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General neurology
Research paper
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis
  1. Natalie Kappus1,
  2. Bianca Weinstock-Guttman2,
  3. Jesper Hagemeier1,
  4. Cheryl Kennedy1,
  5. Rebecca Melia1,
  6. Ellen Carl1,
  7. Deepa P Ramasamy1,
  8. Mariya Cherneva1,
  9. Jacqueline Durfee1,
  10. Niels Bergsland1,3,
  11. Michael G Dwyer1,
  12. Channa Kolb2,
  13. David Hojnacki2,
  14. Murali Ramanathan4,
  15. Robert Zivadinov1,2,5
  1. 1Department of Neurology, Buffalo Neuroimaging Analysis Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
  2. 2Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
  3. 3Magnetic Resonance Laboratory, IRCCS Don Gnocchi Foundation, Milan, Italy
  4. 4Department of Pharmaceutical Sciences, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, New York, USA
  5. 5MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
  1. Correspondence to Dr Robert Zivadinov, Buffalo Neuroimaging Analysis Center, MRI Clinical Translational Research Center, Department of Neurology, School of Medicine and Biomedical Sciences, 100 High St, Buffalo, NY 14203, USA; rzivadinov{at}bnac.net

Abstract

Background Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS).

Objectives To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes.

Methods In a prospective study, 326 patients with relapsing–remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status.

Results Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p=0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥2 CV risks (p=0.003), while the frequency of ≥3 CV risks was 18.8% in the MS group and 8.6% in the HCs group (p=0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes (p<0.05), while overweight/obesity was associated with increased T1-LV (p<0.39) and smoking with decreased whole brain volume (p=0.049). Increased lateral ventricle volume was associated with heart disease (p=0.029) in CIS.

Conclusions Patients with MS with one or more CV risks showed increased lesion burden and more advanced brain atrophy.

  • MULTIPLE SCLEROSIS

https://doi.org/10.1136/jnnp-2014-310051

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