Disability progression in Multiple Sclerosis (MS) is driven by inflammation and neurodegeneration. Arterial spin labelling (ASL) is a non-invasive MRI method for the assessment of brain perfusion without the need for gadolinium. Here, we explored ASL perfusion as a biomarker for diseases progression and disability in a cohort of 77 patients with primary progressive MS (PPMS). While brain perfusion seemed rather stable during the follow-up of up to 5 years, we observed an association between higher regional perfusion rates and cognitive performance and hand functioning. Altered perfusion in PPMS seems thus not closely related to the major pathomechanism neurodegeneration.
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