Distinct influence of different vascular risk factors on white matter brain lesions in multiple sclerosis

Ruth Geraldes, Maciej Juryńczyk, Giordani Dos Passos, Alexander Prichler, Karen Chung, Marloes Hagens, Serena Ruggieri, Elena Huerga, Jaume Sastre-Garriga, Christian Enzinger, Declan T. Chard, Frederik Barkhof, Claudio Gasperini, Alex Rovira, Gabriele C. Deluca, Jacqueline Palace

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective : To determine if vascular risk factor (VRF), that is, smoking, arterial hypertension (HT), dyslipidaemia and diabetes, have an effect on multiple sclerosis (MS) pathology as measured by MS typical brain lesions, we have compared brain MRIs from patients with MS with and without VRF age-matched and sex-matched. Methods: Brain MRIs from five centres were scored for the presence of Dawson's fingers (DF) and juxtacortical lesions (JCL). A regression model was built to predict the effect of each individual VRF on DF and JCL, considering age and disease duration. Results: 92 MS cases without VRF and 106 MS with one or more VRF (80 ever-smokers, 43 hypertensives, 25 dyslipidaemics and 10 diabetics) were included. Ever-smoking associated with a higher burden of DF (Exp(B)=1.29, 95% CI 1.10 to 1.51, p<0.01) and JCL (Exp(B)=1.38, 95% CI 1.21 to 1.57, p<0.01). No other VRF had an impact on DF. Dyslipidaemia associated with increased JCL (Exp(B)=1.30, 95% CI 1.10 to 1.56, p<0.01) but HT did not associate with any of the outcomes. Conclusions: Individual VRF appear to affect MS-specific lesions differently. An increase in MS lesions was mainly seen in smokers; however, this VRF is most likely to be present from onset of MS, and other VRF effects may be partly mitigated by treatment. Our findings support that treating VRF and cessation of smoking may be important in the management of MS.

Original languageEnglish
Number of pages4
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume91
Issue number4
DOIs
Publication statusE-pub ahead of print - 1 Jan 2020

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