This Is MS Multiple Sclerosis Community: Knowledge & Support

Dr. Ge: Mitochondrial dysfunction is a form of metabolic hypoxia in MS

Dr. Ge: Venous structures in MR scans of MS patients are diminished nin advanced stages

Dr. Ge: Oxygen delivery and consumption are critical to neuronal health and critically under studied in MS

Dr. Ge being questioned about his data by Dr. Zamboni about cerebral blood flow...now Dr. Haacke weighs in. Fascinating!

Technology Insights of Oxygen Metabolic Abnormalities in MS (Yulin Ge, USA)

The role of vascular pathology in multiple sclerosis (MS) was suggested long ago by Ribbert (1882) and Putnam
(1933). With the invention and advances of imaging technology, now there is accumulating evidence in vivo of
primary vascular pathogenesis and hemodynamic impairment in MS. In particular, there is cerebral blood
perfusion changes in lesions and normal appearing brain tissues, suggesting there might be an ischemic and/or
hypoxic origin of MS disease. In this presentation, I am going to discuss the hemodynamic perfusion changes
and vascular abnormalities measured with several advanced MRI techniques and their pathophysiological
significance in MS. First, the close perivenous relationship of MS lesions associated with the underlying
vascular inflammatory changes can be evaluated with high resolution susceptibility-weighted imaging. Second,
cerebral blood perfusion changes including cerebral blood volume (CBV) and flow (CBF) have been evaluated
with dynamic susceptibility contrast-enhanced (DSC) and arterial spin labeling (ASL) MRI techniques. The
lesions showed different patterns of perfusion change despite that hypoperfusion is a general feature seen in
MS tissues. The perfusion changes in MS may provide additional information of microvascular abnormalities.
Third, the recent promising vascular ischemic / hypoxic hypothesis can be evaluated in vivo with several
techniques including perfusion- and diffusion- weighted imaging during the acute phase and oxygen
metabolic measures as well as functional MRI techniques. In summary, there is increased awareness from both
histopathologic and imaging studies of the role of microvascular and hemodynamic impairment in tissue injury
in MS; therefore, targeting hypoxic injury may be indicated in the new therapeutic strategy.