[Clinical and radiological (PET, MRI) correlations depending on disease progression in patients with multiple sclerosis].

: The aim of the study was to investigate the structural-functional changes in the cerebral gray matter (cortical and subcortical areas) of patients with multiple sclerosis (MS) depending on the disease severity. One hundred and seven patients (107) with definite diagnosis of MS (Mc Donald's criteria), aged 16-60 years, illness duration 1-30 years, and 21 healthy age-matched controls have been studied. Neurological assessment including Kurtzke and EDSS scales (range 0-8) was performed in all the patients. The patients and controls underwent MRI with a 1,5 imager and PET using 18F-flurodeoxyglucose (FDG). A type of the disease course was determined as remitting in 63 patients, primarily-progressive in 8, remitting progressive in 6 and secondary-progressive in 30. To analyze pathogenesis of the disease progression, the patients were divided into 3 clinical groups: (1) remitting (RRMS, n=63); (2) progressive (PRMS) with EDSS 6 (n=11). Along with the progression of MS from RRMS to PRMS and increasing of EDSS, the rCMRglu reduction of the cerebral gray matter developed from the supplementary motor cortex of a dominant hemisphere to the marked global reduction of cerebral metabolic rate in the PRMS group (EDSS >6). In the PRMS group with EDSS56, there was functional reorganization of cortical and subcortical areas compensatorily developing with the disease progression. In the PRMS group with EDSS >6, the data obtained did not support the evidence for the regional compensatory increase of rCMRglu in the same brain areas. Decompensation of the functional cortical reorganization in the PRMS group with EDSS >6 correlated with diffuse brain atrophy as well as with atrophy of the gray matter of the regional basal ganglia, first of all of the thalamus.