Background and Purpose
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.
Materials and Methods
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.
Results
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.
Conclusions
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.