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Cerebrovascular hemodynamics association with brain structure and function in Multiple Sclerosis.

Cristina Duque1, Simin Mahinrad2, Sanaz Sedaghat3

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Multiple Sclerosis and Related Disorders
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Efficient cerebral autoregulation in Multiple Sclerosis (MS) is linked to better brain structure and cognitive function. This study explored cerebrovascular hemodynamics (CVH) and its relation to MS progression.

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Cerebral autoregulationCognitionMRIMultiple SclerosisTranscranial Doppler ultrasound

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Area of Science:

  • Neuroscience
  • Vascular Biology
  • Medical Imaging

Background:

  • Vascular risk factors may influence Multiple Sclerosis (MS) progression, but the underlying mechanisms remain unclear.
  • Understanding cerebrovascular hemodynamics (CVH) in MS is crucial for elucidating the link between vascular health and MS.
  • Cerebrovascular hemodynamics encompass dynamic cerebral autoregulation (dCA) and vasoreactivity (VR).

Purpose of the Study:

  • To investigate the relationship between CVH (dCA and VR) and brain structure (MRI) and function (cognition, gait) in individuals with MS.
  • To assess how dynamic cerebral autoregulation and vasoreactivity correlate with gray matter volume, white matter hyperintensities, and cognitive performance.
  • To determine if CVH markers are associated with gait function in MS patients.

Main Methods:

  • Utilized Transcranial Doppler ultrasound (TCD) to measure dCA (phase and gain) and VR.
  • Calculated dCA from spontaneous blood pressure and flow velocity oscillations.
  • Quantified brain structure using MRI (GM, WM, WMH volumes, WM lesion counts) and assessed cognitive and gait function.

Main Results:

  • Higher phase values (indicating better dCA) correlated with greater gray matter volume and reduced white matter hyperintensity burden.
  • Improved dCA was associated with higher scores in memory and global cognitive domains.
  • No significant relationship was found between CVH markers (dCA or VR) and gait speed, nor between VR and brain structure or function.

Conclusions:

  • Enhanced dynamic cerebral autoregulation is associated with better brain structure, specifically larger gray matter volumes and lower white matter hyperintensity burden in MS patients.
  • More efficient cerebral autoregulation is linked to improved cognitive function in individuals with MS.
  • Cerebral autoregulation does not appear to influence gait function in this MS cohort.