Natalizumab and Regulation of Cerebral Blood Flow: Results from an Observational StudyReinhard M. · Rosengarten B. · Kirchhoff L. · Hetzel A. · Rauer S.
Departments of Neurology,aUniversity of Freiburg, Freiburg, and bUniversity of Giessen, Giessen, Germany
Background: Natalizumab inhibits adherence of leukocytes to the cerebral endothelium. Since leukocytes play a role in regulating vascular tone, natalizumab may also affect cerebral vasoregulation. The aim of this observational study was to investigate whether neurovascular coupling and cerebral autoregulation are altered following routine clinical infusion of natalizumab in patients with relapsing-remitting multiple sclerosis. Methods: In 18 patients receiving regular infusion of 300 mg natalizumab, neurovascular coupling to visual stimulation and dynamic cerebral autoregulation (phase and gain of 0.1-Hz oscillations) were measured by transcranial Doppler ultrasound (before, and 2 h and 2 days after the infusion). A repeated examination 28 days after infusion served as a control situation. Results: Neurovascular coupling was altered 2 h and 2 days after infusion with an overshooting initial hemodynamic response. After 28 days, neurovascular coupling was similar to values before the infusion. Dynamic cerebral autoregulation, cerebral blood flow velocity and pulsatility index in the middle and posterior cerebral artery were unaltered. Conclusion: Natalizumab infusion is associated with a temporarily increased initial hyperemia to functional activation. Such a hyperreactivity suggests an increased bioavailability of nitric oxide during functional activation.
PD Dr. Matthias Reinhard
Department of Neurology, University of Freiburg, Neurocenter
Breisacherstrasse 64, DE–79106 Freiburg (Germany)
Tel. +49 761 270 5307, Fax +49 761 270 5390
Sebastian Rauer received honoraria for lectures from Biogen Idec.
Received: January 19, 2010
Accepted: June 7, 2010
Published online: July 22, 2010
Number of Print Pages : 5
Number of Figures : 1, Number of Tables : 2, Number of References : 18
Vol. 64, No. 2, Year 2010 (Cover Date: August 2010)
Journal Editor: Bogousslavsky J. (Montreux)
ISSN: 0014-3022 (Print), eISSN: 1421-9913 (Online)
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