Vascular comorbidity is associated with lower brain volumes and lower neuroperformance in a large multiple sclerosis...

Area of Science:

• Neurology
• Immunology
• Vascular Medicine

Background:

• Multiple Sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
• Vascular comorbidities are increasingly recognized as potential contributors to disease progression in MS.
• Understanding the impact of these comorbidities is crucial for comprehensive patient management.

Purpose of the Study:

• To investigate the association between the burden of vascular comorbidities and clinical/imaging markers of disease severity in a large multiple sclerosis cohort.
• To determine if conditions like diabetes, hypertension, and dyslipidemia influence neurological function and brain structure in MS patients.

Main Methods:

• Utilized data from the MS Partners Advancing Technology Health Solutions (MS PATHS) cohort, including 11,506 participants.
• Employed propensity score-weighted models to assess associations between vascular comorbidities (diabetes, hypertension, dyslipidemia) and MS characteristics.
• Evaluated objective neurologic function assessments and quantitative brain magnetic resonance imaging (MRI) metrics.

Main Results:

• Individuals with two or more vascular comorbidities exhibited significantly slower walking speed, reduced manual dexterity, and poorer cognitive processing speed compared to those without comorbidities.
• A higher comorbidity burden was associated with lower brain parenchymal and gray matter fractions.
• Significant reductions in cortical and deep gray matter volumes were observed in individuals with increased vascular comorbidity burden.

Conclusions:

• Increased vascular comorbidity burden is significantly associated with clinical and imaging indicators of neurologic dysfunction and neurodegeneration in multiple sclerosis.
• These findings highlight the importance of managing vascular risk factors in individuals with MS to potentially mitigate disease progression.
• Optimizing comorbidity management strategies is warranted for people living with MS.