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The effect of methylprednisolone treatment on cerebral reactivity in patients with multiple sclerosis
Serhat Ozkan1, Nevzat Uzuner, Ceyhan Kutlu
1Osmangazi University, Medical Faculty, Department of Neurology, Meselik Campus, 26480 Eskisehir, Turkey. scozkan@yahoo.com
Abstract:
We assessed the effect of intravenous high-dose methylprednisolone (IVMP) on cerebral reactivity in multiple sclerosis (MS) patients during exacerbations by means of functional transcranial Doppler imaging. Forty-eight clinically defined MS patients were evaluated with visual evoked potentials (VEP) and functional transcranial Doppler sonography (TCD) of both posterior cerebral arteries before and after 5 days of 1000 mg IVMP. After treatment, mean Expanded Disability Status Scale score, mean blood flow velocities and mean blood flow velocities at rest and at stimulation, significantly decreased (p < 0.0001, for each). The change in cerebral blood flow velocity ratio (CBFv) with visual stimulation after treatment increased slightly (p = 0.20). All TCD parameters were not significantly correlated with VEP changes. In conclusion, we observed significant changes in CBFv with a non-significant increase in vascular reactivity after treatment with IVMP in exacerbations of MS. Case-control studies are necessary to draw conclusions regarding the beneficial effects of IVMP treatment.
Insights
High-dose methylprednisolone (IVMP) treatment for multiple sclerosis (MS) exacerbations significantly reduced blood flow velocities. While vascular reactivity showed a non-significant increase, further studies are needed to confirm IVMP
Area of Science:
- Neurology
- Vascular Medicine
- Neuroimmunology
Background:
- Multiple sclerosis (MS) exacerbations can impact cerebral blood flow.
- Intravenous high-dose methylprednisolone (IVMP) is a common treatment for MS relapses.
- Assessing the effect of IVMP on cerebral hemodynamics is crucial for understanding its therapeutic mechanisms.
Purpose of the Study:
- To evaluate the impact of IVMP on cerebral reactivity in MS patients during exacerbations.
- To investigate changes in cerebral blood flow velocities and vascular reactivity post-treatment.
Main Methods:
- Forty-eight MS patients undergoing exacerbation were studied.
- Functional transcranial Doppler sonography (TCD) assessed posterior cerebral artery blood flow.
- Visual evoked potentials (VEP) were used alongside TCD before and after 5 days of 1000 mg IVMP.
Main Results:
- Significant decreases in Expanded Disability Status Scale scores and mean blood flow velocities (at rest and stimulation) were observed post-IVMP (p < 0.0001).
- The cerebral blood flow velocity ratio with visual stimulation showed a slight, non-significant increase (p = 0.20).
- No significant correlation was found between TCD parameters and VEP changes.
Conclusions:
- IVMP treatment in MS exacerbations led to significant changes in cerebral blood flow velocities.
- A non-significant increase in vascular reactivity suggests potential, but unconfirmed, benefits.
- Case-control studies are recommended to definitively establish the beneficial effects of IVMP on cerebral reactivity in MS.
