Aude Metzger1,2, Emmanuelle Le Bars3,4,5, Jeremy Deverdun3,4,5, François Molino5,6, Bénédicte Maréchal7,8,9, Marie-Christine Picot10, Xavier Ayrignac11, Clarisse Carra11, Luc Bauchet12,13, Alexandre Krainik14, Pierre Labauge11, Nicolas Menjot de Champfleur3,4,5,15. 1. Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France. audemetzger2@gmail.com. 2. Department of Neurology, Memory Ressource and Research Center, University Hospital Center, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France. audemetzger2@gmail.com. 3. Département de Neuroradiologie, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France. 4. Institut d'Imagerie Fonctionnelle Humaine (I2FH), Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France. 5. Laboratoire Charles Coulomb, CNRS UMR 5221, Université de Montpellier, Montpellier, France. 6. Institut de Génomique Fonctionnelle, CNRS UMR 5203, INSERM U661, Université de Montpellier, Montpellier, France. 7. Advanced Clinical Imaging Technology, Siemens Healthcare, HC CEMEA SUI DI, Lausanne, PI, Switzerland. 8. Department of Radiology, CHUV, Lausanne, Switzerland. 9. LTS5, EPFL, Lausanne, Switzerland. 10. Département de Biostatistiques, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France. 11. Department of Neurology, University Hospital Center, Gui de Chauliac Hospital, Montpellier, France. 12. Département de Neurochirurgie, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire de Montpellier, Montpellier, France. 13. Institut de Neurosciences de Montpellier, INSERM U1051, Hôpital Saint Eloi, Montpellier, France. 14. MR Unit CS 10217, University Hospital of Grenoble, Grenoble, France. 15. Département d'Imagerie Médicale, Centre Hospitalier Universitaire Caremeau, Nîmes, France.
Abstract
OBJECTIVE: The link between cerebral vasoreactivity and cognitive status in multiple sclerosis remains unclear. The aim of the present study was to investigate a potential decrease of cerebral vasoreactivity in multiple sclerosis patients and correlate it with cognitive status. METHODS: Thirty-three patients with multiple sclerosis (nine progressive and 24 remitting forms, median age: 39 years, 12 males) and 22 controls underwent MRI with a hypercapnic challenge to assess cerebral vasoreactivity and a neuropsychological assessment. Cerebral vasoreactivity, measured as the cerebral blood flow percent increase normalised by end-tidal carbon dioxide variation, was assessed globally and by regions of interest using the blood oxygen level-dependent technique. Non-parametric statistics tests were used to assess differences between groups, and associations were estimated using linear models. RESULTS: Cerebral vasoreactivity was lower in patients with cognitive impairment than in cognitively normal patients (p=0.004) and was associated with education level in patients (R2 = 0.35; p = 0.047). There was no decrease in cerebral vasoreactivity between patients and controls. CONCLUSIONS: Cognitive impairment in multiple sclerosis may be mediated through decreased cerebral vasoreactivity. Cerebral vasoreactivity could therefore be considered as a marker of cognitive decline in multiple sclerosis. KEY POINTS: • Cerebral vasoreactivity does not differ between multiple sclerosis patients and controls. • Cerebral vasoreactivity measure is linked to cognitive impairment in multiple sclerosis. • Cerebral vasoreactivity is linked to level of education in multiple sclerosis.
