Abstract
Magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS) has provided major insights into the disease’s natural history, and many studies have focussed on possible correlations between MRI findings and the clinical manifestations of MS. In contrast, there are few reports on possible relationships between functional imaging data and cognitive function. The present study assessed the relationship between clinical presentation and combined anatomical and functional imaging data in MS. Twenty patients with definite MS underwent MRI and positron emission tomography (PET) to evaluate cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2). The relationships between these neuroimaging findings and clinical data, including the Expanded Disability Status Scale (EDSS), Mini-mental status scale, Hasegawa Dementia Scale and relapse time, were evaluated with Spearman’s rank correlation coefficients. A general reduction in rCBF and rCMRO2 in the gray and white matter were found in the MS patients. EDSS was correlated with the number and size of the lesions on MRI and was negatively correlated with rCMRO2. A correlation between the decrease in rCMRO2 and the level of cognitive impairment was also found. The severity of cerebral hypometabolism was also related to the number of relapses. Morphological and functional findings obtained by MRI and PET are closely related to the clinical status in MS. Our results suggest that measurement of cerebral metabolism in MS has the potential to be an objective marker for monitoring disease activity and to provide prognostic information.
Similar content being viewed by others
References
Lukes SA, Crooks LE, Aminoff MJ, Kaufman L, Panitch HS, Mills C, et al. Nuclear magnetic resonance imaging in multiple sclerosis.Ann Neurol 13: 592–601, 1983.
McDonald WI. The dynamics of multiple sclerosis.J Neurol 240: 28–36, 1993.
Miller DH, Albert PS, Barkhof F, Francis G, Frank JA, Hodgkinson S, et al. Guidelines for the use of magnetic resonance techniques in monitoring the treatment of multiple sclerosis.Ann Neurol 39: 6–16, 1996.
Filippi M, Horsfield MA, Morrissey SP, MacManus DG, Rudge P, McDonald WI, et al. Quantitative brain MRI lesion load predicts the course of clinically isolated syndromes suggestive of multiple sclerosis.Neurology 44: 635–641, 1994.
Khoury SJ, Guttmann CR, Orav EJ, Hohol MJ, Ahn SS, Hsu L, et al. Longitudinal MRI in multiple sclerosis: correlation between disability and lesion burden. Neurology 44: 2120–2124, 1994.
Filippi M, Paty DW, Kappos L, Barkhof F, Compston DAS, Thompson AJ, et al. Correlations between changes in disability and T2-weighted brain MRI activity in multiple sclerosis: a follow-up study.Neurology 45: 255–260, 1995.
Brooks DJ, Leenders KL, Head G, Marshall J, Legg NJ, Jones T. Studies on regional cerebral oxygen utilisation and cognitive function in multiple sclerosis.J Neurol Neurosurg Psychiatry 47: 1182–1191, 1984.
Pozzilli C, Passafiume D, Bernardi S, Pantano P, Incoccia C, Bastianello S, et al. SPECT, MRI and cognitive functions in multiple sclerosis.J Neurol Neurosurg Psychiatry 54: 110–115, 1991.
Poster CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann Neurol 13: 227–231, 1983.
Kurtzke JK. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology 33: 1444–1452, 1983.
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res 12: 189–198, 1975.
Hasegawa K. The clinical assessment of dementia in the aged; a dementia screening scale for psychogeriatric patients.In Aging in the Eighties and Beyond, New York, Springer-Verlag, pp. 207–218, 1983.
Tanaka M, Kondo S, Hirai S, Ishiguro K, Ishihara T, Morimatsu M. Crossed cerebellar diaschisis accompanied by hemiataxia: a PET study.J Neurol Neurosurg Psychiatry 55: 121–125, 1992.
Sun X, Tanaka M, Kondo S, Hirai S, Ishihara T. Reduced cerebellar blood flow and oxygen metabolism in spinocerebellar degeneration: a combined PET and MRI study.J Neurol 241: 295–300, 1994.
Frackowiak RS, Pozzilli C, Legg NJ, DuBoulay GH, Marshall J, Lenzi GL, et al. Regional cerebral oxygen supply and utilization in dementia. A clinical and physiological study with oxygen-15 and positron tomography.Brain 104: 753–778, 1981.
Estes ML, Rudick RA, Bamett GH, Ransohoff RM. Stereotactic biopsy of an active multiple sclerosis lesion: Immunocytochemical analysis and neuropathologic correlation with magnetic resonance imaging.Arch Neurol 47: 1299–1303, 1990.
Filippi M, Campi A, Mammi S, Martinelli V, Locatelli T, Scotti G, et al. Brain magnetic resonance imaging and multimodal evoked potentials in benign and secondary progressive multiple sclerosis.J Neurol Neurosurg Psychiatry 58: 31–37, 1995.
DeCarli C, Murphy DGM, Tranh M, Grady CL, Haxby JV, Gillette JA, et al. The effect of white matter hyperintensity volume on brain structure, cognitive performance, and cerebral metabolism of glucose in 51 healthy adults.Neurology 45: 2077–2084, 1995.
Mattews WB. Pathology of multiple sclerosis.In McAlpine’s Multiple Sclerosis: Mattews WB, Acheson ED, Batchelor JR, Weller RO (eds.), New York, Churchill-Livingstone, pp. 301–341, 1985.
Husted CA, Goodin DS, Hugg JW, Maudsley AA, Tsuruda JS, deBie SH, et al. Biochemical alterations in multiple sclerosis lesions and normal-appearing white matter detected byin vivo 31P and1H spectroscopic imaging.Ann Neurol 36: 157–165, 1994.
Beatty WW, Goodkin DE. Screening for cognitive impairment in multiple sclerosis: an evaluation of the mini-mental state examination.Arch Neurol 47: 297–301, 1990.
Anzola GP, Bevilacqua L, Cappa SF, Capra R, Faglina L, Farina E, et al. Neuropsychological assessment in patients with relapsing-remitting multiple sclerosis and mild functional impairment: correlation with magnetic resonance imaging.J Neurol Neurosurg Psychiatry 53: 142–145, 1990.
Comi G, Filippi M, Martinelli V, Sirabian G, Visciani A, Campi A, et al. Brain magnetic resonance imaging correlates of cognitive impairment in multiple sclerosis.J Neurol Sci 15 (suppl): S66-S73, 1993.
Peyser JM, Rao SM, LaRocca NG, Kaplan E. Guidelines for neuropsychological research in multiple sclerosis.Arch Neurol 47: 94–97, 1990.
Thompson AJ, Kermode AG, MacManus DG, Kendall BE, Kingsley DRE, Moseley IF, et al. Patterns of disease activity in multiple sclerosis: clinical and magnetic resonance imaging study.Br Med J 300: 631–634, 1990.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sun, X., Tanaka, M., Kondo, S. et al. Clinical significance of reduced cerebral metabolism in multiple sclerosis: A combined PET and MRI study. Ann Nucl Med 12, 89–94 (1998). https://doi.org/10.1007/BF03164835
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03164835