Heterogeneity of cortical lesions in multiple sclerosis: an MRI perfusion study

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
• Cortical lesions are increasingly recognized as significant contributors to disability in MS.
• Understanding the pathophysiology of cortical lesions is crucial for disease management.

Purpose of the Study:

• To quantify cerebral perfusion parameters in cortical lesions of patients with relapsing-remitting MS.
• To investigate changes in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) associated with cortical lesions.
• To evaluate the utility of dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI) in assessing cortical lesion evolution.

Main Methods:

• Dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI) was employed in 44 patients with relapsing-remitting MS.
• Cerebral perfusion parameters (CBF, CBV, MTT) were quantified.
• Perfusion in cortical lesions was compared to normal-appearing gray matter.

Main Results:

• Cortical lesions exhibited significantly reduced CBF and CBV compared to normal-appearing gray matter.
• No significant differences in MTT were observed between cortical lesions and normal-appearing gray matter.
• A subset of outliers displayed increased CBF and/or CBV, suggesting potential inflammatory evolution.

Conclusions:

• Perfusion is significantly altered within cortical lesions in MS.
• Reduced perfusion in MS cortical lesions may reflect neuronal loss and metabolic reduction.
• DSC-MRI is a valuable tool for investigating the dynamic changes and evolution of cortical lesions in MS.