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JNNP Online First, published on February 26, 2015 as 10.1136/jnnp-2014-310051 General neurology
RESEARCH PAPER
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis Natalie Kappus,1 Bianca Weinstock-Guttman,2 Jesper Hagemeier,1 Cheryl Kennedy,1 Rebecca Melia,1 Ellen Carl,1 Deepa P Ramasamy,1 Mariya Cherneva,1 Jacqueline Durfee,1 Niels Bergsland,1,3 Michael G Dwyer,1 Channa Kolb,2 David Hojnacki,2 Murali Ramanathan,4 Robert Zivadinov1,2,5 For numbered affiliations see end of article. Correspondence to Dr Robert Zivadinov, Buffalo Neuroimaging Analysis Center, MRI Clinical Translational Research Center, Department of Neurology, School of Medicine and Biomedical Sciences, 100 High St, Buffalo, NY 14203, USA; [email protected] Received 1 December 2014 Revised 26 January 2015 Accepted 4 February 2015
To cite: Kappus N, Weinstock-Guttman B, Hagemeier J, et al. J Neurol Neurosurg Psychiatry Published Online First: [please include Day Month Year] doi:10.1136/jnnp2014-310051
ABSTRACT Background Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). Objectives To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. Methods In a prospective study, 326 patients with relapsing–remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. Results Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p=0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥2 CV risks ( p=0.003), while the frequency of ≥3 CV risks was 18.8% in the MS group and 8.6% in the HCs group ( p=0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes ( p
JNNP Online First, published on February 26, 2015 as 10.1136/jnnp-2014-310051 General neurology
RESEARCH PAPER
Cardiovascular risk factors are associated with increased lesion burden and brain atrophy in multiple sclerosis Natalie Kappus,1 Bianca Weinstock-Guttman,2 Jesper Hagemeier,1 Cheryl Kennedy,1 Rebecca Melia,1 Ellen Carl,1 Deepa P Ramasamy,1 Mariya Cherneva,1 Jacqueline Durfee,1 Niels Bergsland,1,3 Michael G Dwyer,1 Channa Kolb,2 David Hojnacki,2 Murali Ramanathan,4 Robert Zivadinov1,2,5 For numbered affiliations see end of article. Correspondence to Dr Robert Zivadinov, Buffalo Neuroimaging Analysis Center, MRI Clinical Translational Research Center, Department of Neurology, School of Medicine and Biomedical Sciences, 100 High St, Buffalo, NY 14203, USA; [email protected] Received 1 December 2014 Revised 26 January 2015 Accepted 4 February 2015
To cite: Kappus N, Weinstock-Guttman B, Hagemeier J, et al. J Neurol Neurosurg Psychiatry Published Online First: [please include Day Month Year] doi:10.1136/jnnp2014-310051
ABSTRACT Background Cardiovascular (CV) risk factors have been associated with changes in clinical outcomes in patients with multiple sclerosis (MS). Objectives To investigate the frequency of CV risks in patients with MS and their association with MRI outcomes. Methods In a prospective study, 326 patients with relapsing–remitting MS and 163 patients with progressive MS, 61 patients with clinically isolated syndrome (CIS) and 175 healthy controls (HCs) were screened for CV risks and scanned on a 3T MRI scanner. Examined CV risks included hypertension, heart disease, smoking, overweight/obesity and type 1 diabetes. MRI measures assessed lesion volumes (LVs) and brain atrophy. Association between individual or multiple CV risks and MRI outcomes was examined adjusting for age, sex, race, disease duration and treatment status. Results Patients with MS showed increased frequency of smoking (51.7% vs 36.5%, p=0.001) and hypertension (33.9% vs 24.7%, p=0.035) compared with HCs. In total, 49.9% of patients with MS and 36% of HCs showed ≥2 CV risks ( p=0.003), while the frequency of ≥3 CV risks was 18.8% in the MS group and 8.6% in the HCs group ( p=0.002). In patients with MS, hypertension and heart disease were associated with decreased grey matter (GM) and cortical volumes ( p
