PMID- 27012299
OWN - NLM
STAT- MEDLINE
DCOM- 20171121
LR  - 20180828
IS  - 1936-959X (Electronic)
IS  - 0195-6108 (Linking)
VI  - 37
IP  - 8
DP  - 2016 Aug
TI  - Cortical Perfusion Alteration in Normal-Appearing Gray Matter Is Most Sensitive
      to Disease Progression in Relapsing-Remitting Multiple Sclerosis.
PG  - 1454-61
LID - 10.3174/ajnr.A4737 [doi]
AB  - BACKGROUND AND PURPOSE: The role of gray matter in multiple sclerosis is
      increasingly evident; however, conventional images demonstrate limitations in
      cortical lesion identification. Perfusion imaging appears sensitive to changes in
      tissue type and disease severity in MS. We sought to use bookend perfusion to
      quantify parameters in healthy controls and normal-appearing and lesional tissue 
      at different relapsing-remitting MS stages. MATERIALS AND METHODS: Thirty-nine
      patients with relapsing-remitting MS and 19 age-matched healthy controls were
      prospectively recruited. The Minimal Assessment of Cognitive Function in MS
      battery was used to assess cognitive performance. Perfusion parameters, including
      cerebral blood flow and volume and mean transit time, were compared for healthy
      controls and normal-appearing and lesional tissue for all study groups.
      Dispersion of perfusion measures for white matter lesions and cortical lesions
      was assessed. RESULTS: Twenty of the 39 patients with relapsing-remitting MS were
      cognitively impaired. Significant differences were displayed between all
      relapsing-remitting MS subgroups and healthy controls in all comparisons except
      for normal-appearing gray matter CBV between healthy controls and unimpaired
      patients with relapsing-remitting MS and for all normal-appearing white matter
      perfusion parameters between healthy controls and unimpaired patients with
      relapsing-remitting MS. White matter lesion but not cortical lesion perfusion was
      significantly reduced in cognitively impaired patients with relapsing-remitting
      MS versus unimpaired patients with relapsing-remitting MS. Perfusion reduction
      with disease progression was greater in normal-appearing gray matter and
      normal-appearing white matter compared with cortical lesions and white matter
      lesions. Smaller dispersion was observed for cortical lesions compared with white
      matter lesions for each perfusion parameter. CONCLUSIONS: Quantitative GM and WM 
      analysis demonstrated significant but disproportionate white matter lesion,
      cortical lesion, normal-appearing white matter, and normal-appearing gray matter 
      changes present between healthy controls and patients with relapsing-remitting MS
      with and without cognitive impairment, necessitating absolute rather than
      relative lesion perfusion measurement.
CI  - (c) 2016 by American Journal of Neuroradiology.
FAU - Hojjat, S-P
AU  - Hojjat SP
AUID- ORCID: 0000-0003-0188-1578
AD  - Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences
      Centre, Toronto, Ontario, Canada Medical Imaging (S.-P.H., R.I.A.), University of
      Toronto, Toronto, Ontario, Canada Parsa.Hojjat@sunnybrook.ca.
FAU - Kincal, M
AU  - Kincal M
AUID- ORCID: 0000-0002-2044-5440
AD  - Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences
      Centre, Toronto, Ontario, Canada.
FAU - Vitorino, R
AU  - Vitorino R
AUID- ORCID: 0000-0001-6416-6278
AD  - Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences
      Centre, Toronto, Ontario, Canada.
FAU - Cantrell, C G
AU  - Cantrell CG
AUID- ORCID: 0000-0003-0559-8681
AD  - Departments of Biomedical Engineering (C.G.C., T.J.C.).
FAU - Feinstein, A
AU  - Feinstein A
AUID- ORCID: 0000-0002-0132-0909
AD  - From the Departments of Psychiatry (A.F.) Psychiatry (A.F.).
FAU - Zhang, L
AU  - Zhang L
AUID- ORCID: 0000-0002-5882-6070
AD  - Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences
      Centre, Toronto, Ontario, Canada.
FAU - Lee, L
AU  - Lee L
AUID- ORCID: 0000-0001-7322-9672
AD  - Neurology (L.L.) Departments of Medicine (P.O., L.L.).
FAU - O'Connor, P
AU  - O'Connor P
AUID- ORCID: 0000-0002-5632-8385
AD  - Departments of Medicine (P.O., L.L.).
FAU - Carroll, T J
AU  - Carroll TJ
AUID- ORCID: 0000-0002-5149-8377
AD  - Departments of Biomedical Engineering (C.G.C., T.J.C.) Radiology (T.J.C.),
      Northwestern University, Chicago, Illinois.
FAU - Aviv, R I
AU  - Aviv RI
AUID- ORCID: 0000-0003-0259-970X
AD  - Medical Imaging (S.-P.H., M.K., R.V., R.I.A., L.Z.), Sunnybrook Health Sciences
      Centre, Toronto, Ontario, Canada Medical Imaging (S.-P.H., R.I.A.), University of
      Toronto, Toronto, Ontario, Canada.
LA  - eng
GR  - R21 EB017928/EB/NIBIB NIH HHS/United States
GR  - 130366/CIHR/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, N.I.H., Extramural
DEP - 20160324
PL  - United States
TA  - AJNR Am J Neuroradiol
JT  - AJNR. American journal of neuroradiology
JID - 8003708
SB  - IM
MH  - Adult
MH  - Cerebrovascular Circulation
MH  - Cognition Disorders/diagnostic imaging/etiology/pathology
MH  - Disease Progression
MH  - Female
MH  - Gray Matter/blood supply/*diagnostic imaging/pathology
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Multiple Sclerosis, Relapsing-Remitting/complications/*diagnostic
      imaging/pathology
MH  - Perfusion Imaging/*methods
MH  - White Matter/blood supply/diagnostic imaging/pathology
MH  - Young Adult
PMC - PMC4983506
MID - NIHMS753101
EDAT- 2016/03/26 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/03/26 06:00
PHST- 2015/11/03 00:00 [received]
PHST- 2016/01/12 00:00 [accepted]
PHST- 2016/03/26 06:00 [entrez]
PHST- 2016/03/26 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - ajnr.A4737 [pii]
AID - 10.3174/ajnr.A4737 [doi]
PST - ppublish
SO  - AJNR Am J Neuroradiol. 2016 Aug;37(8):1454-61. doi: 10.3174/ajnr.A4737. Epub 2016
      Mar 24.