Regional Frontal Perfusion Deficits in Relapsing-Remitting Multiple Sclerosis with Cognitive Decline.

Area of Science:

• Neuroscience
• Medical Imaging
• Neurology

Background:

• Cortical dysfunction is common in multiple sclerosis (MS), often leading to cognitive impairment.
• Cerebral perfusion imaging can quantify this dysfunction.

Purpose of the Study:

• To identify differences in cerebral perfusion distribution in patients with relapsing-remitting MS (RRMS) with and without cognitive impairment.
• To compare these differences with healthy controls.

Main Methods:

• 39 RRMS patients (20 cognitively impaired, 19 non-impaired) and 19 healthy controls underwent neurocognitive testing and MRI.
• Voxel-based analysis was used to compare regional gray matter (GM) perfusion and volume.

Main Results:

• Reduced cerebral blood flow (CBF) and cerebral blood volume (CBV) were observed in the left middle frontal cortex in all MS patients.
• Cognitively impaired MS patients showed additional deficits in the left superior frontal gyrus and limbic regions.
• Reduced CBV was noted in the right middle frontal gyrus (cognitively impaired MS) and temporal gyrus (non-impaired MS) compared to controls.

Conclusions:

• Frontal cortical perfusion deficits are characteristic of RRMS.
• Widespread hypoperfusion in MS patients with cognitive impairment is independent of structural brain changes.
• Cerebral perfusion may serve as a valuable biomarker for cortical dysfunction and cognitive impairment in MS.