The presence of cardiovascular (CV) risk factors is associated with brain atrophy in MS patients ≤50 years, who are unlikely to have small vessel disease. An Italian cross-sectional observational study suggests CV risk factors have synergistic effects in MS .
The impact of CV risk factors on T2 hyperintense lesion volume and brain atrophy in MS patients aged ≤50 years was evaluated in 124 MS patients (relapsing-remitting MS, n=79; progressive MS, n=45) and 95 matched healthy controls. Participants underwent a complete neurological assessment and brain 3D T2-weighted and FLAIR MRI, as well as 3D T1-weighted MRI. Assessed traditional CV risk factors were smoking ≥5 pack-years, hypertension, dyslipidaemia, and (pre-)diabetes. More stringent cut-offs were also assessed: smoking ≥10 pack-years, and hypertension, dyslipidaemia, or diabetes while on medication. Of the 124 MS patients, 48 had 1 traditional CV risk factor, 15 had 2 or more. Of 95 healthy controls, 19 had 1 risk factor, 4 had more (P<0.001). Thirty MS patients had 1 stringent risk-factor, and 8 had more than 1, as did 10 and 3 healthy controls (P=0.01). The most common CV risk factor was smoking.
In MS patients, having 2 or more traditional CV risk factors was associated with reduced normalised grey matter volume (nGMV; P=0.01), white matter volume (nWMV; P=0.03), and whole brain volume (nBV; P=0.003), but not with T2-lesion volume (T2-LV; P=0.27). Only hypertension was associated with MRI measures (nWMV and nBV). Having 1 stringent CV risk factor was associated with reduced nGMV (P=0.006), nWMV (P=0.003), and nBV (P<0.001), and higher T2-LV (P=0.03). In healthy controls, neither traditional nor stringent risk factors significantly impacted the abovementioned measures.
- Bonacchi R, et al. Cardiovascular risk factors affect brain volume in young MS patients. MSVirtual 2020, Abstract PS04.05.
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Table of Contents: MS Virtual 2020
Letter from the Editor
MS Virtual 2020 Highlights Podcast
COVID-19 and MS
Treatment Strategies and Results
Management of progressive MS with approved DMT
Novel Treatment Directions
Neuromyelitis Optica Spectrum Disorders
ECTRIMS 2021 Highlights Podcast
Switching from natalizumab to moderate- versus high-efficacy DMT
Long-term safety and efficacy of ozanimod in relapsing MS