Higher Framingham Risk Scores are associated with greater loss of brain volume over time in multiple sclerosis

Abstract

Background: Few studies have evaluated the association between comorbidities associated with increased vascular risk and brain volume changes in multiple sclerosis (MS). To date, findings have not been consistent with respect to which comorbidities are associated with lower brain volumes or whether comorbidities associated with increased vascular risk are associated with greater brain volume loss over time. Objectives: We aimed to evaluate the association between the Framingham Risk Score (FRS) which evaluates vascular risk and normalized whole brain volume in MS. Methods: We included 98 participants with MS who underwent two brain MRIs two years apart, from which whole brain volumes were calculated. Each participant reported their comorbidities and medications taken. Blood pressure, height and weight were recorded and we calculated the FRS. We tested the association between the FRS at baseline and brain volume at the second time point using quantile regression adjusting for baseline normalized brain volume, age, gender and use of disease-modifying therapy. Results: As the FRS increased, brain volume was lower, both at enrollment (β= -0.24; 95%CI: -0.42, -0.04) and at follow-up (-0.27; 95%CI: -0.45, -0.08). After further adjustment for age, gender, and use of disease modifying therapy, higher FRS remained associated with lower brain volume at follow-up at the 90th percentile of brain volume (β= -2.22; 95%CI: -3.40, -1.04) but not at the 10th or 50th percentiles. Conclusion: Higher FRS were associated with lower brain volumes in persons with MS at baseline, and with brain volume loss over time. This effect was most pronounced for persons with higher brain volumes at baseline, which suggests that prevention, detection and effective management of comorbidities associated with vascular risk in people with MS is particularly important early in the disease course.

Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure

“…As described previously ( 18 ), all participants underwent a 3 Tesla brain MRI (Siemens TIM Trio, software version VB17a, Siemens Healthcare, Erlangen, Germany; Siemens 32-channel receive-only head coil), within 4 weeks of their study visit. The images acquired included a high-resolution T1-weighted (T1w) whole brain 3D magnetization prepared rapid gradient echo (MPRAGE), dual-echo proton density-weighted (PDw), T2-weighted (T2w), fluid attenuated inversion recovery (FLAIR) images, and two 55-direction high angular resolution diffusion imaging (HARDI) scans that had phase encoding in opposite directions (see Supplementary Table e1 for scan parameters).…”

Vascular comorbidity is associated with decreased cognitive functioning in inflammatory bowel disease

“…Age was excluded from the FRS to ensure we did not confound the effect of age on cognition with the effects of vascular risk factors 19 .…”

“…Higher FRS scores have been associated with decreased brain volume in population-speci c samples such as older adults 18,19 and more recent ndings that reveal lower FRS scores in type 2 diabetes may be associated with better cognitive performance, as compared to those with higher FRS scores 20 . Given the increased co-occurrence of cardiovascular disease in IBD 12 , and inconsistencies in ndings of prior studies of cognition in IBD, we aimed to evaluate the association between FRS and cognitive performance in a sample of persons with IBD.…”

The comorbidity and cognition in multiple sclerosis (CCOMS) neuroimaging protocol: Study rationale, MRI acquisition, and minimal image processing pipelines

“…The neuroimaging protocol for the CCOMS study, which includes several advanced structural, functional, and perfusion MRI measures, was not part of the original IMID study and has not been previously reported in full (Pirzada et al, 2020;Marrie et al, 2021aMarrie et al, , 2022. Thus, the goal of the current paper is to provide a detailed overview of the neuroimaging acquisition parameters and pre-processing methods that have been employed to serve as a technical reference for subsequent study papers.…”

“…are provided in the text describing each sequence if/when appropriate. Some of the parameters for the T1w, T2-FLAIR, and PD/T2w sequences have been previously reported(Marrie et al, 2021a). Ax, Axial; EPI, Echo-Planar Imaging; FOV, Field Of View; GE, Gradient Echo; MB, Multiband; MEGE, Multi-Echo Gradient Echo; mGRASE, multi-echo gradient and spin echo; Sag, Sagittal; SE, Spin Echo; TSE, Turbo Spin Echo.…”