Research: Cognitive Impairment and Blood flow

Francis PL et al. Robust Perfusion Deficits in Cognitively Impaired Patients with Secondary-Progressive Multiple Sclerosis.AJNR Am J Neuroradiol. 2012 Jun 14. [Epub ahead of print]

BACKGROUND AND PURPOSE:Cognitive impairment is a common, disabling symptom of MS. We investigated the impact of cerebral perfusion and brain and lesion volumetry on cognitive performance in 45 patients with SPMS by using MR imaging.

MATERIALS AND METHODS: Cognition was assessed by using a standard battery, the Minimal Assessment of Cognitive Function in Multiple Sclerosis. MRI was used to assess cerebral blood volume and MRI was used to assess the volume of the grey matter, the white matter and the white matter lesion volume
RESULTS: There was reduced blood volume in the the superior medial frontal cortex of impaired MSers.  There was also lower blood volume in the bilateral thalami and caudate nuclei of impaired patients.

Performance on the Symbol Digit Modalities Test, which assesses information-processing speed, correlated most strongly overall with cerebral perfusion. Focal analyses of grey matter, white matter and the white matter lesion volume revealed no significant differences between patients with and without cognitive impairment, though global GM volume was significantly decreased and global WML volume was significantly increased in impaired patients.

CONCLUSIONS:These results suggest that cognitively impaired patients with SPMS exhibit robust perfusion deficits in cortical and subcortical GM and impaired processing speed.
This study suggests that there may be reduced blood flow in certain areas of the brains of MSers that have problem of with mental processing/cognition during secondary progression. Such people have evidence of reduced nerve content in the grey matter and more MS lesions in the white matter. However it is not clear what this reduced perfusion (blood flow) is due to.

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