Decrease in Secondary Neck Vessels in Multiple Sclerosis: A 5-year Longitudinal Magnetic Resonance Angiography Study

Author(s): Dejan Jakimovski, Matthew Topolski, Kana Kimura, Virja Pandya, Bianca Weinstock-Guttman, Robert Zivadinov*.

Journal Name: Current Neurovascular Research

Volume 16 , Issue 3 , 2019

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Abstract:

Background: Studies have previously shown greater arterial and venous extracranial vascular changes in persons with multiple sclerosis (PwMS) when compared to healthy controls (HCs).

Objectives: To determine the change in the number and size of secondary neck vessels in PwMS and HCs over a 5-year follow-up period.

Methods: Both at baseline and follow-up, 83 PwMS and 25 HCs underwent magnetic resonance angiography (MRA) imaging and analysis. The number and cross-sectional area (CSA) of all secondary neck vessels (excluding the common/internal carotid, vertebral artery, and internal jugular vein) measured at levels from C2-T1 were determined by semi-automated edge detection/ contouring software. The longitudinal change in the number and CSA of the secondary neck vessels from the PwMS and HCs were analyzed by non-parametric Wilcoxon repeated measure. Benjamini-Hochberg procedure adjusted for false discovery rate (FDR).

Results: For over 5 years, PwMS demonstrated a consistent longitudinal decrease in both the number of secondary neck vessels (Z-change between -3.3 and -5.4, q=0.001) and their CSA (Zchange between -2.9 and -5.2, q=0.004). On the contrary, the HCs did not demonstrate a significant longitudinal change in secondary neck vessels over the follow-up period. Due to the longitudinal decrease, the PwMS showed a lower number of secondary neck vessels when compared to HCs measured at follow-up (p<0.029, except for C4 with trending p=0.071). The PwMS changes were also corroborated within each MS phenotype.

Conclusion: PwMS demonstrate a significant mid-term decrease in the number and the size of the secondary neck vessels. The clinical relevance of these findings and the effect on intracranial blood flow are currently unknown.

Keywords: Multiple sclerosis (MS), secondary neck vessels, MRA, extracranial, longitudinal analysis, neurovascular.

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Article Details

VOLUME: 16
ISSUE: 3
Year: 2019
Page: [215 - 223]
Pages: 9
DOI: 10.2174/1567202616666190612111127
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