Abstract Details

Title Lower Total Cerebral Arterial Flow Contributes to Cognitive Performance in Multiple Sclerosis Patients

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-037

Objective To investigate whether lower total cerebral arterial blood flow (CABF) measured at the level of the carotid and vertebral arteries, may contribute to worse cognitive performance in multiple sclerosis (MS) patients and age-matched healthy controls (HCs).

Background The cognitive performance in MS patients declines with aging, longer disease duration, and possibly with higher cardiovascular comorbidities.

Design/Methods One hundred thirty two (132) MS patients and 47 age-matched HCs were prospectively recruited. Extracranial Doppler examination was employed and the total CABF was derived by addition of the bilateral flow within the common carotid arteries (CCA) and vertebral arteries (VA). Structural T2-lesion volume (LV) and gray matter volume (GMV) were measured on a 3T MRI-acquired scans. The cognitive performance was assessed by Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Tests-Revised (BVMT-R), and California Verbal Learning Test Second Edition (CVLT-II). The cognitively impaired (CI) status of the MS patients was obtained by HCs-based z-scores. Analysis of covariance (ANCOVA), partial correlation, and regression models were used to test the differences between study groups and cognition/CABF correlations after multiple comparisons correction.

Results Association between lower total CABF and the lower cognitive performance was observed only in MS patients (r=0.318, p<0.001 and r=0.244, p=0.012, for SDMT, and BVMT-R, respectively). Lower GMV, higher T2-LV, and CABF were significantly associated with poorer performance on the processing speed measure of SDMT (adjusted R²=0.295, t-statistics = 2.538, Standardized B=0.203 and p=0.020), but not with memory tests. Cognitively impaired MS patients had lower total CABF compared to cognitively preserved (884.5ml/min vs. 1020.2ml/min p=0.008).

Conclusions Cognitively impaired MS patients presented with lower total CABF. The lower arterial flow may contribute to abnormal cognitive aging in MS or may be a result of reduced metabolic rate.

Authors/Disclosures
Dejan Jakimovski, MD, PhD (Buffalo Neuroimaging Analysis Center, University at Buffalo) PRESENTER	Dr. Jakimovski has nothing to disclose.
Ralph H. Benedict, PhD (University At Buffalo)	Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Benedict has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bristol Meyers Squibb. Dr. Benedict has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Immunic Therapeutics. Dr. Benedict has received intellectual property interests from a discovery or technology relating to health care.
Karen Marr, BA	No disclosure on file
Sirin Gandhi, MBBS	Dr. Gandhi has nothing to disclose.
Niels Bergsland (Buffalo Neuroimaging Analysis Center / State University of New York At Buffalo)	Prof. Bergsland has nothing to disclose.
Bianca Weinstock-Guttman, MD (Department of Neurology, University At Buffalo)	Dr. Weinstock-Guttman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme &Sanofi. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Weinstock-Guttman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. Dr. Weinstock-Guttman has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Weinstock-Guttman has received personal compensation in the range of $0-$499 for serving as a Reviewer with NIH.
Robert Zivadinov, MD, PhD, FAAN (Buffalo Neuroimaging Analysis Center)	The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Omnicuris. The institution of Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Myrobalan. Dr. Zivadinov has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Zivadinov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Zivadinov has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.

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