ASL-detected Basal Ganglia Hyperperfusion in SSPE Correlates with Disability, Not Illness Duration

In SSPE, ASL perfusion revealed basal ganglia hyperperfusion in 54.5% (vs 15.2% structural MRI); a 4-region CNR composite AUC=0.90, 100% specificity, correlated with disability severity but not duration. Retrospective, 33 patients.

• Retrospective case-control: 33 SSPE patients (mean 13.9 years) vs 8 controls, 3T ASL MRI with cerebellar-normalized perfusion ratios (CNRs).
• Strongest discriminators: lentiform nucleus, occipital cortex, caudate; composite CNR AUC 0.90 (100% specificity).
• Basal ganglia hyperperfusion on ASL (54.5%) far exceeded structural MRI abnormalities (15.2%), suggesting early perfusion changes before structural injury. Small, retrospective, single-center design requires prospective validation.

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