Cerebrovascular reactivity and disease activity in relapsing-remitting multiple sclerosis

Smoliński, Łukasz; Litwin, Tomasz; Kruk, Karolina; Skowrońska, Marta; Kurkowska‐Jastrzębska, Iwona; Członkowska, Anna

doi:10.17219/acem/114762

Cited by 10 publications

(9 citation statements)

References 37 publications

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“…Moreover, the vascular reactivity, e.g., effects of nitric oxide, should be considered during the interpretation of results. However, no disturbances in cerebrovascular reactivity in MS patients were recently reported [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

2021

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Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS+ON, NMOSD+ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS+ON and MS-ON eyes compared to healthy eyes. In NMOSD+ON and NMOSD-ON, the DCP did not remarkably differ from the control group. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS+ON, MS-ON, and NMOSD+ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to ganglion cells’ atrophy, while vasculopathy seems to be a primary process in NMOSD patients.

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Section: Discussionmentioning

confidence: 99%

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

2021

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“…This strategy reduced the variability of the reported BHI when compared with other TCD studies. Smoliński et al ( 86 ), who found no difference in BHI between MS patients and HC, performed one unilateral measurement in each subject and reported a standard deviation in RRMS patients outside of relapse 2.5 times larger than the reported results of Lattanzi et al ( 84 ) This finding indicates that for BHI, which is a method reported to have a good short-term but poor long-term reproducibility, a concern is methodological variability.…”

Section: Discussionmentioning

confidence: 91%

“…However, a similar relationship has been observed for neurodegenerative diseases ( 100 ), and thus, it remains to be seen how much of the CVR changes observed in MS are driven by early cognitive impairment, since this potential confounder has not been addressed in most studies. Other potential confounding factors may be recent relapses and steroid treatment, which has been found to significantly decrease CVR on a single subject level in one study ( 86 ).…”

Section: Discussionmentioning

confidence: 99%

“…Several smaller TCD studies have also reported no difference in BHI between MS patients and HC; however, they applied variable methodologies, which ranged from using a short breath hold of 15 sec ( 77 ), which may not be long enough to achieve a sufficient CO 2 increase ( 99 ), to using migraine patients as control subjects ( 80 ). It is noteworthy that most of these negative studies have utilized a single unilateral measurement and generally reported relatively high standard deviations of the measured BHI ( 86 , 87 ). Finally, three of these negative studies showed a non-significant trend toward lower BHI in RRMS when compared with HC ( 77 , 82 , 87 ), and may have been underpowered and unable to detect potentially small differences.…”

Section: Discussionmentioning

confidence: 99%

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Cerebrovascular Reactivity and Neurovascular Coupling in Multiple Sclerosis—A Systematic Review

et al. 2022

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The inflammatory processes observed in the central nervous system in multiple sclerosis (MS) could damage the endothelium of the cerebral vessels and lead to a dysfunctional regulation of vessel tonus and recruitment, potentially impairing cerebrovascular reactivity (CVR) and neurovascular coupling (NVC). Impaired CVR or NVC correlates with declining brain health and potentially plays a causal role in the development of neurodegenerative disease. Therefore, we examined studies on CVR or NVC in MS patients to evaluate the evidence for impaired cerebrovascular function as a contributing disease mechanism in MS. Twenty-three studies were included (12 examined CVR and 11 examined NVC). Six studies found no difference in CVR response between MS patients and healthy controls. Five studies observed reduced CVR in patients. This discrepancy can be because CVR is mainly affected after a long disease duration and therefore is not observed in all patients. All studies used CO2 as a vasodilating stimulus. The studies on NVC demonstrated diverse results; hence a conclusion that describes all the published observations is difficult to find. Future studies using quantitative techniques and larger study samples are needed to elucidate the discrepancies in the reported results.

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“…There are reports available on the effects of the upregulation of Th17 cells, that transforming growth factor-beta, which can cause myointimal brosis in NMO patients 25 . Moreover, the vascular reactivity, e.g., effects of nitric oxide, should be considered during the interpretation of results, however, no disturbances in cerebrovascular reactivity in MS patients were recently reported 26 .…”

Section: Discussionmentioning

confidence: 99%

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: an optical coherence tomography angiography study.

Rogaczewska

Michalak

Stopa

2020

Preprint

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Multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) are inflammatory and demyelinating diseases that commonly manifest with optic neuritis (ON) but differ in the pathogenic mechanism. Although it was shown that retinal vessels might alter in MS and NMOSD, a comparative study has not been reported. This study evaluated the macular vessel density in 40 MS patients, 13 NMOSD patients, and 20 controls by using optical coherence tomography angiography. The vessel density of superficial capillary plexus (SCP) was significantly lower in ON eyes (MS + ON, NMOSD + ON) than in non-ON eyes (MS-ON, NMOSD-ON) and controls. The density of deep capillary plexus (DCP) was significantly increased in MS + ON, and MS-ON eyes compared to healthy eyes and decreased in NMOSD + ON compared to MS + ON. A significant positive correlation was noted between SCP and ganglion cell complex (GCC) thickness in MS + ON, MS-ON, and NMOSD + ON. The DCP did not significantly correlate with GCC thickness, but it increased or decreased with ganglion cell loss in MS and NMOSD, respectively. In conclusion, our findings suggest that the capillary changes in MS patients are secondary to the reduced metabolic demand of the atrophied ganglion cell layer, while the vasculopathy seems to be a primary process in NMOSD patients.

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Cerebrovascular reactivity and disease activity in relapsing-remitting multiple sclerosis

Cited by 10 publications

References 37 publications

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: An optical coherence tomography angiography study

Cerebrovascular Reactivity and Neurovascular Coupling in Multiple Sclerosis—A Systematic Review

Macular vessel density differs in multiple sclerosis and neuromyelitis optica spectrum disorder: an optical coherence tomography angiography study.

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