Abstract
BackgroundWe investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS). Moreover, we evaluated the association between CCSVI and other frequent self-reported MS symptoms.MethodsWe looked at the presence of CI in incident MS patients with CCVSI in a population-based cohort of Catania, Italy. All subjects were group-matched by age, sex, disease duration and EDSS score with MS patients without CCSVI, serving as controls. CI was assessed with the Brief Repeatable Battery (BRB) and the Stroop Test (ST) and it was defined by the presence of at least three impaired tests. Fatigue and depressive symptoms were assessed with Fatigue Severity Scale (FSS) and Hamilton Depressive Rating Scale (HDRS), respectively. Bladder and sexual symptoms were assessed with the respective items of the Italian version of Guy's Neurological Disability Scale (GNDS). Quality of life was evaluated with Multiple Sclerosis Quality of Life-54 Instrument (MSQOL-54).ResultsOut of 61 MS patients enrolled in the study, 27 were CCSVI positive and 34 were CCSVI negative. Of them, 43 were women (70.5%); the mean age was 43.9 ± 11.8 years; the mean disease duration was 159.7 ± 113.7 months; mean EDSS was 3.0 ± 2.6. Of them, 36 (59.0%) were classified relapsing-remitting (RR), 12 (19.7%) secondary progressive (SP), seven (11.5%) primary progressive (PP) and six (9.3%) Clinically Isolated Syndrome (CIS). Overall, CI was detected in 29/61 (47.5%) MS patients; particularly 13/27 (48.1%) in the CCSVI positive group and 16/34 (47.0%) in the CCSVI negative group. Presence of CCSVI was not significantly associated with the presence of CI (OR 1.04; 95% CI 0.37-2.87; p-value = 0.9). Not significant differences were found between the two groups regarding the other MS symptoms investigated.ConclusionsOur findings suggest a lack of association between CCSVI and CI in MS patients. Fatigue, depressive, bladder/sexual symptoms and self-reported quality of life are not associated with CCSVI.
Highlights
We investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS)
Exclusion criteria were the presence of known vascular malformations and mental illness, history of chronic drug or alcohol abuse prior to neuropsychological (NPS) examination, any traumatic history occurring within 3 months prior to NPS examination and pregnancy
Out of the 138 MS and Clinically Isolated Syndrome (CIS) patients without CCSVI, identified in the previous study, using a frequency matching, 34 similar in terms of age (± 5 years), sex, mean Expanded Disability Status Scale (EDSS), mean disease duration and disease course were enrolled in the study as control group
Summary
We investigated the association between chronic cerebrospinal venous insufficiency (CCSVI) and cognitive impairment (CI) in multiple sclerosis (MS). Multiple sclerosis (MS) is an inflammatory-mediated demyelinating disease of the Central Nervous System (CNS), characterized by axonal damage in the brain and spinal cord [1] and cortical lesions [2]; its pathogenesis is still unknown, but it is most likely caused by a complex interplay between polygenetic and environmental factors [3,4]. It was hypothesized that extra-cranial venous abnormalities, named chronic cerebrospinal venous insufficiency (CCSVI), might play a role in the pathogenesis of MS [5,6]. The cerebral flow reduction, which is a key feature of brain vascular diseases, has been recently investigated in MS [18]. A widespread cerebral hypo perfusion seen in MS [18], leading to brain atrophy, could be the result of the venous outflow obstructions secondary to CCSVI [19]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
