Perfusion Reduction in the Absence of Structural Differences in Cognitively Impaired Versus Unimpaired RRMS Patients

Overview

Journal Mult Scler

Publisher Sage Publications

Specialty Neurology

Date 2016 Feb 6

PMID 26846987

Citations 14

Authors

Seyed-Parsa Hojjat

Charles Grady Cantrell

Timothy J Carroll

Rita Vitorino

Anthony Feinstein

Lying Zhang

Sean P Symons

Sarah A Morrow

Liesly Lee

Paul OConnor

Richard I Aviv

Affiliations

Soon will be listed here.

Abstract

Background: Cognitive impairment affects 40%-68% of relapsing-remitting multiple sclerosis (RRMS) patients. Gray matter (GM) demyelination is complicit in cognitive impairment, yet cortical lesions are challenging to image clinically. We wanted to determine whether cortical cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) differences exist between cognitively impaired (CI) and unimpaired (NI) RRMS.

Methods: Prospective study of healthy controls (n = 19), CI (n = 20), and NI (n = 19) undergoing magnetic resonance imaging (MRI) and cognitive testing <1 week apart. White matter (WM) T2 hyperintense lesions and T1 black holes were traced. General linear regression assessed the relationship between lobar WM volume and cortical and WM CBF, CBV, and MTT. Relationship between global and lobar cortical CBF, CBV, and MTT and cognitive impairment was tested using a generalized linear model. Adjusted Bonferroni p < 0.005 was considered significant.

Results: No significant differences for age, gender, disease duration, and any fractional brain or lesion volume were demonstrated for RRMS subgroups. Expanded Disability Status Scale (EDSS) and Hospital Anxiety and Depression Scale-Depression (HADS-D) were higher in CI. Lobar cortical CBF and CBV were associated with cognitive impairment (p < 0.0001) after controlling for confounders. Cortical CBV accounted for 7.2% of cognitive impairment increasing to 8.7% with cortical CBF (p = 0.06), while WM and cortical CBF accounted for 8.2% of variance (p = 0.04).

Conclusion: Significant cortical CBF and CBV reduction was present in CI compared to NI in the absence of structural differences.

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