Vascular comorbidity is associated with lower brain volumes and lower neuroperformance in a large multiple sclerosis cohort

Kathryn C. Fitzgerald, Anne Damian, Devon Conway, Ellen M. Mowry

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The objective of this study is to assess the association between vascular comorbidity burden with clinical and imaging features of disease burden in a large population of people with multiple sclerosis (MS). Methods: We included participants from the MS Partners Advancing Technology Health Solutions (MS PATHS) cohort. We evaluated if vascular comorbidities (diabetes, hypertension, and dyslipidemia) or a composite sum of comorbidities was associated with MS characteristics, including objective neurologic function assessments and quantitative brain magnetic resonance imaging (MRI) measurements in propensity score–weighted models. Results: In total, 11,506 participants (6409 (55%) with brain MRI) were included. Individuals with 2+ vascular comorbidities had slower walking speed (standard deviation (SD) = −0.49; 95% confidence interval (CI) = −0.78, −0.19; p = 0.001), slower manual dexterity (SD = −0.41; 95% CI = −0.57, −0.26; p < 0.0001), and fewer correct scores on cognitive processing speed (SD = −0.11; 95% CI = −0.20, −0.02; p = 0.02) versus those with no comorbidities. Those with 2+ had lower brain parenchymal (−0.41%, 95% CI = −0.64, −0.17) and gray matter fractions (−0.30%, 95% CI = −0.49, −0.10), including reduced cortical (−10.10 mL, 95% CI = −15.42, −4.78) and deep (−0.44 mL, 95% CI = −0.84, −0.04) gray matter volumes versus those with no comorbidity. Conclusion: Increased vascular comorbidity burden was associated with clinical and imaging markers of neurologic dysfunction and neurodegeneration in MS. Strategies to optimize comorbidity management in people with MS are warranted.

Original languageEnglish (US)
JournalMultiple Sclerosis Journal
DOIs
StateAccepted/In press - 2021

Keywords

  • Comorbidity
  • epidemiology
  • metabolic disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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