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Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis.

Andrew W Varga1, Glyn Johnson, James S Babb

  • 1Department of Radiology, New York University, New York, NY, USA.

Journal of the Neurological Sciences
|February 3, 2009
PubMed
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Cerebral blood flow decreases in normal-appearing white matter of patients with clinically isolated syndrome (CIS) and early relapsing-remitting (RR) multiple sclerosis (MS). These perfusion changes suggest an early stage of the disease impacting brain tissue.

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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Science

Background:

  • Hypoperfusion is observed in multiple sclerosis (MS) lesions and normal-appearing brain tissue using perfusion MRI.
  • Early hemodynamic changes in clinically isolated syndrome (CIS) and early relapsing-remitting (RR) MS are not well understood.

Purpose of the Study:

  • To assess hemodynamic changes in normal-appearing white matter (NAWM) and subcortical gray matter (NAGM) in CIS patients.
  • To compare these changes with healthy controls and early RR-MS patients.

Main Methods:

  • Dynamic susceptibility contrast enhanced (DSC) T2*-weighted MRI was used.
  • Absolute cerebral blood flow (CBF), blood volume (CBV), and mean transit time (MTT) were measured.
  • Participants included 12 CIS patients, 12 early RR-MS patients, and 12 healthy controls.

Main Results:

  • CBF was significantly decreased in the periventricular NAWM of CIS patients compared to controls.
  • RR-MS patients showed significantly decreased CBF in periventricular NAWM and putamen compared to controls.
  • RR-MS patients exhibited a significant CBF decrease in the putamen compared to CIS patients.

Conclusions:

  • Decreased CBF in NAWM of CIS and RR-MS patients indicates early disease-related perfusion changes.
  • CBF reduction in subcortical NAGM of RR-MS patients suggests disease progression.
  • These findings suggest a continuum of perfusion decrease from white to gray matter as MS progresses.