Hemodynamic Alterations in Multiple Sclerosis

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Hemodynamic Alterations in Multiple Sclerosis

https://www.intechopen.com/online-first/80100

Abstract

Multiple Sclerosis is an autoimmune disease of the central nervous system. It is a demyelinating and neurodegenerative condition, however, changes in the vasculature can occur and play a role in the pathophysiology. Cardiac and vascular risk factors contribute to the disease severity. Understanding the occurring hemodynamic changes may potentially lead to improved diagnosis, better patient management, and prevention of disease progression.

This paper discusses the hemodynamic impairment in multiple sclerosis focusing on both the cerebral and cervical regions and presents an up-to-date review of the literature.

Conclusion

The pathways of tissue damage in MS are heterogeneous and not completely understood. The studies exploring the relationships between cerebral hemodynamics, functional impairment, disease course, and therapeutic response may reasonably allow to improve the understanding of MS pathophysiology and translate in implications for clinical practice.

The NVU dysfunction and interplay between inflammatory and vascular changes seem to be the key players in the pathophysiology of MS.

Altered cervical and cerebral perfusion in MS is associated with reduced brain integrity. WM and GM integrity changes lead to a higher risk of relapses, disability, and disease-modifying therapy escalation. So, understanding the hemodynamic effects is very critical to help PwMS.

There are debatable issues for cervical and cerebral hemodynamics in MS. These disagreements can at least be partially explained by the heterogeneity of inclusion criteria and methods. The variety of the tools, techniques, and used protocols cause different outcomes.

In order to avoid additional factors damaging the brain, to provide improved diagnosis, superior patient management and prevention of disease progression, to define reliable biomarkers, and to design novel therapeutic strategies, a thorough understanding of the hemodynamic changes in MS is critical.

Future research especially follow-up studies with larger populations under different activity conditions would ease answering today’s questions.