Spatial Correlation of Pathology and Perfusion Changes within the Cortex and White Matter in Multiple Sclerosis

A.D. Mulholland; R. Vitorino; S.-P. Hojjat; A.Y. Ma; L. Zhang; L. Lee; T.J. Carroll; C.G. Cantrell; C.R. Figley; R.I. Aviv

doi:10.3174/ajnr.A5410

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FIGURE.
Whole-brain depiction of perfusion differences in cortical gray matter among HCs and patients with RRMS and SPMS. Units for CBF are milliliter/100 gram/minute; CBV, milliliter/100 gram; MTT, second.

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Table 1:

Comparison of demographic and clinical data for HCs and subjects with RRMS and SPMS^{^a}

Parameter	HC (n = 19)	RRMS (n = 19)	SPMS (n = 20)	RRMS vs HC (P Value)	SPMS vs HC (P Value)	SPMS vs RRMS (P Value)
Age (yr)	49.0 ± 7.1	46.4 ± 7.2	55.2 ± 6.5	.27	.0168^{^b}	.0041^{^b}
Sex (F/M)	14:5	15:4	11:9	.70	.23	.12
Education (yr)	16.9 ± 2.9	16.1 ± 1.3	15.1 ± 2.6	.22	.051	.15
Disease duration (yr)	0.00	11.8 ± 5.4	16.7 ± 6.5	NA	NA	.0234
EDSS (median) (IQR)	0.00	1.5 (1–2)	6 (6–6.5)	NA	NA	.0006^{^b}

Note:—IQR indicates interquartile range; NA, not applicable.
↵a All values are mean (SD) except where indicated. Bonferroni corrected P < .017 is considered statistically significant.
↵b Significant.

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Table 2:

Comparison of perfusion and volumetric data for cGM, NAWM, and T2h-l between HCs and subjects with RRMS and SPMS after adjusting for confounding factors^{^a}

Parameter	Median (Interquartiles)			P Value
Parameter	HC (n = 19)	RRMS (n = 19)	SPMS (n = 20)	RRMS vs HC	SPMS vs HC	SPMS vs RRMS
cGM
Global volume	890 (869–914)	864 (827–895)	673 (646–697)	.10	.0026^{^b}	.0020^{^b}
CBF	43.20 (33.91–54.49)	41.07 (29.85–55.68)	34.05 (27.19–43.68)	<.0001^{^b}	<.0001^{^b}	.0011^{^b}
CBV	2.64 (2.02–3.29)	2.53 (1.94–3.37)	2.40 (1.92–3.07)	.078	.046	.0062^{^b}
MTT	3.77 (3.20–4.31)	3.90 (3.32–4.41)	4.30 (3.66–4.99)	.0001^{^b}	<.0001^{^b}	<.0001^{^b}
NAWM
Global volume	878 (812–894)	818 (738–850)	697 (669–729)	.0115^{^b}	.0011^{^b}	.0049^{^b}
CBF	23.49 (18.69–27.78)	21.55 (16.05–29.50)	19.54 (16.74–24.92)	.68	.58	.0080^{^b}
CBV	1.59 (1.28–2.00)	1.57 (1.17–2.15)	1.51 (1.30–1.98)	.89	.16	.0103^{^b}
MTT	4.51 (4.09–5.10)	4.62 (4.08–5.20)	4.86 (4.28–5.41)	.25	.0005^{^b}	.0094^{^b}
T2h-l
Global volume	0.00	5.4 (1.2–9.3)	6.4 (1.0–10.9)	NA	NA	.82
CBF	0.00	12.77 (8.23–17.24)	11.15 (8.95–15.71)	NA	NA	.049
CBV	0.00	0.99 (0–1.32)	1.08 (0.83–1.47)	NA	NA	.0026^{^b}
MTT	0.00	4.91 (4.00–5.63)	5.64 (4.82–6.30)	NA	NA	.43

Note:—NA, not applicable.
↵a Bonferroni-corrected P < .017 is considered statistically significant. Age was considered a confounding factor for comparing RRMS vs HC and SPMS vs HC; age, EDSS, and disease duration were considered confounding factors for comparing SPMS vs RRMS. All volumes are in cubic centimeters; CBF, milliliter/100 gram/meter; CBV, milliliter/100 gram; MTT, second.
↵b Significant.

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Table 3:

Lobar GM and WM volume differences among HCs and subjects with RRMS and SPMS after adjusting for confounding factors^{^a}

Parameter	Median (Interquartiles)			P Value
Parameter	HC (n = 19)	RRMS (n = 19)	SPMS (n = 19)	RRMS vs HC (n = 19)	SPMS vs HC (n = 19)	SPMS vs RRMS (n = 19)
Gray matter
Frontal lobe	200.040 (190.352–167.944)	199.248 (192.480–207.896)	200.352 (193.500–207.540)	.69	.60	.22
Parietal lobe	90.296 (83.992–94.512)	89.824 (85.048–95.176)	93.368 (88.956–96.352)	.72	.03	.095
Temporal lobe	122.740 (110.640–130.560)	121.336 (114.672–128.544)	106.892 (99.432–112.928)	.86	.0044^{^b}	.0073^{^b}
Occipital lobe	101.088 (98.536–106.272)	97.160 (95.728–102.960)	72.792 (69.868–75.196)	.10	.0030^{^b}	.0033^{^b}
White matter
Frontal lobe	190.568 (170.368–201.528)	170.316 (159.520–189.112)	146.260 (134.908–157.136)	<.0001^{^b}	.0006^{^b}	<.0001^{^b}
Parietal lobe	101.200 (94.536–109.152)	93.272 (84.944–97.208)	81.952 (77.736–87.532)	.0001^{^b}	.0018^{^b}	<.0001^{^b}
Temporal lobe	70.132 (56.648–79.352)	68.512 (64.116–74.016)	61.208 (51.576–71.720)	.026	.98	.0026^{^b}
Occipital lobe	32.024 (30.248–35.092)	29.092 (24.136–33.768)	26.864 (23.552–31.832)	.65	.0098^{^b}	.0003^{^b}

↵a Bonferroni-corrected P < .017 is considered statistically significant. Age was considered a confounding factor for comparing RRMS vs HC and SPMS vs HC; age, EDSS, and disease duration were considered confounding factors for comparing SPMS vs RRMS. All volumes are in cubic centimeters.
↵b Significant.