• Mult. Scler. · Nov 2016

    Perfusion reduction in the absence of structural differences in cognitively impaired versus unimpaired RRMS patients.

    • Seyed-Parsa Hojjat, Charles Grady Cantrell, Timothy J Carroll, Rita Vitorino, Anthony Feinstein, Lying Zhang, Sean P Symons, Sarah A Morrow, Liesly Lee, Paul O'Connor, and Richard I Aviv.
    • Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Parsa.Hojjat@sunnybrook.ca.
    • Mult. Scler. 2016 Nov 1; 22 (13): 1685-1694.

    BackgroundCognitive impairment affects 40%-68% of relapsing-remitting multiple sclerosis (RRMS) patients. Gray matter (GM) demyelination is complicit in cognitive impairment, yet cortical lesions are challenging to image clinically. We wanted to determine whether cortical cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) differences exist between cognitively impaired (CI) and unimpaired (NI) RRMS.MethodsProspective study of healthy controls (n = 19), CI (n = 20), and NI (n = 19) undergoing magnetic resonance imaging (MRI) and cognitive testing <1 week apart. White matter (WM) T2 hyperintense lesions and T1 black holes were traced. General linear regression assessed the relationship between lobar WM volume and cortical and WM CBF, CBV, and MTT. Relationship between global and lobar cortical CBF, CBV, and MTT and cognitive impairment was tested using a generalized linear model. Adjusted Bonferroni p < 0.005 was considered significant.ResultsNo significant differences for age, gender, disease duration, and any fractional brain or lesion volume were demonstrated for RRMS subgroups. Expanded Disability Status Scale (EDSS) and Hospital Anxiety and Depression Scale-Depression (HADS-D) were higher in CI. Lobar cortical CBF and CBV were associated with cognitive impairment (p < 0.0001) after controlling for confounders. Cortical CBV accounted for 7.2% of cognitive impairment increasing to 8.7% with cortical CBF (p = 0.06), while WM and cortical CBF accounted for 8.2% of variance (p = 0.04).ConclusionSignificant cortical CBF and CBV reduction was present in CI compared to NI in the absence of structural differences.© The Author(s), 2016.

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