OBJECTIVE: The link between cerebral vasoreactivity and cognitive status in multiple sclerosis remains unclear. The aim of the present study was to investigate a potential decrease of cerebral vasoreactivity in multiple sclerosispatients and correlate it with cognitive status. METHODS: Thirty-three patients with multiple sclerosis (nine progressive and 24 remitting forms, median age: 39 years, 12 males) and 22 controls underwent MRI with a hypercapnic challenge to assess cerebral vasoreactivity and a neuropsychological assessment. Cerebral vasoreactivity, measured as the cerebral blood flow percent increase normalised by end-tidal carbon dioxide variation, was assessed globally and by regions of interest using the blood oxygen level-dependent technique. Non-parametric statistics tests were used to assess differences between groups, and associations were estimated using linear models. RESULTS: Cerebral vasoreactivity was lower in patients with cognitive impairment than in cognitively normal patients (p=0.004) and was associated with education level in patients (R2 = 0.35; p = 0.047). There was no decrease in cerebral vasoreactivity between patients and controls. CONCLUSIONS:Cognitive impairment in multiple sclerosis may be mediated through decreased cerebral vasoreactivity. Cerebral vasoreactivity could therefore be considered as a marker of cognitive decline in multiple sclerosis. KEY POINTS: • Cerebral vasoreactivity does not differ between multiple sclerosispatients and controls. • Cerebral vasoreactivity measure is linked to cognitive impairment in multiple sclerosis. • Cerebral vasoreactivity is linked to level of education in multiple sclerosis.
Authors: D T Berry; G S Carpenter; D A Campbell; F A Schmitt; K Helton; T Lipke-Molby Journal: Arch Clin Neuropsychol Date: 1994-05 Impact factor: 2.813
Authors: Melissa Cambron; Miguel D'Haeseleer; Guy Laureys; Ralph Clinckers; Jan Debruyne; Jacques De Keyser Journal: J Cereb Blood Flow Metab Date: 2012-01-04 Impact factor: 6.200
Authors: Claire M Modica; Niels Bergsland; Michael G Dwyer; Deepa P Ramasamy; Ellen Carl; Robert Zivadinov; Ralph Hb Benedict Journal: Mult Scler Date: 2015-04-28 Impact factor: 6.312
Authors: Laëtitia Debernard; Tracy R Melzer; Saskia Van Stockum; Charlotte Graham; Claudia Am Wheeler-Kingshott; John C Dalrymple-Alford; David H Miller; Deborah F Mason Journal: J Neurol Neurosurg Psychiatry Date: 2013-09-13 Impact factor: 10.154
Authors: W Rashid; L M Parkes; G T Ingle; D T Chard; A T Toosy; D R Altmann; M R Symms; P S Tofts; A J Thompson; D H Miller Journal: J Neurol Neurosurg Psychiatry Date: 2004-09 Impact factor: 10.154
Authors: Daniela Pinter; James Sumowski; John DeLuca; Franz Fazekas; Alexander Pichler; Michael Khalil; Christian Langkammer; Siegrid Fuchs; Christian Enzinger Journal: PLoS One Date: 2014-01-27 Impact factor: 3.240
Authors: Jeremy Deverdun; Arthur Coget; Xavier Ayrignac; Clarisse Carra-Dalliere; Alexandre Krainik; Aude Metzger; Pierre Labauge; Nicolas Menjot de Champfleur; Emmanuelle Le Bars Journal: Brain Topogr Date: 2021-01-23 Impact factor: 3.020
Authors: Cindi G Marinho; Hyder A Melo; Roberto Salvatori; Marco A P Nunes; Carla R P Oliveira; Viviane C Campos; Cynthia S Barros-Oliveira; Alécia A Oliveira-Santos; Nelmo V Menezes; Hertz T Santos-Júnior; Elenilde G Santos; Manuela A Melo; Joselina L M Oliveira; Enaldo V Melo; Manuel H Aguiar-Oliveira Journal: Endocrine Date: 2020-07-12 Impact factor: 3.633
Authors: Emilie Sleight; Michael S Stringer; Ian Marshall; Joanna M Wardlaw; Michael J Thrippleton Journal: Front Physiol Date: 2021-02-25 Impact factor: 4.566
Authors: Donghoon Kim; Timothy M Hughes; Megan E Lipford; Suzanne Craft; Laura D Baker; Samuel N Lockhart; Christopher T Whitlow; Stephanie E Okonmah-Obazee; Christina E Hugenschmidt; Matthew Bobinski; Youngkyoo Jung Journal: Front Physiol Date: 2021-05-31 Impact factor: 4.755