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Global and regional brain atrophy is associated with low or retrograde facial vein flow in multiple sclerosis

Dejan Jakimovski, Karen Marr, Marcello Mancini, Maria Grazia Caprio, Sirin Gandhi, Niels Bergsland, Ivo Paunkoski, Jesper Hagemeier, Avinash Chandra, Bianca Weinstock-Guttman, Robert Zivadinov
  • Dejan Jakimovski
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Karen Marr
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Marcello Mancini
    Institute of Biostructure and Bioimaging, National Research Council, Napoli, Italy
  • Maria Grazia Caprio
    Institute of Biostructure and Bioimaging, National Research Council, Napoli, Italy
  • Sirin Gandhi
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Niels Bergsland
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Ivo Paunkoski
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Jesper Hagemeier
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Avinash Chandra
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY, United States
  • Bianca Weinstock-Guttman
    Jacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, United States
  • Robert Zivadinov
    Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, NY; Translational Imaging Center at Clinical Translational Science Institute, University of Buffalo, State University of New York, NY, United States | rzivadinov@bnac.net

Abstract

Increased collateral facial vein (FV) flow may be associated with structural damage in patients with multiple sclerosis (MS). The objective was to assess differences in FV flow and magnetic resonance imaging (MRI)-derived outcomes in MS. The study included 136 MS patients who underwent neck and head vascular system examination by echo-color Doppler. Inflammatory MRI markers were assessed on a 3T MRI using a semi-automated edge detection and contouring/ thresholding technique. MRI volumetric outcomes of whole brain (WB), gray matter (GM), white matter (WM), cortex, ventricular cerebrospinal fluid (vCSF), deep gray matter (DGM), thalamus, caudate nucleus (CN), putamen, globus pallidus (GP), and hippocampus were calculated. Independent t-test and ANCOVA, adjusted for age, were used to compare groups based on FV flow quartiles. Thirty-four MS patients with FV flow ≤327.8 mL/min (lowest quartile) had significantly lower WB (P<0.001), WM (P<0.001), thalamus (P=0.004), cortex (P=0.004), GM (P=0.004), DGM (P=0.008), hippocampus (P=0.005), and GP volumes (P=0.044) compared to 102 patients with FV flow of >327.8 mL/min (higher quartiles). There were no differences in T1-, T2- and gadolinium- enhancing lesion volumes between the quartile groups. The lack of an association between FV blood flow and inflammatory MRI measures in MS patients, but an association with brain atrophy, suggests that the severity of neurodegenerative process may be related to hemodynamic alterations. MS patients with more advanced global and regional brain atrophy showed low or retrograde FV volume flow.

Keywords

Facial vein; brain atrophy; multiple sclerosis; Doppler sonography.

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Submitted: 2017-08-04 16:19:10
Published: 2017-09-28 09:47:36
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Copyright (c) 2017 Dejan Jakimovski, Karen Marr, Marcello Mancini, Maria Grazia Caprio, Sirin Gandhi, Niels Bergsland, Ivo Paunkoski, Jesper Hagemeier, Avinash Chandra, Bianca Weinstock-Guttman, Robert Zivadinov

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