The following is a summary of “Cerebrovascular hemodynamics association with brain structure and function in Multiple Sclerosis,” published in the September 2024 issue of Neurology by Duque et al.

Cerebrovascular hemodynamics (CVH) in Multiple Sclerosis (MS) might provide insights into the relationship between vascular risk factors and disease progression.

Researchers conducted a retrospective study to examine the relationship between CVH [dynamic cerebral autoregulation (dCA) and vasoreactivity (VR)] and brain structure (MRI) and function (cognition and gait) in individuals with MS.

They utilized Transcranial Doppler ultrasound (TCD) to assess 2 critical markers of CVH, dCA, and VR. The dCA (reported as phase and gain) was calculated from the spontaneous blood pressure and flow velocity oscillations. The VR was calculated as the slope of change in cerebral blood flow velocity in response to end-tidal CO₂. Global gray matter (GM), white matter (WM), WM hyperintensity (WMH) volumes, and WM lesion counts were measured from brain MRI. All participants underwent detailed cognitive and gait assessments.

The results showed 80 participants (age 44 ± 11, 26% male). About 75 had relapsing-remitting MS (94%), with a disease duration of 8 (Panerai, 2008 Mar) years [median (IQR)] since MS diagnosis and an Expanded Disability Status Scale (EDSS) of 2.0 (4.0). Higher phase (better dCA) was associated with greater GM volume, lower WHM burden, and higher cognitive scores in the memory and global cognitive domains (all P values <0.05). There was no relationship between CVH and gait speed in the study participants. There is no relationship between VR and any brain structure and function measures.

They concluded more efficient cerebral autoregulation was associated with better brain structure (more giant GM and lower WMH volumes) and function (cognition, but not gait) in patients with MS.

Source: msard-journal.com/article/S2211-0348(24)00458-9/abstract