Hypoperfusion of brain parenchyma is associated with the severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis: a cross-sectional preliminary report

BMC Medicine

Research Article

Ellen Carl¹  Christopher Magnano¹  Cheryl Kennedy¹  Niels Bergsland¹  Michael G Dwyer¹  Claudiu V Schirda¹  Bianca Weinstock-Guttman²  David Hojnacki²  Robert Zivadinov³  Paolo Zamboni⁴  Ilaria Bartolomei⁴  Erica Menegatti⁴  Fabrizio Salvi⁴  Anna M Malagoni⁴ 

[1] Buffalo Neuroimaging Analysis Center, University at Buffalo, Buffalo, NY, USA;The Jacobs Neurological Institute, University at Buffalo, Buffalo, NY, USA;The Jacobs Neurological Institute, University at Buffalo, Buffalo, NY, USA;Buffalo Neuroimaging Analysis Center, University at Buffalo, Buffalo, NY, USA;Vascular Diseases Center, University of Ferrara-Bellaria Neurosciences, Ferrara and Bologna, Italy;

关键词: Multiple Sclerosis;    Cerebral Blood Flow;    Multiple Sclerosis Patient;    Brain Parenchyma;    Cerebral Blood Volume;   

DOI  :  10.1186/1741-7015-9-22

 received in 2011-01-12, accepted in 2011-03-07,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundSeveral studies have reported hypoperfusion of the brain parenchyma in multiple sclerosis (MS) patients. We hypothesized a possible relationship between abnormal perfusion in MS and hampered venous outflow at the extracranial level, a condition possibly associated with MS and known as chronic cerebrospinal venous insufficiency (CCSVI).MethodsWe investigated the relationship between CCSVI and cerebral perfusion in 16 CCSVI MS patients and 8 age- and sex-matched healthy controls. Subjects were scanned in a 3-T scanner using dynamic susceptibility, contrast-enhanced, perfusion-weighted imaging. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in the gray matter (GM), white matter (WM) and the subcortical GM (SGM). The severity of CCSVI was assessed according to the venous hemodynamic insufficiency severity score (VHISS) on the basis of the number of venous segments exhibiting flow abnormalities.ResultsThere was a significant association between increased VHISS and decreased CBF in the majority of examined regions of the brain parenchyma in MS patients. The most robust correlations were observed for GM and WM (r = -0.70 to -0.71, P < 0.002 and P corrected = 0.022), and for the putamen, thalamus, pulvinar nucleus of thalamus, globus pallidus and hippocampus (r = -0.59 to -0.71, P < 0.01 and P corrected < 0.05). No results for correlation between VHISS and CBV or MTT survived multiple comparison correction.ConclusionsThis pilot study is the first to report a significant relationship between the severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons.

【 授权许可】

CC BY   
© Zamboni et al; licensee BioMed Central Ltd. 2011