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Updated: Oct 3, 2025

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Brain grey matter perfusion in primary progressive multiple sclerosis: Mild decrease over years and regional

Benoit Testud1,2,3, Clara Delacour3, Ahmed Ali El Ahmadi3

  • 1CEMEREM, APHM La Timone, Marseille, France.

European Journal of Neurology
|February 15, 2022
PubMed
Summary
This summary is machine-generated.

Brain perfusion decreases over time in primary progressive multiple sclerosis (PPMS), correlating with increased disability. Regional perfusion patterns may reflect neurodegeneration and functional reorganization in MS.

Keywords:
ASLMRImultiple sclerosisneurodegenerationperfusion

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Neurodegeneration in multiple sclerosis (MS) may be reflected by brain perfusion.
  • Assessing brain perfusion dynamics and its link to disability in primary progressive MS (PPMS) is crucial.

Purpose of the Study:

  • To investigate the evolution of brain perfusion over several years in PPMS patients.
  • To explore the association between regional and global brain perfusion and disability progression.

Main Methods:

  • Followed 77 PPMS patients for up to 5 years.
  • Utilized 3-T MRI with pulsed arterial spin labelling for perfusion assessment.
  • Assessed disability using Timed 25-Foot Walk, 9-Hole Peg Test (NHPT), Symbol Digit Modalities Test (SDMT), and Expanded Disability Status Scale (EDSS).

Main Results:

  • Brain perfusion decreased over time in PPMS patients (p < 0.001).
  • Lower global perfusion correlated with higher disability scores (EDSS, NHPT, Timed 25-Foot Walk; p < 0.001).
  • SDMT performance correlated with perfusion in frontal regions, suggesting functional maladaptation.

Conclusions:

  • Decreasing brain perfusion may indicate neurodegeneration and reduced resilience in MS.
  • Regional perfusion patterns offer insights into adaptive and maladaptive functional reorganization in PPMS.