Vitorino R, Hojjat S-P, Cantrell C G, Feinstein A, Zhang L, Lee L, O'Connor P, Carroll T J, Aviv R I
Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Medical Imaging (R.V., S.-P.H., L.Z., R.I.A.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
AJNR Am J Neuroradiol. 2016 Oct;37(10):1800-1807. doi: 10.3174/ajnr.A4824. Epub 2016 May 19.
Cortical dysfunction, quantifiable by cerebral perfusion techniques, is prevalent in patients with MS, contributing to cognitive impairment. We sought to localize perfusion distribution differences in patients with relapsing-remitting MS with and without cognitive impairment and healthy controls.
Thirty-nine patients with relapsing-remitting MS (20 cognitively impaired, 19 nonimpaired) and 19 age- and sex-matched healthy controls underwent a neurocognitive battery and MR imaging. Voxel-based analysis compared regional deep and cortical GM perfusion and volume among the cohorts.
After we adjusted for localized volumetric differences in the right frontal, temporal, and occipital lobes, progressive CBF and CBV deficits were present in the left middle frontal cortex for all cohorts and in the left superior frontal gyrus for patients with cognitive impairment compared with patients without impairment and controls. Compared with healthy controls, reduced CBF was present in the limbic regions of patients with cognitive impairment, and reduced CBV was present in the right middle frontal gyrus in patients with cognitive impairment and in the temporal gyrus of relapsing-remitting MS patients without cognitive impairment.
Consistent regional frontal cortical perfusion deficits are present in patients with relapsing-remitting MS, with more widespread hypoperfusion in those with cognitive impairment, independent of structural differences, indicating that cortical perfusion may be a useful biomarker of cortical dysfunction and cognitive impairment in MS.
通过脑灌注技术可量化的皮质功能障碍在多发性硬化症（MS）患者中普遍存在，这会导致认知障碍。我们试图确定复发缓解型MS患者中有无认知障碍者以及健康对照者的灌注分布差异。
39例复发缓解型MS患者（20例有认知障碍，19例无认知障碍）以及19例年龄和性别匹配的健康对照者接受了神经认知测试和磁共振成像。基于体素的分析比较了各组之间区域深部和皮质灰质的灌注及体积。
在对右侧额叶、颞叶和枕叶的局部体积差异进行校正后，与无认知障碍的患者及对照者相比，所有组在左侧额中回均存在渐进性脑血流量（CBF）和脑血容量（CBV）不足，而有认知障碍的患者在左侧额上回也存在渐进性CBF和CBV不足。与健康对照者相比，有认知障碍的患者边缘区域CBF降低，有认知障碍的患者右侧额中回以及无认知障碍的复发缓解型MS患者颞回CBV降低。
复发缓解型MS患者存在一致的额叶皮质灌注不足，认知障碍患者的灌注不足更为广泛，且与结构差异无关，这表明皮质灌注可能是MS中皮质功能障碍和认知障碍的有用生物标志物。
