Vascular comorbidity is associated with lower brain volumes and lower neuroperformance in a large multiple sclerosis cohort.
Vascular comorbidity is associated with lower brain volumes and lower neuroperformance in a large multiple sclerosis cohort.
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DOI：
10.1177/1352458520984746
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发表时间：
2021-10
期刊：
影响因子：
--
通讯作者：
Mowry EM
中科院分区：
文献类型：
--
作者：
Fitzgerald KC;Damian A;Conway D;Mowry EM
评估大量多发性硬化症 (MS) 患者的血管合并症负担与疾病负担的临床和影像学特征之间的关联。我们纳入了来自 MS Partners Advancing Technology Health Solutions (MS PATHS) 队列的参与者。我们评估了血管合并症（糖尿病、高血压、血脂异常）或合并症的综合总和是否与 MS 特征相关，包括倾向评分加权模型中的客观神经功能评估和定量脑部 MRI 测量。包括 11,506 名参与者（6409 名 [55%] 进行了脑部 MRI 检查）。患有2种以上血管合并症的个体步行速度较慢（−0.49 SD；95% CI：−0.78，−0.19；p=0.001），手动灵活性较慢（−0.41 SD；95% CI：−0.57，−0.26；p<0.0001），并且认知处理速度的正确得分较少（−0.11 SD；−0.20， −0.02；p=0.02）与没有合并症的患者相比。 2+的患者脑实质（-0.41%，95% CI：-0.64%，-0.17%）和灰质分数（-0.30%，95% CI -0.49，-0.10）较低，包括皮质（-10.10 mL，95% CI -15.42，-4.78）和深部（-0.44mL，95% CI）减少−0.84, −0.04) 灰质体积与无合并症的灰质体积相比。血管合并症负担的增加与多发性硬化症中神经功能障碍和神经变性的临床和影像学标志物相关。有必要采取优化多发性硬化症患者合并症管理的策略。
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). We included participants from the MS Partners Advancing Technology Health Solutions (MS PATHS) cohort. We evaluated if vascular comorbidities (diabetes, hypertension, dyslipidemia) or a composite sum of comorbidities was associated with MS characteristics, including objective neurologic function assessments and quantitative brain MRI measurements in propensity score weighted models. 11,506 participants (6409 [55%] with brain MRI) were included. Individuals with 2+ vascular comorbidities had slower walking speed (−0.49 SD; 95% CI: −0.78, −0.19; p=0.001), slower manual dexterity (−0.41SD; 95% CI: −0.57, −0.26; p<0.0001), and fewer correct scores on cognitive processing speed (−0.11SD; −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 (−0.44mL, 95% CI −0.84, −0.04) gray matter volumes versus those with no comorbidity. 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.
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影响因子：
2.6
作者：
Learmonth YC;Motl RW;Sandroff BM;Pula JH;Cadavid D
通讯作者：
Cadavid D
DOI：
10.1212/cpj.0000000000000230
发表时间：
2016-04
期刊：
Neurology. Clinical practice
影响因子：
--
作者：
Marrie RA;Fisk J;Tremlett H;Wolfson C;Warren S;Blanchard J;Patten SB;CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
通讯作者：
CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis
DOI：
10.1056/nejmra1401483
发表时间：
2018-01-11
期刊：
The New England journal of medicine
影响因子：
--
作者：
Reich DS;Lucchinetti CF;Calabresi PA
通讯作者：
Calabresi PA
影响因子：
48
作者：
Lane, Christopher A.;Barnes, Josephine;Schott, Jonathan M.
通讯作者：
Schott, Jonathan M.
影响因子：
9.9
作者：
Wallin, Mitchell T.;Culpepper, William J.;LaRocca, Nicholas G.
通讯作者：
LaRocca, Nicholas G.