Second Department of Neurology, Institute of Psychiatry and Neurology, Warszawa, Poland.
Adv Clin Exp Med. 2020 Feb;29(2):183-188. doi: 10.17219/acem/114762.
In multiple sclerosis (MS), insufficient blood supply might worsen energy deficiency of the brain tissue. Thus, cerebrovascular reactivity (CVR), which is the capacity of cerebral circulation to match blood supply to metabolic demand, might be important in MS pathology.
The objective of this study was to investigate the relationship of CVR to disease activity and neuroimaging markers of disease progression in patients with MS.
In 43 patients with relapsing remitting MS (RRMS) in clinical remission, 30 patients with a relapse of MS and 30 healthy controls, we measured CVR with transcranial Doppler as a relative change in flow velocity after breath-holding (breath-holding index) and voluntary hyperventilation (hyperventilation index). All patients in remission underwent brain magnetic resonance imaging at baseline and 33 underwent repeated imaging after 12 months, with various brain volume measurements taken.
Cerebrovascular reactivity indices did not differ between patients in remission, patients with a relapse and controls. In patients in remission, CVR did not differ between those with or without contrast-enhancing lesions. In patients with a relapse, glucocorticoids significantly reduced both CVR indices. Cerebrovascular reactivity was not related to brain volume, white matter lesion volume, percent brain volume change, and the change in total white matter lesion volume.
In RRMS, CVR appeared normal and unrelated to disease activity. There was no substantial association of CVR to brain atrophy and accumulation of white matter lesions.
在多发性硬化症（MS）中，血液供应不足可能会加重脑组织的能量不足。因此，脑血管反应性（CVR），即大脑循环适应血液供应与代谢需求的能力，在 MS 病理中可能很重要。
本研究旨在探讨 CVR 与 MS 患者疾病活动和神经影像学疾病进展标志物的关系。
在 43 例处于临床缓解期的复发缓解型多发性硬化症（RRMS）患者、30 例 MS 复发患者和 30 名健康对照者中，我们使用经颅多普勒测量 CVR，以血流速度的相对变化作为屏气（屏气指数）和自愿过度通气（过度通气指数）后的指标。所有缓解期患者在基线时进行脑磁共振成像，33 名患者在 12 个月后进行重复成像，并进行各种脑容量测量。
缓解期患者、复发患者和对照组之间的 CVR 指数没有差异。在缓解期患者中，CVR 在有无对比增强病变的患者之间没有差异。在复发患者中，糖皮质激素显著降低了两种 CVR 指数。CVR 与脑容量、白质病变体积、脑容量变化百分比以及总白质病变体积变化无关。
在 RRMS 中，CVR 似乎正常且与疾病活动无关。CVR 与脑萎缩和白质病变积累之间没有实质性的关联。
