White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis

Andrew W. Varga, Glyn Johnson, James S. Babb, Joseph Herbert, Robert I. Grossman, Matilde Inglese

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Abstract

BACKGROUND: Hypoperfusion has been reported in lesions, normal-appearing white (NAWM) and gray matter (NAGM) of patients with clinically definite multiple sclerosis (MS) by using perfusion MRI. However, it is still unknown how early such changes in perfusion occur. The aim of our study was to assess the presence of hemodynamic changes in the NAWM and subcortical NAGM of patients with clinically isolated syndrome (CIS) in comparison to healthy controls and to patients with early relapsing-remitting (RR) MS. METHODS: Absolute cerebral blood flow (CBF), blood volume (CBV) and mean transit time (MTT) were measured in the periventricular and frontal NAWM, thalamus and putamen nuclei of 12 patients with CIS, 12 with early RR-MS and 12 healthy controls using dynamic susceptibility contrast enhanced (DSC) T2*-weighted MRI. RESULTS: Compared to controls, CBF was significantly decreased in the periventricular NAWM of CIS patients and in the periventricular NAWM and putamen of RR-MS patients. Compared to CIS, RR-MS patients showed a significant CBF decrease in the putamen. CONCLUSIONS: CBF was decreased in the NAWM of both CIS and RR-MS patients and in the subcortical NAGM of RR-MS patients suggesting a continuum of tissue perfusion decreases beginning in white matter and spreading to gray matter, as the disease progresses.
Original languageEnglish
Pages (from-to)28-33
Number of pages6
JournalJournal of the Neurological Sciences
Volume282
Issue number1-2
Early online date31 Jan 2009
DOIs
Publication statusPublished - 2009

Keywords

  • Clinically isolated syndrome
  • relapsing-remitting MS
  • Normal-appearing white matter
  • Normal-appearing gray matter
  • Dynamic susceptibility contrast perfusion MRI
  • Conventional MRI

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