Study Of Cingulum Integrity And Cingulate Cortical Perfusion In Patients With Relapsing Remitting Multiple Sclerosis

Objective:To investigate the correlation between cingulum microstructure and changes of cingulate cortical perfusion and clinical scores in patients with relapsing remitting multiple sclerosis(RRMS)by diffusion tensor imaging(DTI)and three-dimensional pseudo continuous arterial spin labeling(3D-pCASL).Methods:Expanded disability status scale(EDSS)and neuropsychological scale score were performed to 24 RRMS patients(MS group)and 26 examines(control group).All subjects received DTI and 3D-pCASL to measure fractional anisotropy(FA)value and mean diffusion(MD)value of bilateral cingulum as well as cerebral blood flow(CBF)value in 8sub-regions of cingulate cortex of left and right cingulum and assess correlation with EDSS and neuropsychological scale scores.Results:Compared with control group,CBF value of left anterior caudal CC,right posterior and isthmus of CC as well as mean CBF value of right cingulate cortex were significantly reduced(P<0.05).FA value of bilateral cingulum-cingulate gyrus(CGC)in MS group was decreased while MD value was elevated.FA value of right cingulum-hippocampus(CGH)was lowered and MD value of bilateral CGH was elevated(all P<0.05).There was correlations between symbol digit modalities test(SDMT)scores and CBF value of left anterior caudal CC,right posterior and isthmus of CC,FA value of bilateral CGC and MD value of right CGH(r=0.391,0.346,0.307,0.389,0.374 and-0.371,all P<0.05).There was also correlations between HAMD scoring and FA value as well as MD value of bilateral CGC(r=-0.296,-0.338,0.324 and 0.343,all P<0.05).After controlling age,gender and degree of education,there was still significant correlation between SDMT scoring and FA value of bilateral CGC.ConclusionThere were changes seen in cingulum and cingulate cortex of patients in RRMS group,which was related to cognitive disorder and depression of the patients.This might represent functional heterogeneity of cingulate gyrus.