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Updated: Dec 29, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Distinct influence of different vascular risk factors on white matter brain lesions in multiple sclerosis
Ruth Geraldes1,2, Maciej Juryńczyk1, Giordani Dos Passos1
1Nuffield Department of Clinical Neurosciences, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Objective:
To determine if vascular risk factor (VRF), that is, smoking, arterial hypertension (HT), dyslipidaemia and diabetes, have an effect on multiple sclerosis (MS) pathology as measured by MS typical brain lesions, we have compared brain MRIs from patients with MS with and without VRF age-matched and sex-matched.
Methods:
Brain MRIs from five centres were scored for the presence of Dawson's fingers (DF) and juxtacortical lesions (JCL). A regression model was built to predict the effect of each individual VRF on DF and JCL, considering age and disease duration.
Results:
92 MS cases without VRF and 106 MS with one or more VRF (80 ever-smokers, 43 hypertensives, 25 dyslipidaemics and 10 diabetics) were included. Ever-smoking associated with a higher burden of DF (Exp(B)=1.29, 95% CI 1.10 to 1.51, p<0.01) and JCL (Exp(B)=1.38, 95% CI 1.21 to 1.57, p<0.01). No other VRF had an impact on DF. Dyslipidaemia associated with increased JCL (Exp(B)=1.30, 95% CI 1.10 to 1.56, p<0.01) but HT did not associate with any of the outcomes.
Conclusions:
Individual VRF appear to affect MS-specific lesions differently. An increase in MS lesions was mainly seen in smokers; however, this VRF is most likely to be present from onset of MS, and other VRF effects may be partly mitigated by treatment. Our findings support that treating VRF and cessation of smoking may be important in the management of MS.
Insights
Vascular risk factors like smoking and dyslipidemia are linked to increased multiple sclerosis (MS) brain lesions. Managing these factors, especially smoking cessation, may help control MS progression.
Area of Science:
- Neurology
- Radiology
- Epidemiology
Background:
- Vascular risk factors (VRFs) such as smoking, hypertension, dyslipidemia, and diabetes are prevalent in the general population.
- The impact of these VRFs on the specific pathological markers of multiple sclerosis (MS) brain lesions requires further elucidation.
Purpose of the Study:
- To investigate the association between individual vascular risk factors (VRFs) and the presence of MS-typical brain lesions.
- To compare brain MRI findings in MS patients with and without VRFs, controlling for age and sex.
Main Methods:
- Brain MRIs from 92 MS patients without VRFs and 106 MS patients with one or more VRFs were analyzed.
- Lesions, including Dawson's fingers (DF) and juxtacortical lesions (JCL), were scored. A regression model assessed the effect of individual VRFs on lesion burden.
Main Results:
- Ever-smoking was significantly associated with a higher burden of both DF and JCL in MS patients.
- Dyslipidemia was associated with an increased number of JCL.
- Arterial hypertension and diabetes did not show a significant association with the studied MS lesions.
Conclusions:
- Individual VRFs differentially impact MS pathology, with smoking showing a notable association with increased lesion load.
- These findings underscore the potential importance of managing VRFs, particularly smoking cessation, in the comprehensive management of multiple sclerosis.
