PT - JOURNAL ARTICLE AU - R. Vitorino AU - S.-P. Hojjat AU - C.G. Cantrell AU - A. Feinstein AU - L. Zhang AU - L. Lee AU - P. O'Connor AU - T.J. Carroll AU - R.I. Aviv TI - Regional Frontal Perfusion Deficits in Relapsing-Remitting Multiple Sclerosis with Cognitive Decline AID - 10.3174/ajnr.A4824 DP - 2016 May 19 TA - American Journal of Neuroradiology 4099 - http://www.ajnr.org/content/early/2016/05/19/ajnr.A4824.short 4100 - http://www.ajnr.org/content/early/2016/05/19/ajnr.A4824.full AB - BACKGROUND AND PURPOSE: Cortical dysfunction, quantifiable by cerebral perfusion techniques, is prevalent in patients with MS, contributing to cognitive impairment. We sought to localize perfusion distribution differences in patients with relapsing-remitting MS with and without cognitive impairment and healthy controls.MATERIALS AND METHODS: Thirty-nine patients with relapsing-remitting MS (20 cognitively impaired, 19 nonimpaired) and 19 age- and sex-matched healthy controls underwent a neurocognitive battery and MR imaging. Voxel-based analysis compared regional deep and cortical GM perfusion and volume among the cohorts.RESULTS: After we adjusted 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 patients with cognitive impairment compared with patients without impairment and controls. Compared with healthy controls, reduced CBF was present in the limbic regions of patients with cognitive impairment, and reduced CBV was present in the right middle frontal gyrus in patients with cognitive impairment and in the temporal gyrus of relapsing-remitting MS patients without cognitive impairment.CONCLUSIONS: Consistent regional frontal cortical perfusion deficits are present in patients with relapsing-remitting MS, with more widespread hypoperfusion in those with cognitive impairment, independent of structural differences, indicating that cortical perfusion may be a useful biomarker of cortical dysfunction and cognitive impairment in MS.AbbreviationsBABrodmann areaDARTELDiffeomorphic Anatomical Registration Through Exponentiated Lie AlgebraHChealthy controlsMNIMontreal Neurological InstituteqCBFquantitative cerebral blood flowqCBVquantitative cerebral blood volumeRRMSrelapsing-remitting multiple sclerosisVBMvoxel-based morphometry