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Updated: Aug 23, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Abnormalities of cerebral perfusion in multiple sclerosis
W Rashid1, L M Parkes, G T Ingle
1MS NMR Research Unit, Department of Neuroinflammation, Brain Injury and Rehabilitation, Institute of Neurology, University College London, UK.
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 beta-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 T(1) 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.
Insights
Brain perfusion MRI reveals distinct patterns in multiple sclerosis (MS) subtypes. Progressive MS shows lower grey matter perfusion, while relapsing MS exhibits increased white matter perfusion, suggesting differing disease mechanisms.
Area of Science:
- Neuroimaging
- Medical Physics
- Neurology
Background:
- Perfusion imaging offers insights into brain tissue metabolic activity.
- Multiple sclerosis (MS) studies show altered perfusion in grey matter (GM) and white matter (WM), but patterns across clinical subtypes remain unclear.
Purpose of the Study:
- Investigate perfusion differences in MS clinical subgroups using continuous arterial spin labelling (CASL) MRI.
- Determine if distinct MS subtypes exhibit unique perfusion changes.
- Elucidate potential pathological mechanisms underlying observed perfusion alterations.
Main Methods:
- Compared perfusion in 60 MS patients (relapsing remitting, secondary progressive, primary progressive, benign) and 34 healthy controls.
- Utilized Statistical Parametric Mapping (SPM '99) for regional perfusion analysis in GM and WM.
- Quantified global white matter perfusion via WM segmentation using T(1) relaxation times.
Main Results:
- Primary and secondary progressive MS cohorts showed reduced GM perfusion, notably in the thalamus.
- Relapsing remitting and secondary progressive MS cohorts demonstrated increased WM perfusion.
Conclusions:
- Decreased GM perfusion in progressive MS may indicate neuronal loss or dysfunction.
- Increased WM perfusion in relapsing and progressive MS could signify heightened cellularity and inflammation.
- Further longitudinal studies with advanced imaging techniques are recommended to explore regional/temporal perfusion changes and their clinical correlations.
Related Concept Videos
01:19Multiple Sclerosis l: Introduction
01:22Cerebral Edema ll: Pathophysiology