BACKGROUND AND PURPOSE: There is increasing evidence implicating microvascular impairment in MS pathogenesis. Perfusion imaging offers a unique opportunity to investigate the functional impact of GM pathology. We sought to quantify differences in MR imaging-based bookend-derived cerebral perfusion between cognitively impaired and nonimpaired patients with SPMS. MATERIALS AND METHODS: Patients were prospectively recruited and assessed using MR imaging and the standard cognitive battery called the Minimal Assessment of Cognitive Function in MS. Patients exhibiting impairment on ≥ 2 individual tests were classified as cognitively impaired. Healthy controls were prospectively recruited and assessed using MR imaging to validate bookend assumptions. Structural and perfusion scans were coregistered and partitioned into anatomic brain regions and tissue compartments. Clinical and radiologic characteristics were compared between patients with and without impairment to identify potential confounders. A Bonferroni adjusted P value threshold (P < .005) was used for lobar and sublobar level analyses to correct for multiple comparisons. RESULTS: Thirty-seven patients with SPMS (age 56 ± 9 years; 23 women, 14 men) and 10 age- and sex-matched healthy controls were recruited. Bookend assumptions were found to be valid in MS. GM and WM qCBV were all globally reduced in impaired patients. After adjusting for potential confounders while examining sublobar level perfusion, only GM qCBV was significantly different between cognitive groups, and this hypoperfusion localized to the bilateral medial superior frontal regions and left inferior, middle, and superior frontal regions (P < .005) of impaired patients compared with nonimpaired patients. GM qCBV accounted for 22.5% of the model variance compared with a model including only confounders (P = .0007). CONCLUSIONS: Bookend-derived GM qCBV was significantly reduced in cognitively impaired patients with SPMS in functionally relevant brain regions.
BACKGROUND AND PURPOSE: There is increasing evidence implicating microvascular impairment in MS pathogenesis. Perfusion imaging offers a unique opportunity to investigate the functional impact of GM pathology. We sought to quantify differences in MR imaging-based bookend-derived cerebral perfusion between cognitively impaired and nonimpaired patients with SPMS. MATERIALS AND METHODS:Patients were prospectively recruited and assessed using MR imaging and the standard cognitive battery called the Minimal Assessment of Cognitive Function in MS. Patients exhibiting impairment on ≥ 2 individual tests were classified as cognitively impaired. Healthy controls were prospectively recruited and assessed using MR imaging to validate bookend assumptions. Structural and perfusion scans were coregistered and partitioned into anatomic brain regions and tissue compartments. Clinical and radiologic characteristics were compared between patients with and without impairment to identify potential confounders. A Bonferroni adjusted P value threshold (P < .005) was used for lobar and sublobar level analyses to correct for multiple comparisons. RESULTS: Thirty-seven patients with SPMS (age 56 ± 9 years; 23 women, 14 men) and 10 age- and sex-matched healthy controls were recruited. Bookend assumptions were found to be valid in MS. GM and WM qCBV were all globally reduced in impaired patients. After adjusting for potential confounders while examining sublobar level perfusion, only GM qCBV was significantly different between cognitive groups, and this hypoperfusion localized to the bilateral medial superior frontal regions and left inferior, middle, and superior frontal regions (P < .005) of impaired patients compared with nonimpaired patients. GM qCBV accounted for 22.5% of the model variance compared with a model including only confounders (P = .0007). CONCLUSIONS: Bookend-derived GM qCBV was significantly reduced in cognitively impairedpatients with SPMS in functionally relevant brain regions.
Authors: Nicola R Sibson; Andrew M Blamire; V Hugh Perry; Jack Gauldie; Peter Styles; Daniel C Anthony Journal: Brain Date: 2002-11 Impact factor: 13.501
Authors: E Paulesu; D Perani; F Fazio; G Comi; C Pozzilli; V Martinelli; M Filippi; V Bettinardi; G Sirabian; D Passafiume; A Anzini; G L Lenzi; N Canal; C Fieschi Journal: Neuroimage Date: 1996-10 Impact factor: 6.556
Authors: Matilde Inglese; Sumita Adhya; Glyn Johnson; James S Babb; Laura Miles; Hina Jaggi; Joseph Herbert; Robert I Grossman Journal: J Cereb Blood Flow Metab Date: 2007-05-02 Impact factor: 6.200
Authors: S C J Huijbregts; N F Kalkers; L M J de Sonneville; V de Groot; I E W Reuling; C H Polman Journal: Neurology Date: 2004-07-27 Impact factor: 9.910
Authors: J Dehmeshki; D T Chard; S M Leary; H C Watt; N C Silver; P S Tofts; A J Thompson; D H Miller Journal: J Neurol Date: 2003-01 Impact factor: 4.849
Authors: A Eilaghi; A Kassner; I Sitartchouk; P L Francis; R Jakubovic; A Feinstein; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2013-05-30 Impact factor: 3.825
Authors: P L Francis; R Jakubovic; P O'Connor; L Zhang; A Eilaghi; L Lee; T J Carroll; J Mouannes-Srour; A Feinstein; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2012-06-14 Impact factor: 3.825
Authors: Miguel D'haeseleer; Stéphanie Hostenbach; Ilse Peeters; Souraya El Sankari; Guy Nagels; Jacques De Keyser; Marie B D'hooghe Journal: J Cereb Blood Flow Metab Date: 2015-06-24 Impact factor: 6.200
Authors: S-P Hojjat; M Kincal; R Vitorino; C G Cantrell; A Feinstein; L Zhang; L Lee; P O'Connor; T J Carroll; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2016-03-24 Impact factor: 3.825
Authors: R Vitorino; S-P Hojjat; C G Cantrell; A Feinstein; L Zhang; L Lee; P O'Connor; T J Carroll; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2016-05-19 Impact factor: 3.825
Authors: R M D'Ortenzio; S P Hojjat; R Vitorino; C G Cantrell; L Lee; A Feinstein; P O'Connor; T J Carroll; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2016-09-29 Impact factor: 3.825
Authors: 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; Richard I Aviv Journal: Mult Scler Date: 2016-02-04 Impact factor: 6.312
Authors: P L Francis; T L Chia; R Jakubovic; P O'Connor; L Lee; A Feinstein; R I Aviv Journal: AJNR Am J Neuroradiol Date: 2014-05-15 Impact factor: 3.825