Vascular Disease Risk Factors in MS Linked to Disease Progression, Reduced Brain ATP

Specific vascular disease risk factors may be linked to disease progression and decreased brain phosphate metabolism in patients with multiple sclerosis.

The following article is part of conference coverage from the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting. 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 the AAN 2021 Virtual Annual Meeting.

Patients with multiple sclerosis (MS) and vascular disease risk factors (VDRF) have reduced brain adenosine triphosphate (ATP); this may contribute to disease progression, according to study findings to be presented at the American Academy of Neurology (AAN) 2021 Virtual Annual Meeting, to be held from April 17 to 22, 2021.

In this 3-year single-site prospective observational study, researchers collected magnetic resonance imaging (MRI) brain data from patients with MS (mean age, 54.6 years) and VDRF (n=29) and without VDRF (n=23) at baseline and at 12, 24, and 36 months. They also collected clinical and biomarker data every 6 months during the study.

The study researchers evaluated changes in high-energy phosphate metabolites in cerebral gray matter, brain parenchymal volume, clinical impairment, disability, and quality of life.

Additionally, they performed cross-sectional and longitudinal analyses of the MRI data for 52 patients who attended a visit at baseline and 37 patients who attended a visit at 24 months. The investigators noted that VDRF could include conditions such as hyperlipidemia, hypertension, obesity, diabetes, and heart disease.

Findings indicated a 3.3% decrease in ATP to total phosphate signal ratio in patients with VDRFs (P <.05) compared with patients without VDRF. Patients with VDRFs also had a larger reduction in parenchymal volume fraction (0.01544; P =.025) from baseline to 24 months compared with patients without VDRF (0.00423). There were no significant differences between the groups regarding changes in phosphate metabolites over time.

According to the study researchers, the depletion of ATP in patients with MS and VDRF “may reflect mitochondrial dysfunction and contribute to MS disease progression as suggested by the increased brain atrophy.”


Yadav V, Lane M, Fryman A, Sammi M. Vascular disease risk factors in multiple sclerosis (MS) is associated with brain adenosine triphosphate abnormalities: dysmetabolism may drive MS disease progression. Presented at: the American Academy of Neurology 2021 Virtual Annual Meeting; April 17 to 22, 2021. Abstract S2.004.