Sage Journals: Discover world-class research

Abstract

Background:

Vascular risk factors (VRF) in multiple sclerosis (MS) patients have been associated with lower brain volumes. It is currently unknown if this association already exists in early MS and how it develops over time.

Methods:

We identified 82 patients with clinically isolated syndrome (CIS) (n = 61) or with early relapsing-remitting MS (n = 21) and assessed their VRF including arterial hypertension, hyperlipidaemia, diabetes mellitus and smoking. We analysed T2-lesion load, normalized brain volume (NBV), cortical grey (cGMV) and white matter volumes (WMV), thalamic and basal ganglia volumes at baseline and follow-up magnetic resonance imaging (MRI) and assessed the percentage of brain volume change (PBVC) using SIENA.

Results:

Patient mean age was 32.4 (±8.7) years and 54 (65%) were women. Median follow-up period was 42 (29–54) months. In total, 26 patients (31.7%) had one or more VRF (VRF+). At baseline, VRF+ patients had a lower NBV (1530.9 cm³ vs 1591.2 cm³, p = 0.001), a lower cGMV (628.5 cm³ vs 668.6 cm³, p = 0.002) and WMV (752.2 cm³ vs 783.9 cm³, p = 0.009) than VRF-negative patients. Similar results were obtained at follow-up. PBVC was comparable between patients with and without VRF.

Conclusion:

VRF are associated with lower brain volume already in early MS but do not lead to increased brain volume loss during 3.5 years of follow-up.

Keywords

Vascular risk factors multiple sclerosis brain volume lesion load

Get full access to this article

View all access options for this article.

References

Thormann

Magyari

Koch-Henriksen

et al . Vascular comorbidities in multiple sclerosis: A nationwide study from Denmark. J Neurol 2016; 263(12): 2484–2493.

Tettey

Simpson

Taylor

et al . Vascular comorbidities in the onset and progression of multiple sclerosis. J Neurol Sci 2014; 347: 23–33.

Marrie

Rudick

Horwitz

et al . Vascular comorbidity is associated with more rapid disability progression in multiple sclerosis. Neurology 2010; 74: 1041–1047.

Marrie

Horwitz

RI.

Emerging effects of comorbidities on multiple sclerosis. Lancet Neurol 2010; 9: 820–828.

Dagan

Gringouz

Kliers

et al . Disability progression in multiple sclerosis is affected by the emergence of comorbid arterial hypertension. J Clin Neurol 2016; 12: 345.

Geraldes

Esiri

DeLuca

et al . Age-related small vessel disease: A potential contributor to neurodegeneration in multiple sclerosis. Brain Patho. Epub ahead of print 19 November 2016. DOI: 10.1111/bpa.12460.

Kappus

Weinstock-Guttman

Hagemeier

et al . Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis. J Neurol Neurosurg Psychiatry 2016; 87(2): 181–187.

Filippi

Preziosa

Copetti

et al . Gray matter damage predicts the accumulation of disability 13 years later in MS. Neurology 2013; 81: 1759–1767.

Fisniku

Chard

Jackson

et al . Gray matter atrophy is related to long-term disability in multiple sclerosis. Ann Neurol 2008; 64: 247–254.

10.

Sbardella

Petsas

Tona

et al . Assessing the correlation between grey and white matter damage with motor and cognitive impairment in multiple sclerosis patients. PLoS ONE 2013; 8: e63250.

11.

Jehna

Pirpamer

Khalil

et al . Periventricular lesions correlate with cortical thinning in multiple sclerosis. Ann Neurol 2015; 78: 530–539.

12.

Kurtzke

JF.

Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS). Neurology 1983; 33: 1444–1452.

13.

Mancia

Fagard

Narkiewicz

et al . 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens 2013; 31: 1281–1357.

14.

Catapano

Graham

de Backer

et al . 2016 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J 2016; 37: 2999–3058.

15.

Khalil

Langkammer

Ropele

et al . Determinants of brain iron in multiple sclerosis: A quantitative 3T MRI study. Neurology 2011; 77: 1691–1697.

16.

Pichler

Khalil

Langkammer

et al . Combined analysis of global and compartmental brain volume changes in early multiple sclerosis in clinical practice. Mult Scler 2016; 22: 340–346.

17.

Smith

Jenkinson

Woolrich

et al . Advances in functional and structural MR image analysis and implementation as FSL. Neuroimage 2004; 23(Suppl 1): S208–S219.

18.

Patenaude

Smith

Kennedy

et al . A Bayesian model of shape and appearance for subcortical brain segmentation. Neuroimage 2011; 56: 907–922.

19.

Enzinger

Ropele

Smith

et al . Accelerated evolution of brain atrophy and ‘black holes’ in MS patients with APOE-epsilon 4. Ann Neurol 2004; 55: 563–569.

20.

Jochemsen

HM.

Blood pressure and progression of brain atrophy. JAMA Neurol 2013; 70: 1046.

21.

Beauchet

Celle

Roche

et al . Blood pressure levels and brain volume reduction. J Hypertens 2013; 31: 1502–1516.

22.

Zlokovic

BV.

Neurovascular pathways to neurodegeneration in Alzheimer’s disease and other disorders. Nat Rev Neurosci 2011; 12: 723–738.

23.

Nation

Preis

Beiser

et al . Pulse pressure is associated with early brain atrophy and cognitive decline. Alzheimer Dis Assoc Disord 2016; 30: 210–215.

24.

Zivadinov

Bergsland

Dolezal

et al . Evolution of cortical and thalamus atrophy and disability progression in early relapsing-remitting MS during 5 years. AJNR Am J Neuroradiol 2013; 34: 1931–1939.

25.

Zivadinov

Havrdová

Bergsland

et al . Thalamic atrophy is associated with development of clinically definite multiple sclerosis. Radiology 2013; 268: 831–841.

26.

Zivadinov

Weinstock-Guttman

Hashmi

et al . Smoking is associated with increased lesion volumes and brain atrophy in multiple sclerosis. Neurology 2009; 73: 504–510.

27.

De Stefano

Stromillo

Giorgio

et al . Establishing pathological cut-offs of brain atrophy rates in multiple sclerosis. J Neurol Neurosurg Psychiatry 2016; 87: 93–99.

28.

Weinstock-Guttman

Zivadinov

Horakova

et al . Lipid profiles are associated with lesion formation over 24 months in interferon-β treated patients following the first demyelinating event. J Neurol Neurosurg Psychiatry 2013; 84: 1186–1191.

29.

Healy

Ali

Guttmann

CRG

et al . Smoking and disease progression in multiple sclerosis. Arch Neurol 2009; 7: 858–864.

30.

Manouchehrinia

Tench

Maxted

et al . Tobacco smoking and disability progression in multiple sclerosis: United Kingdom cohort study. Brain 2013; 136: 2298–2293.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.31 MB

The impact of vascular risk factors on brain volume and lesion load in patients with early multiple sclerosis

Abstract

Background:

Methods:

Results:

Conclusion:

Keywords

Get full access to this article

References

Supplementary Material