Patients with multiple sclerosis (MS) show a diffuse cerebral perfusion decrease, presumably related to multiple metabolism and vascular alterations. It is assumed that white matter fiber alterations cause a localized cerebral vasoreactivity (CVR) disruption through astrocytes metabolism alteration, leading to hypoperfusion. We proposed to (1) evaluate the CVR disruptions in MS, (2) in relation to white matter lesions and (3) compare CVR disruptions maps with standard imaging biomarkers. Thirty-five MS patients (10 progressive, 25 relapsing–remitting) and 22 controls underwent MRI with hypercapnic challenge, DTI imaging and neuropsychological assessment. Areas with disrupted CVR were assessed using a general linear model. Resulting maps were associated with clinical scores, compared between groups, and related to DTI metrics and white matter lesions. MS patients showed stronger disrupted CVR within supratentorial white matter, linking the left anterior insula to both the precentral gyrus and the right middle and superior frontal gyrus through the corpus callosum (P < 0.05, FWE corrected). Patient’s verbal intellectual quotient was negatively associated with a pathway linking both hippocampi to the ispilateral prefrontal cortex (P < 0.05, FWE corrected). Disrupted CVR maps unrelated to DTI metrics and white matter lesions. We have demonstrated for the first time that white matter alterations can be indirectly identified through surrounding vessel alterations, and are related to clinical signs of MS. This offers a new, likely independent marker to monitor MS and supports a mediator role of the astrocytes in the fibers/vessels relationship.

多发性硬化症（MS）患者显示出弥漫性脑灌注下降，可能与多种代谢和血管改变有关。假定白质纤维改变通过星形胶质细胞代谢改变引起局部脑血管反应性（CVR）破坏，从而导致灌注不足。我们建议（1）评估MS中的CVR破坏，（2）与白质病变有关，（3）比较CVR破坏图和标准成像生物标记物。35例MS患者（10例进行性，25例复发-缓解型）和22例对照接受了高碳酸血症性挑战，DTI成像和神经心理学评估的MRI。使用一般线性模型评估CVR受损的区域。结果图与临床评分相关，在各组之间进行比较，与DTI指标和白质病变有关。MS患者表现出更强的上上皮白质内CVR破坏，通过through体将左前岛与中央前回以及右中上额回相连（P <0.05，经FWE校正）。患者的言语智商与将海马体和同侧前额叶皮层相连的途径呈负相关（P <0.05，经FWE校正）。与DTI指标和白质病变无关的CVR映射中断。我们首次证明白质改变可以通过周围血管改变间接识别，并且与MS的临床体征有关。这提供了一个新的