Increased perfusion in normal appearing white matter in high inflammatory multiple sclerosis patients.
Increased perfusion in normal appearing white matter in high inflammatory multiple sclerosis patients.
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DOI：
10.1371/journal.pone.0119356
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Siemonsen S
中科院分区：
文献类型：
--
作者：
Bester M;Forkert ND;Stellmann JP;Stürner K;Aly L;Drabik A;Young KL;Heesen C;Fiehler J;Siemonsen S
虽然多发性硬化症(MS)的脑血流灌注改变早已被认识到，但可测量的血流灌注改变与高度活跃的MS状态之间的关系尚未被研究。我们假设，血流灌注的改变可以在正常的白质中检测到，而在高度炎症的患者中则会增加。33例复发-缓解期MS患者接受了每月4次的3T MRI扫描，包括动态磁化率对比灌注加权MRI。测量正常脑白质的脑血流量(CBF)和脑血容量(CBV)。根据新的对比剂增强病变的数量，患者被分成高炎症组和低炎症组。13例患者被归类为高炎症。与低炎症组相比，高炎症组的脑血流量(P=0.001)和脑血流量(P=0.014)显著升高。评估与CBV和CBF相关的自变量的混合模型分析显示，白质病变负荷和萎缩测量对CBF和CBV没有显著影响。这项工作提供了高炎症病变负荷与CBV和CBF增加相关的证据，强调了血脑屏障渗漏之前的全球修正微循环在MS的病理生理中的作用。因此，除了没有局部血脑屏障破坏的病变发展外，血流灌注的变化可能对活跃的炎症反应敏感，并可用于进一步评估当前炎症的代谢方面。
Although cerebral perfusion alterations have long been acknowledged in multiple sclerosis (MS), the relationship between measurable perfusion changes and the status of highly active MS has not been examined. We hypothesized that alteration of perfusion can be detected in normal appearing white matter and is increased in high inflammatory patients. Thirty-three patients with relapsing-remitting MS underwent four monthly 3T MRI scans including dynamic susceptibility contrast perfusion-weighted MRI. Cerebral blood flow (CBF) and cerebral blood volume (CBV) were measured in normal appearing white matter. Patients were stratified in a high- and low-inflammatory group according to the number of new contrast enhancing lesions. Thirteen patients were classified as high-inflammatory. Compared to low-inflammatory patients, the high-inflammatory group demonstrated significantly higher CBV (p = 0.001) and CBF (p = 0.014) values. A mixed model analysis to assess independent variables associated with CBV and CBF revealed that white matter lesion load and atrophy measurements had no significant influence on CBF and CBV. This work provides evidence that high inflammatory lesion load is associated with increased CBV and CBF, underlining the role of global modified microcirculation prior to leakage of the blood-brain barrier in the pathophysiology of MS. Perfusion changes might therefore be sensitive to active inflammation apart from lesion development without local blood–brain barrier breakdown, and could be utilized to further assess the metabolic aspect of current inflammation.
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影响因子：
4.2
作者：
Cramer, S. P.;Simonsen, H.;Frederiksen, J. L.;Rostrup, E.;Larsson, H. B. W.
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