Cardiovascular Comorbidities Linked to Increased Brain Atrophy in Multiple Sclerosis

MRI scan
MRI scan
Researchers investigated the association between cardiovascular risk factors and the development of brain atrophy in individuals with multiple sclerosis.
The following article is part of conference coverage from the 2018 American Academy of Neurology Annual Meeting in Los Angeles, California. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2018.

LOS ANGELES — Heart disease and hypertension are associated with increased brain atrophy in patients with multiple sclerosis (MS), according to new research presented at the 70th annual American Academy of Neurology meeting, held April 21-27, 2018, in Los Angeles, California. Changes were especially pronounced in patients’ lateral ventricles (LVV) and overall white matter volume.

Researchers conducted a 5-year longitudinal study of patients with MS (N=194). Comprehensive health examinations, including clinical workup, detailed medical histories, and 3T MRI scans studying brain volume and lesion activity, were conducted.

In order to determine if there were notable differences between MS patients with or without cardiovascular risk factors, analysis of covariance was utilized. The researchers adjusted for factors such as age, sex, and disease duration.

At baseline, patients with MS who also had hypertension had larger LVV when compared with those without hypertension (66.1 mL vs 49.9 mL, P =.015). Patients with MS and hypertension demonstrated greater percentage changes in LVV compared with patients with MS without hypertension (24.5% vs 14.1%, P =.009) during the follow-up period.

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The researchers also found that patients with comorbidities of MS and heart disease experienced higher overall white matter volume loss compared with patients with MS without heart disease (-4.2% vs 0.7%, P =.002).

Cardiovascular risk factors were not found to be associated with significant change in lesion volume measurements, nor were they associated with more severe MS disease progression as measured by MRI.

The researchers suggest that “Hypertension and heart disease contribute to advanced central and [white matter] atrophy in MS patients. Management of cardiovascular comorbidities in MS may improve the overall long-term disease outcome.”

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Jakimovski D, Gandhi S, Paunkoski I, et al. Hypertension and heart disease are independently associated with development of brain atrophy in multiple sclerosis patients. A 5-year longitudinal study. Poster presented at: 2018 AAN Annual Meeting; April 21-27, 2018; Los Angeles, CA. Poster 345.