Prevalence of abnormal bloodflow patterns and effects of biochemistry and lifestyle factors on the major neck vessels in patients with Multiple Sclerosis in the Western Cape, South Africa

Objectives The purpose of this study was to investigate the prevalence of vascular dysfunction (chronic cerebrospinal venous insufficiency; CCSVI) and the effects of biochemical and lifestyle factors on carotid arteries and internal jugular veins (IJVs) in patients diagnosed with multiple sclerosis (MS). Methods A B-Mode and Doppler ultrasound examination was done on 29 MS patients assessing the vasculature to identify patency, stenosis, occlusion and/or abnormal bloodflow patterns. Lifestyle (smoking, exercise and diet), Expanded Disability Status Scale (EDSS) and biochemistry (fibrinogen, plasma homocysteine and serum total cholesterol) data were available for 20 patients. Results No evidence was found for CCSVI or deep vein thrombosis. Smokers displayed significantly smaller cross-sectional diameters of the proximal (p=0.03) and mid left IJV (p=0.02) than non-smokers. There was an inverse association (p=0.03) between physical activity and the intima media thickness (IMT) of the left common carotid artery (CCA). The EDSS showed a direct association with the IMT (p<0.0001) and an inverse association with adherence to a lifestyle/dietary program (p=0.03). Fibrinogen was associated with the peak systolic velocity of the left External Carotid Artery (p=0.03) and homocysteine showed an inverse association with the cross sectional diameter of the proximal left IJV (p=0.045). No significant associations were found between ultrasound measuments and total cholesterol. Conclusions This pilot study supports previous findings that there is no association between CCSVI and MS, but rather a detrimental effect of smoking and a sedentary lifestyle on MS disabilty. This may indicate that people diagnosed with MS may improve their disability status by avoiding risk factors that would adversely affect the vasculature.