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Multiple sclerosis: cerebral circulation time.

Marcello Mancini1, Vincenzo Brescia Morra, Orlando Di Donato

  • 1Institute of Biostructure and Bioimaging, National Research Council of Italy, Federico II University School of Medicine, Via Pansini 5, Edificio 10, 80131 Naples, Italy. marcello.mancini@libero.it

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|February 24, 2012
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Summary

Patients with multiple sclerosis (MS) show prolonged cerebral circulation times (CCTs) using contrast-enhanced ultrasonography. This suggests potential vascular impairments associated with MS, distinct from venous insufficiency.

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
  • Vascular abnormalities are increasingly being investigated as a potential factor in MS pathogenesis.
  • Cerebral circulation times (CCTs) offer a quantitative measure of blood flow dynamics.

Purpose of the Study:

  • To evaluate cerebral circulation times (CCTs) in patients with MS compared to healthy controls.
  • To investigate the utility of contrast-enhanced ultrasonography (US) in detecting vascular abnormalities in MS.
  • To determine the association between CCTs, MS, and chronic cerebrospinal venous insufficiency (CCSVI).

Main Methods:

  • Contrast-enhanced ultrasonography (US) was performed on 103 MS patients and 42 controls.
  • Cerebral circulation time (CCT) was measured as the time difference for US contrast agent arrival between the carotid artery and internal jugular vein.
  • Statistical analysis included Mann-Whitney U test and Kruskal-Wallis ANOVA to compare groups.

Main Results:

  • Patients with MS exhibited significantly prolonged longest and average CCTs compared to controls (P < .001 and P < .002, respectively).
  • The prevalence of chronic cerebrospinal venous insufficiency (CCSVI) was significantly higher in MS patients (77%) than in controls (28%) (P < .0001).
  • No significant difference in CCT was observed between MS patients with and without CCSVI (P = .182).

Conclusions:

  • Contrast-enhanced US and CCT assessment may aid in evaluating cerebral blood flow in MS.
  • Prolonged CCT in MS suggests an associated vascular impairment, not solely due to outflow obstruction.
  • Further research is needed to establish the clinical and physiological relevance of CCT and CCSVI in MS.