Effects of lifestyle factors and biochemistry on the major neck blood vessels in patients with multiple sclerosis

Abstract

Effects of lifestyle factors on Doppler ultrasound parameters of the major neck vessels in patients with Multiple Sclerosis MC Kemp*1, F Isaacs1, MS Hassan1, FJ Cronje2, SJ Van Rensburg 3 1Department of Medical Imaging and Therapeutic Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, 2Baromedical Facility, University of Stellenbosch, 3Division of Chemical Pathology, National Health Laboratory Service and Stellenbosch University, Cape Town, South Africa *nelsonme@cput.ac.za Objective: The aim of this study was to investigate the prevalence of vascular dysfunction and the effects of biochemical and lifestyle factors on carotid arteries and internal jugular veins (IJVs) in patients diagnosed with multiple sclerosis (MS). Background: Cerebral hypoperfusion and impaired venous drainage have reported to be risk factors for multiple sclerosis. No literature could be sourced on carotid artery disease in MS. Lifestyle and biochemical factors (fibrinogen, homocysteine) have significant effects on the vascular system. Methods: B-Mode and Doppler ultrasound examinations were done on 29 MS patients assessing the vasculature to identify patency, stenosis, occlusion and abnormal bloodflow patterns. Lifestyle (smoking, exercise and diet), disability (Expanded Disability Status Scale; EDSS) and biochemistry (fibrinogen, plasma homocysteine and serum total cholesterol) data were available for 20 patients. Results: No evidence was found deep vein thrombosis. Smokers displayed significantly smaller cross-sectional diameters of the proximal (p=0.03) and mid left IJVs (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 measuments and total cholesterol. Conclusions: This pilot study supports previous findings of a detrimental effect of smoking and a sedentary lifestyle on MS disabilty. This may indicate that people diagnosed with MS may improve their disability status by avoiding risk factors that would adversely affect the vasculature. KEYWORDS mulitple sclerosis, smoking, physical activity