography; white matter
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2003.026021

Background: Measuring perfusion provides a potential indication of metabolic activity in brain tissue. Studies in multiple sclerosis (MS) have identified areas of decreased perfusion in grey matter (GM) and white matter (WM), but the pattern in clinical subgroups is unclear. Objectives: This study investigated perfusion changes in differing MS clinical subgroups on or off β-interferon therapy using a non-invasive MRI technique (continuous arterial spin labelling) to investigate whether different clinical MS subtypes displayed perfusion changes and whether this could give a further insight into the pathological mechanisms involved. Methods: Sixty patients (21 relapsing remitting, 14 secondary progressive, 12 primary progressive, 13 benign) and 34 healthy controls were compared. Statistical parametric mapping (SPM ’99) was used to investigate regional variations in perfusion in both GM and WM. Global WM perfusion was derived by segmenting WM from images using T1 relaxation times. Results: Regions of lower perfusion in predominantly GM were observed in the primary and secondary progressive cohorts, particularly in the thalamus. Increased WM perfusion was seen in relapsing remitting and secondary progressive cohorts. Conclusions: Low GM perfusion could reflect decreased metabolism secondary to neuronal and axonal loss or dysfunction with a predilection for progressive forms of MS. Increased WM perfusion may indicate increased metabolic activity possibly due to increased cellularity and inflammation. Improved methodology and longitudinal studies may enable further investigation of regional and temporal changes, and their relationship with physical and cognitive impairment.