TY - JOUR
T1 - White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis
AU - Varga, Andrew W.
AU - Johnson, Glyn
AU - Babb, James S.
AU - Herbert, Joseph
AU - Grossman, Robert I.
AU - Inglese, Matilde
N1 - Funding Information:
This study was supported by the National Institute of Health (NIH) grants RO1 NS051623 and RO1 NS 29029.
PY - 2009/7/15
Y1 - 2009/7/15
N2 - Background: Hypoperfusion has been reported in lesions, normal-appearing white (NAWM) and gray matter (NAGM) of patients with clinically definite multiple sclerosis (MS) by using perfusion MRI. However, it is still unknown how early such changes in perfusion occur. The aim of our study was to assess the presence of hemodynamic changes in the NAWM and subcortical NAGM of patients with clinically isolated syndrome (CIS) in comparison to healthy controls and to patients with early relapsing-remitting (RR) MS. Methods: Absolute cerebral blood flow (CBF), blood volume (CBV) and mean transit time (MTT) were measured in the periventricular and frontal NAWM, thalamus and putamen nuclei of 12 patients with CIS, 12 with early RR-MS and 12 healthy controls using dynamic susceptibility contrast enhanced (DSC) T2*-weighted MRI. Results: Compared to controls, CBF was significantly decreased in the periventricular NAWM of CIS patients and in the periventricular NAWM and putamen of RR-MS patients. Compared to CIS, RR-MS patients showed a significant CBF decrease in the putamen. Conclusions: CBF was decreased in the NAWM of both CIS and RR-MS patients and in the subcortical NAGM of RR-MS patients suggesting a continuum of tissue perfusion decreases beginning in white matter and spreading to gray matter, as the disease progresses.
AB - Background: Hypoperfusion has been reported in lesions, normal-appearing white (NAWM) and gray matter (NAGM) of patients with clinically definite multiple sclerosis (MS) by using perfusion MRI. However, it is still unknown how early such changes in perfusion occur. The aim of our study was to assess the presence of hemodynamic changes in the NAWM and subcortical NAGM of patients with clinically isolated syndrome (CIS) in comparison to healthy controls and to patients with early relapsing-remitting (RR) MS. Methods: Absolute cerebral blood flow (CBF), blood volume (CBV) and mean transit time (MTT) were measured in the periventricular and frontal NAWM, thalamus and putamen nuclei of 12 patients with CIS, 12 with early RR-MS and 12 healthy controls using dynamic susceptibility contrast enhanced (DSC) T2*-weighted MRI. Results: Compared to controls, CBF was significantly decreased in the periventricular NAWM of CIS patients and in the periventricular NAWM and putamen of RR-MS patients. Compared to CIS, RR-MS patients showed a significant CBF decrease in the putamen. Conclusions: CBF was decreased in the NAWM of both CIS and RR-MS patients and in the subcortical NAGM of RR-MS patients suggesting a continuum of tissue perfusion decreases beginning in white matter and spreading to gray matter, as the disease progresses.
KW - Clinically isolated syndrome
KW - Conventional MRI
KW - Dynamic susceptibility contrast perfusion MRI
KW - Normal-appearing gray matter
KW - Normal-appearing white matter
KW - Relapsing-remitting MS
UR - http://www.scopus.com/inward/record.url?scp=67349167121&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2008.12.036
DO - 10.1016/j.jns.2008.12.036
M3 - Article
C2 - 19181347
AN - SCOPUS:67349167121
SN - 0022-510X
VL - 282
SP - 28
EP - 33
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
IS - 1-2
ER -