Hypoperfusion and T1-hypointense lesions in white matter in multiple sclerosis

Ponnada A. Narayana, Yuxiang Zhou, Khader M. Hasan, Sushmita Datta, Xiaojun Sun, Jerry S. Wolinsky

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background: Longitudinal magnetic resonance imaging (MRI) studies show that a fraction of the multiple sclerosis (MS) T2-lesions contain T1-hypointense components that may persist to represent severe, irreversible tissue damage. It is not known why certain lesions convert to persistent T1-hypointense lesions. Objective: We hypothesized that the T1-hypointense lesions disproportionately distribute in the more hypoperfused areas of the brain. Here we investigated the association between hypoperfusion and T1-hypointense lesion distributions. Methods: MRI and cerebral blood flow (CBF) data were acquired on 45 multiple sclerosis (MS) patients and 20 healthy controls. CBF maps were generated using pseudo-continuous arterial spin labeling technique. The lesion probability distribution maps were superimposed on the CBF maps. Results: Two distinct CBF clusters were observed in the white matter (WM) both in healthy controls and MS patients. An overall reduction in CBF was observed in MS patients compared to healthy controls. The majority of the T1-hypointense lesions were concentrated almost exclusively in the WM regions with lower CBF. The T2-hyperintense lesions were more generally distributed in both higher and lower perfused WM. Conclusion: This study suggests an association between hypoperfusion and T1-hypointense lesions.

Original languageEnglish (US)
Pages (from-to)365-373
Number of pages9
JournalMultiple Sclerosis Journal
Issue number3
StatePublished - Mar 2014


  • Multiple sclerosis
  • T1-hypointense lesions
  • T2-hyperintense lesions
  • cerebral blood flow
  • magnetic resonance imaging

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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