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Are Cerebral Perfusion and Atrophy Linked in Multiple Sclerosis? Evidence for a Multifactorial Approach to Assess
Maria Marcella Laganá1, Laura Mendozzi1, Laura Pelizzari1,2
1IRCCS, Fondazione Don Carlo Gnocchi ONLUS, via Capecelatro 66, 20148 Milan, Italy.
Background:
Grey Matter (GM) atrophy has been extensively described in Multiple Sclerosis (MS) patients, while cerebral hypoperfusion has been less consistently reported. Since hypoperfusion might be related to atrophy, we evaluated the presence of both damages.
Objective:
We aimed to assess if the regions of altered perfusion and atrophy overlapped with one another and if the two parameters were locally related.
Method:
3D-T1 weighted and arterial spin labelling sequences were acquired using a 1.5T Magnetic Resonance Imaging scanner from 26 relapsing remitting MS patients and 26 Healthy Controls (HC). GM volume and Cerebral Blood Flow (CBF) differences and their correlation were tested with a voxel-wise approach.
Results:
MS patients (41.4±12.5 years; 14 females) had a median [25th-75th percentile range] Expanded Disability Status Scale of 1.0[1.0-2.4] and a median [25th-75th percentile range] disease duration of 8.0 [4.0-16.5] years. HC were age- and sex-matched (43.9±17.4 years; 11 females). GM atrophy was detected for MS group in the right parahippocampal gyrus, thalami and left caudate (pFWE≤0.05). Areas of significant (after family-wise error -FWE- correction for multiple comparisons) (pFWE≤0.05) hypoperfusion were found for MS in the anterior cingulate and paracingulate gyri, supplementary motor cortex, precentral and superior frontal gyrus. GM volume and CBF showed a significant correlation (pFWE≤0.05) in the right lateral occipital cortex and precuneus in the MS group.
Conclusions:
GM atrophy and hypoperfusion in MS were located in different areas. Perfusion estimate might be used as a further marker of tissue damage, in addition to GM volume.
Insights
Grey matter atrophy and cerebral hypoperfusion in Multiple Sclerosis (MS) occur in distinct brain regions. Cerebral blood flow may serve as an additional biomarker for tissue damage in MS patients.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Grey matter (GM) atrophy is common in Multiple Sclerosis (MS).
- Cerebral hypoperfusion is inconsistently reported in MS.
- This study investigates the relationship between GM atrophy and hypoperfusion in MS.
Purpose of the Study:
- To determine if regions of altered perfusion and atrophy overlap in MS patients.
- To assess the local relationship between GM volume and cerebral blood flow (CBF).
Main Methods:
- Magnetic Resonance Imaging (MRI) using 3D-T1 weighted and arterial spin labelling sequences.
- Voxel-wise analysis of GM volume and CBF in 26 MS patients and 26 Healthy Controls (HC).
Main Results:
- GM atrophy was observed in the right parahippocampal gyrus, thalami, and left caudate in MS patients.
- Hypoperfusion was detected in the anterior cingulate/paracingulate gyri, supplementary motor cortex, precentral, and superior frontal gyrus.
- Significant correlation between GM volume and CBF was found in the right lateral occipital cortex and precuneus in MS patients.
Conclusions:
- GM atrophy and hypoperfusion in MS are localized to different brain areas.
- Cerebral blood flow (CBF) may serve as a supplementary biomarker for tissue damage in MS, alongside GM volume.
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