Regional Frontal Perfusion Deficits in Relapsing-Remitting Multiple Sclerosis with Cognitive Decline.
Regional Frontal Perfusion Deficits in Relapsing-Remitting Multiple Sclerosis with Cognitive Decline.
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DOI：
10.3174/ajnr.a4824
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发表时间：
2016-10
期刊：
影响因子：
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通讯作者：
Aviv RI
中科院分区：
文献类型：
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作者：
Vitorino R;Hojjat SP;Cantrell CG;Feinstein A;Zhang L;Lee L;O'Connor P;Carroll TJ;Aviv RI
脑灌注技术可量化的皮质功能障碍在MS患者中普遍存在，导致认知障碍。我们试图定位有认知障碍和无认知障碍的复发缓解型MS患者与健康对照者的灌注分布差异。39名复发缓解型MS患者（20名认知受损，19名未受损）和19名年龄和性别匹配的健康对照接受了神经认知电池和MRI扫描。基于体素的分析比较了队列中区域深层和皮质GM灌注和体积。对右额叶、颞叶和枕叶的局部体积差异进行调整后，与未受损的患者和对照组相比，所有队列的左额叶中皮层和左额叶上回均存在进行性CBF和CBV缺陷。与健康对照相比，认知受损患者的边缘区CBF减少，认知受损患者的右侧额叶中回和未受损复发缓解型MS患者的颞回CBV减少。在复发缓解型多发性硬化症患者中存在一致的区域额叶皮质灌注缺陷，在认知功能受损患者中存在更广泛的灌注不足，与结构差异无关，表明皮质灌注可能是多发性硬化症皮质功能障碍和认知功能障碍的有用生物标志物。
Cortical dysfunction, quantifiable by cerebral perfusion techniques, is prevalent in MS patients contributing to cognitive impairment. We sought to localize perfusion distribution differences in relapsing-remitting MS patients with and without cognitive impairment, and healthy controls. 39 relapsing-remitting MS patients (20 cognitively impaired, 19 non-impaired) and 19 age and gender-matched healthy controls underwent a neurocognitive battery and MRI scanning. Voxel-based analysis compared regional deep and cortical GM perfusion and volume among the cohorts. Adjusting for localized volumetric differences in the right frontal, temporal and occipital lobes, progressive CBF and CBV deficits were present in the left middle frontal cortex for all cohorts and in the left superior frontal gyrus for cognitively impaired patients compared to unimpaired patients and controls. Compared to healthy controls, reduced CBF was present in the limbic regions of cognitively impaired patients and reduced CBV in the right middle frontal gyrus of cognitively impaired and temporal gyrus of non-impaired relapsing-remitting MS patients. Consistent regional frontal cortical perfusion deficits are present in relapsing-remitting MS patients, with more widespread hypoperfusion in cognitively impaired patients, independent of structural differences indicating that cortical perfusion may be a useful biomarker of cortical dysfunction and cognitive impairment in MS.