Deep gray matter perfusion in multiple sclerosis - Dynamic susceptibility contrast perfusion magnetic resonance imaging at 3 T

Objectives: To assess the presence of perfusion abnormalities in the deep gray matter of patients with relapsing-remitting and primary progressive multiple sclerosis ( MS) in comparison with healthy controls and to investigate the impact of perfusion impairment on clinical disability and fatigue. Design: Survey. Setting: Research-oriented hospital. Patients: Twenty-two patients with MS and 11 age- and sex-matched healthy volunteers. Intervention: Absolute cerebral blood flow, cerebral blood volume, and mean transit time were measured in the thalamus, putamen, and caudate nuclei. Main Outcome Measures: Decrease of cerebral blood flow in the deep gray matter of patients with MS and correlation between perfusion impairment and the severity of fatigue. Results: The cerebral blood flow value averaged over the thalamus, putamen, and caudate nuclei was significantly lower in patients with primary progressive MS (P <.001) and in patients with relapsing-remitting MS (P=.01) compared with controls, and there was a trend for patients with primary progressive MS to have lower average cerebral blood flow than patients with relapsing-remitting MS (P=.06). With respect to cerebral blood volume, there was a significant difference between patients with primary progressive MS and controls (P <.001) and between the 2 groups of patients (P=.03) but not between patients with relapsing-remitting MS and controls (P >.30). The fatigue score was significantly correlated with cerebral blood flow (r=0.4; P <.001) and cerebral blood volume (r=0.5; P=.004). Conclusion: The decrease of tissue perfusion in the deep gray matter of patients with MS is associated with the severity of fatigue.