Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 18, Issue 11, Pages 1570-1576Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458512441984
Keywords
arterial spin labelling; multiple sclerosis; lesion load; cerebral blood flow; pulsed arterial spin labelling; cortical perfusion
Categories
Funding
- GlaxoSmithKline
- Swiss MS Society
- German Federal Ministry of Education and Research (BMBF)
- Acorda
- Actelion
- Allozyne
- BaroFold
- Bayer HealthCare Pharmaceuticals
- Bayer Schering
- Bayhill
- Biogen Idec
- Boehringer Ingelheim
- Elan
- Genmab
- Glenmark
- Merck Serono
- Medicinova
- Novartis
- sanofi-aventis
- Santhera
- Shire
- Roche
- Teva
- UCB
- Wyeth
- Swiss National Research Foundation
- European Union
- Gianni Rubatto Foundation
- Novartis Research Foundation
- Roche Research Foundation
- TEVA Neurosciences
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Background: We hypothesized that in multiple sclerosis (MS) patients, reduced cortical perfusion is associated with chronic white matter injury. Objective: To investigate the influence of different clinical and magnetic resonance imaging characteristics on cortical perfusion. Methods: Cerebral blood flow (CBF) was assessed by applying a pulsed arterial spin labelling (ASL) technique combined with single-shot 3D-GRASE (gradient-spin echo) in a cohort of 165 MS patients with a relapsing-remitting (n=123) or secondary progressive disease course (n=42). Mean age was 45.4 years (20-68 years), mean disease duration was 14.2 years (1-48 years). Results: Mean cortical CBF was 45.6 ml/100g per min (SD: 7.8 ml/100g per min). Stepwise multiple linear regression models were calculated to investigate the relationship between different factor sets and mean CBF. The model with the highest adjusted coefficient of determination included T2 lesion load, age, gender and disease duration as significant factors. Post-hoc Spearman rank correlation revealed significant correlation of adjusted CBF with T2 lesion load (rho=-0.35, p=1*10(-6)), with age (rho =-0.34, p=4*10(-6)), and with disease duration (rho=0.16, p=0.03), while Expanded Disability Status Scale (EDSS) did not reach significance in either model. Conclusion: This study suggests that the amount of white matter lesions indicates a reduced metabolic demand and reduced perfusion at a cortical level.
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