n Medical Technology SA - Prevalence of abnormal bloodflow patterns and effects of biochemistry and lifestyle factors on the major neck vessels in patients with Multiple Sclerosis in the Western Cape, South Africa : peer reviewed original article

Abstract

Objectives The purpose of this study was to investigate the prevalence of vascular dysfunction (chronic cerebrospinal venous insufficiency; CCSVI) and the effects of biochemical and lifestyle factors on carotid arteries and internal jugular veins (IJVs) in patients diagnosed with multiple sclerosis (MS).

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Methods A B-Mode and Doppler ultrasound examination was done on 29 MS patients assessing the vasculature to identify patency, stenosis, occlusion and/or abnormal bloodflow patterns. Lifestyle (smoking, exercise and diet), Expanded Disability Status Scale (EDSS) and biochemistry (fibrinogen, plasma homocysteine and serum total cholesterol) data were available for 20 patients.

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Results No evidence was found for CCSVI or deep vein thrombosis. Smokers displayed significantly smaller cross-sectional diameters of the proximal (p=0.03) and mid left IJV (p=0.02) than non-smokers. There was an inverse association (p=0.03) between physical activity and the intima media thickness (IMT) of the left common carotid artery (CCA). The EDSS showed a direct association with the IMT (p<0.0001) and an inverse association with adherence to a lifestyle/dietary program (p=0.03). Fibrinogen was associated with the peak systolic velocity of the left External Carotid Artery (p=0.03) and homocysteine showed an inverse association with the cross sectional diameter of the proximal left IJV (p=0.045). No significant associations were found between ultrasound measurements and total cholesterol.

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Conclusions This pilot study supports previous findings that there is no association between CCSVI and MS, but rather a detrimental effect of smoking and a sedentary lifestyle on MS disability. This may indicate that people diagnosed with MS may improve their disability status by avoiding risk factors that would adversely affect the vasculature.