Cerebral blood flow in dystonia due to pantothenate kinase-associated neurodegeneration

Neuroradiol J. 2020 Dec;33(6):479-485. doi: 10.1177/1971400920943967. Epub 2020 Aug 27.

Abstract

Background and purpose: The aim of this study was to look for deviations of cerebral perfusion in patients suffering from pantothenate kinase-associated neurodegeneration, where the globus pallidus is affected by severe accumulation of iron.

Material and methods: Under resting conditions, cerebral blood flow was measured by the magnetic resonance imaging technique of arterial spin labelling in cortical areas and basal ganglia in eight pantothenate kinase-associated neurodegeneration patients and 14 healthy age-matched control subjects and correlated to T2* time of these areas and - in patients - to clinical parameters.

Results: Despite highly significant differences of T2* time of the globus pallidus (20 vs 39 ms, p < 0.001), perfusion values of this nucleus were nearly identical in both groups (32 ± 3.3 vs 31 ± 4.0 ml/min/100 g) as well as in total brain gray matter (both 62 ± 6.7 resp. ±10.3 ml/min/100 g), putamen (41 ± 5.4 vs 40 ± 6.1 ml/min/100 g), in selected cortical regions, and the cerebellum. Correlations between perfusion and T2* time to clinical data did not reach significance (p > 0.05).

Conclusion: The absence of any obvious deviations of perfusion in the group of patients during a resting condition does not support the view that (non-functional) vascular pathology is a major pathogenic factor in pantothenate kinase-associated neurodegeneration in the younger age group. The findings underline the value of the arterial spin technique to measure cerebral blood flow in areas of disturbed susceptibility.

Keywords: Pantothenate kinase-associated neurodegeneration; cerebral blood flow; globus pallidus; tiger’s eye.

MeSH terms

  • Adolescent
  • Adult
  • Cerebrovascular Circulation*
  • Dystonia / etiology
  • Female
  • Humans
  • Magnetic Resonance Angiography / methods*
  • Male
  • Pantothenate Kinase-Associated Neurodegeneration / complications
  • Pantothenate Kinase-Associated Neurodegeneration / diagnostic imaging*
  • Prospective Studies