Reduced grey matter perfusion without volume loss in early relapsing-remitting multiple sclerosis

The primary question the research group addressed was if perfusion MRI in early RRMS might detect a reduction in grey matter (GM) perfusion in the absence of GM atrophy, which may potentially indicate a reversible state of neuronal dysfunction prior to irreversible neuronal loss. The detection of GM abnormalities in early MS may be very important in understanding and predicting the long-term course of MS.

The study included 25 people with RRMS with disease duration of less than five years and 25 matched controls. The MRI protocol included a pseudo-continuous arterial spin labelling sequence to quantify GM perfusion and structural images in addition to cognitive and neurological assessments.

The results showed that there was reduced global GM perfusion in people with MS compared to controls. There were extensive regions of reduced cortical and deep grey matter perfusion in people with MS. GM perfusion did not correlate with disability measures. An association was found between GM perfusion and memory scores. The reduction in GM perfusion, without an associated decrease in GM volume in likely due to neuronal metabolic dysfunction. Further studies are needed to fully understand the prognostic significance of early GM perfusion abnormalities in RRMS.

Authors: Debernard L, Melzer TR
Source: J Neurol Neurosurg Psychiatry. 2013 Sep 13. doi: 10.1136/jnnp-2013-305612. [Epub ahead of print]

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