Open AccessPhysiological instability is linked to mortality in primary central nervous system lymphoma: A case–control fMRI study
Author(s) -
Poltojainen Valter,
Kemppainen Janette,
Keinänen Nina,
Bode Michaela,
Isokangas JuhaMatti,
Kuitunen Hanne,
Nikkinen Juha,
Sonkajärvi Eila,
Korhonen Vesa,
Tuovinen Timo,
Järvelä Matti,
Huotari Niko,
Raitamaa Lauri,
Kananen Janne,
Korhonen Tommi,
Tetri Sami,
Kuittinen Outi,
Kiviniemi Vesa
Publication year - 2022
Publication title -
human brain mapping
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.005
H-Index - 191
eISSN - 1097-0193
pISSN - 1065-9471
DOI - 10.1002/hbm.25901
Subject(s) - fluid attenuated inversion recovery , magnetic resonance imaging , medicine , central nervous system , voxel , primary central nervous system lymphoma , pathology , population , neuroimaging , nuclear medicine , cardiology , neuroscience , radiology , psychology , environmental health
Primary central nervous system lymphoma (PCNSL) is an aggressive brain disease where lymphocytes invade along perivascular spaces of arteries and veins. The invasion markedly changes (peri)vascular structures but its effect on physiological brain pulsations has not been previously studied. Using physiological magnetic resonance encephalography (MREG BOLD ) scanning, this study aims to quantify the extent to which (peri)vascular PCNSL involvement alters the stability of physiological brain pulsations mediated by cerebral vasculature. Clinical implications and relevance were explored. In this study, 21 PCNSL patients (median 67y; 38% females) and 30 healthy age‐matched controls (median 63y; 73% females) were scanned for MREG BOLD signal during 2018–2021. Motion effects were removed. Voxel‐by‐voxel Coefficient of Variation (CV) maps of MREG BOLD signal was calculated to examine the stability of physiological brain pulsations. Group‐level differences in CV were examined using nonparametric covariate‐adjusted tests. Subject‐level CV alterations were examined against control population Z‐score maps wherein clusters of increased CV values were detected. Spatial distributions of clusters and findings from routine clinical neuroimaging were compared [contrast‐enhanced, diffusion‐weighted, fluid‐attenuated inversion recovery (FLAIR) data]. Whole‐brain mean CV was linked to short‐term mortality with 100% sensitivity and 100% specificity, as all deceased patients revealed higher values ( n = 5, median 0.055) than surviving patients ( n = 16, median 0.028) ( p < .0001). After adjusting for medication, head motion, and age, patients revealed higher CV values (group median 0.035) than healthy controls (group median 0.024) around arterial territories ( p ≤ .001). Abnormal clusters (median 1.10 × 10 5 mm 3 ) extended spatially beyond FLAIR lesions (median 0.62 × 10 5 mm 3 ) with differences in volumes ( p = .0055).