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Published on: June 3, 2021
Cerebral hemodynamics in patients with multiple sclerosis
Simona Lattanzi1, Maria Cristina Acciarri1, Maura Danni1
1Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca 71, 60020 Ancona, Italy.
Background And Purpose:
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Although the currently predominant view is that of an autoimmune inflammatory condition, changes in brain vasculature can occur and contribute to pathophysiology. The aim of this study was to evaluate cerebral hemodynamics in patients with MS and explore its relationship with disease status.
Methods:
Patients with MS and age- and sex- matched healthy controls were recruited. All participants underwent assessment of cerebral hemodynamics through transcranial Doppler ultrasonography. Cerebral vasomotor reactivity (CVR) to hypercapnia was measured by the breath-holding index (BHI).
Results:
A total of 80 patients with MS and 80 healthy controls were recruited. BHI values obtained in healthy controls, relapsing-remitting (RR)-MS and secondary progressive (SP)-MS patients were 1.15±0.11, 0.87±0.18 and 0.51±0.20, respectively (p<0.001). Group-wise, patients showed decreased CVR in comparison to controls and BHI values were significantly lower in SP-MS than in RR-MS patients. At linear regression analysis, the disease form was significantly associated with cerebral hemodynamics being the SP phenotype an independent predictor of lower BHI values [β=-0.36, 95% confidence interval (CI): -0.44 to -0.27, p<0.001; adjusted β=-0.37, 95% CI: -0.50 to -0.23, p<0.001).
Conclusions:
Cerebrovascular hemodynamic insufficiency in MS may be secondary to the downstream effects of neuro-inflammatory cascades.
Insights
Multiple sclerosis patients exhibit impaired cerebral hemodynamics, with significantly reduced cerebrovascular reactivity observed in secondary progressive MS compared to relapsing-remitting MS. This suggests vascular dysfunction may contribute to MS pathophysiology.
Area of Science:
- Neurology
- Neuroscience
- Vascular Biology
Background:
- Multiple sclerosis (MS) is primarily viewed as an autoimmune inflammatory disease affecting the central nervous system.
- Emerging evidence suggests that alterations in brain vasculature may also play a role in MS pathophysiology.
- Understanding cerebral hemodynamics in MS is crucial for a comprehensive view of the disease.
Purpose of the Study:
- To evaluate cerebral hemodynamics in patients diagnosed with multiple sclerosis.
- To investigate the relationship between cerebral hemodynamic status and disease characteristics in MS.
- To compare cerebrovascular reactivity between different MS phenotypes and healthy controls.
Main Methods:
- Recruited 80 patients with MS and 80 age- and sex-matched healthy controls.
- Assessed cerebral hemodynamics using transcranial Doppler ultrasonography.
- Measured cerebral vasomotor reactivity (CVR) to hypercapnia via the breath-holding index (BHI).
Main Results:
- Patients with MS demonstrated significantly reduced CVR compared to healthy controls.
- Breath-holding index (BHI) values were significantly lower in secondary progressive (SP)-MS (0.51±0.20) than in relapsing-remitting (RR)-MS (0.87±0.18) patients.
- The SP MS phenotype was identified as an independent predictor of lower BHI values, indicating impaired cerebral hemodynamics.
Conclusions:
- Cerebrovascular hemodynamic insufficiency is evident in multiple sclerosis patients.
- This vascular dysfunction may be a consequence of the downstream effects of neuro-inflammatory processes in MS.
- Findings highlight the potential contribution of vascular factors to MS progression.
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