Premium
Hypertension and heart disease are associated with development of brain atrophy in multiple sclerosis: a 5‐year longitudinal study
Author(s) -
Jakimovski D.,
Gandhi S.,
Paunkoski I.,
Bergsland N.,
Hagemeier J.,
Ramasamy D. P.,
Hojnacki D.,
Kolb C.,
Benedict R. H. B.,
WeinstockGuttman B.,
Zivadinov R.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13769
Subject(s) - medicine , atrophy , overweight , hyperlipidemia , cardiology , multiple sclerosis , brain size , diabetes mellitus , lesion , disease , obesity , magnetic resonance imaging , pathology , radiology , endocrinology , psychiatry
Background Cardiovascular diseases ( CVD s) are more frequent in multiple sclerosis ( MS ) patients when compared to controls. In particular, CVD s are linked with higher accumulation of lesions and advanced brain atrophy. Objective To investigate whether CVD s contribute to accelerated lesion accumulation and brain atrophy over 5 years in patients with MS . Methods 194 MS patients and 43 controls without neurologic disease were followed for 5 years. Full physical, neurological evaluation, and structured questionnaire investigating CVD and risk factors (hypertension, hyperlipidemia, heart disease, smoking, diabetes, obesity/overweight) were collected using interview‐based questionnaire and further cross‐reference with electronic medical records. Lesion and brain atrophy outcomes were assessed with 3T MRI . ANCOVA adjusted for age, gender, and disease duration were used accordingly. False discovery rate correction was performed using Benjamini‐Hochberg correction. Results Patients with diagnosis of heart disease showed higher white matter and whole brain volume loss compared to those without (−4.2% vs. −0.7%, P = 0.01 and −3.4% vs. −1.6%, P = 0.01, respectively). The percentage lateral ventricle volume change in MS patients with hypertension was higher compared to non‐hypertensive patients (24.5% vs. 14.1%, P = 0.05). Hyperlipidemia, smoking, and obesity/overweight were not associated with progression of MRI ‐derived outcomes. CVD s did not contribute to larger lesion volume accrual over the 5‐year period. The presence of CVD s was not associated with MRI ‐derived changes in the controls. Conclusions Hypertension and heart disease contribute to advanced brain atrophy in MS patients. CVD s did not contribute to additional lesion accrual. CVD comorbidities in MS patients may contribute to neurodegenerative tissue injury that can be detected with brain MRI .