Title:Decrease in Secondary Neck Vessels in Multiple Sclerosis: A 5-year Longitudinal Magnetic Resonance Angiography Study
VOLUME: 16 ISSUE: 3
Author(s):Dejan Jakimovski, Matthew Topolski, Kana Kimura, Virja Pandya, Bianca Weinstock-Guttman and Robert Zivadinov*
Affiliation:Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, Jacobs Comprehensive MS Treatment and Research Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, Buffalo Neuroimaging Analysis Center (BNAC), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY
Keywords:Multiple sclerosis (MS), secondary neck vessels, MRA, extracranial, longitudinal analysis, neurovascular.
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.