John A Lincoln1, Khader M Hasan2, Refaat E Gabr2, Jerry S Wolinsky1. 1. Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA. 2. Department of Diagnostic and Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.
Abstract
BACKGROUND AND PURPOSE: Changes in cerebral perfusion occur early in relapsing and progressive multiple sclerosis (MS) patients, though whether cerebral blood flow (CBF) can be altered by therapy is unknown. We sought to characterize the time course of change in CBF (cerebral vascular reactivity [CVR]), following intravenous (IV) acetazolamide (ACZ) in whole brain and within various gray and white matter brain regions in MS patients. METHODS: We enrolled five relapsing MS patients on injectable therapies. Participants received a 1000 mg IV bolus of ACZ and CBF was measured using pseudocontinuous arterial spin labeling MRI. To quantify differences in time course between patients, we calculated the numerical integration of CVR over time using the trapezoidal rule to estimate area under the curve (AUC(CVR) ). RESULTS: A change in whole brain CBF of 30%-65% was seen in all participants at 15 minutes after ACZ challenge. CBF increases >20% above baseline were sustained for 90 minutes within whole-brain, normal-appearing white matter and total T2-hyperintense lesioned tissue. AUC(CVR) values for both gray (cortical and deep gray matter) and white (normal-appearing and T2-lesioned) matter regions were similar between patients. CONCLUSION: Our findings show a prolonged time course in vascular reactivity after ACZ stimulus in MS patients with a similar time course for both gray and white matter brain regions, including in previously injured tissue. Our preliminary results suggest that blood flow can be augmented in the established MS lesion suggesting that even previously injured tissue might be responsive to treatment.
BACKGROUND AND PURPOSE: Changes in cerebral perfusion occur early in relapsing and progressive multiple sclerosis (MS) patients, though whether cerebral blood flow (CBF) can be altered by therapy is unknown. We sought to characterize the time course of change in CBF (cerebral vascular reactivity [CVR]), following intravenous (IV) acetazolamide (ACZ) in whole brain and within various gray and white matter brain regions in MS patients. METHODS: We enrolled five relapsing MS patients on injectable therapies. Participants received a 1000 mg IV bolus of ACZ and CBF was measured using pseudocontinuous arterial spin labeling MRI. To quantify differences in time course between patients, we calculated the numerical integration of CVR over time using the trapezoidal rule to estimate area under the curve (AUC(CVR) ). RESULTS: A change in whole brain CBF of 30%-65% was seen in all participants at 15 minutes after ACZ challenge. CBF increases >20% above baseline were sustained for 90 minutes within whole-brain, normal-appearing white matter and total T2-hyperintense lesioned tissue. AUC(CVR) values for both gray (cortical and deep gray matter) and white (normal-appearing and T2-lesioned) matter regions were similar between patients. CONCLUSION: Our findings show a prolonged time course in vascular reactivity after ACZ stimulus in MS patients with a similar time course for both gray and white matter brain regions, including in previously injured tissue. Our preliminary results suggest that blood flow can be augmented in the established MS lesion suggesting that even previously injured tissue might be responsive to treatment.
Authors: Nolan S Hartkamp; Jeroen Hendrikse; H Bart van der Worp; Gert J de Borst; Reinoud P H Bokkers Journal: Stroke Date: 2011-11-03 Impact factor: 7.914
Authors: Efrosini Z Papadaki; Vasileios C Mastorodemos; Emmanouil Z Amanakis; Konstantinos C Tsekouras; Antonis E Papadakis; Nikolaos D Tsavalas; Panagiotis G Simos; Apostolos H Karantanas; Andreas Plaitakis; Thomas G Maris Journal: Magn Reson Med Date: 2012-02-24 Impact factor: 4.668
Authors: Christopher M Holland; Arnaud Charil; Istvan Csapo; Zsuzsanna Liptak; Masanori Ichise; Samia J Khoury; Rohit Bakshi; Howard L Weiner; Charles R G Guttmann Journal: J Neuroimaging Date: 2011-03-29 Impact factor: 2.486
Authors: Ponnada A Narayana; Yuxiang Zhou; Khader M Hasan; Sushmita Datta; Xiaojun Sun; Jerry S Wolinsky Journal: Mult Scler Date: 2013-07-08 Impact factor: 6.312
Authors: Béla Fülesdi; Szilárd Szatmári; Csaba Antek; Zoltán Fülep; Péter Sárkány; László Csiba; Csilla Molnár Journal: J Crit Care Date: 2012-01-09 Impact factor: 3.425
Authors: Belinda S Y Li; Juleiga Regal; Brian J Soher; Lois J Mannon; Robert I Grossman; Oded Gonen Journal: AJNR Am J Neuroradiol Date: 2003-01 Impact factor: 3.825