Clinical Features Of Multiple Sclerosis Research Articles

Clinical Characteristics of Multiple Sclerosis in an Asian American Population (P4-6.006)

Clinical Characteristics of Multiple Sclerosis in an Asian American Population (P4-6.006)

Clinical significance and prognostic value of serum autoantibody tests in multiple sclerosis.

It is known that multiple sclerosis (MS) often coexists with other autoimmune diseases. Hence, autoantibody (auto-Ab) tests may prove useful in the differential diagnosis of MS. The objectives of this study were to: (a) investigate the prevalence of auto-Ab positivity at the beginning of the MS diagnostic process; (b) assess whether Auto-Ab+ and Auto-Ab- patients differ in baseline clinical, laboratory, and radiological parameters; and (c) investigate the prognostic value during a two-year follow-up period. This retrospective study consisted of 450 patients aged between 18 and 55 years. All patients underwent a wide range of auto-Ab tests, anti-nuclear antibody (ANA) tests in particular. The expanded disability status scale (EDSS) scores of the patients were recorded at the time of diagnosis and at the end of a two-year follow-up period. The mean age of the 212 patients, 148 (69.8%) female and 64 (30.2%) male, included in the study sample was 37 ± 10.83 years. The rate of relapsing cases was 84% (178). Oligoclonal band (OCB) was positive in 142 (86.6%) of the 164 tested cases. At least one of the auto-Ab tests was positive in 51 (24.1%) of the cases. ANA test was positive in 21 (9.9%) cases. There was no significant difference between patients with at least one positive auto-Ab test and without any positive auto-Ab test and between ANA-positive and ANA-negative patients in terms of age, gender, clinical features of MS, presence of brain stem lesion, presence of spinal lesion, OCB positivity, level of clinical improvement after the first pulse steroid treatment, family history, presence of comorbidity, presence of autoimmune disease, or EDSS scores recorded at the end of the two-year follow-up period (p > 0.05). Our study findings revealed that Auto-Ab positivity was more common in MS patients than in the general population. However, given their limited contribution to the diagnosis and differential diagnosis of MS with no effect on the prognostic process, auto-Ab tests should be requested only in the event of accompanying autoimmune disease symptoms, and in cases where the diagnosis of MS may be suspected.

Seasonality and clinical characteristics of MS in an equatorial country

BackgroundMonth and season of birth have been associated with risk of multiple sclerosis (MS), but there is relatively little evidence regarding their influence on the timing and severity of disease at onset. ObjectiveTo assess whether month and season of birth influence the age and phenotype at onset of MS as well as its severity in a cohort of Colombian patients. MethodsThis study is an analysis on MS cases only, drawn from a previously published case-control study. MS cases confirmed with current diagnostic criteria cared for at least once in our center were included. We assessed the influence of the month and season of birth in the age at MS onset, MS severity score, and age-related MS severity score using multiple and pairwise comparisons. Age at onset was also studied using Kaplan–Meier survival estimates compared with the log-rank test. The likelihood of progressive MS onset was evaluated with OR estimated from logistic regression models adjusted for age at onset and sex. Results668 MS cases were included. No significant differences were found in the age at MS onset according to month of birth or season of birth. Neither month of birth nor season of birth conferred significant differences in MS severity score or age-related MS severity score. No significant association was found between month (ORs ranging from 0.62 to 3.11, none significant) or season of birth (OR 0.91; 95 %CI: 0.46–1.84) with primary progressive MS. ConclusionThe month or season of birth do not appear to influence the age onset and phenotype of MS in our country.

Fatigue, pain interference, and psychiatric morbidity in multiple sclerosis: The role of childhood stress.

Multiple sclerosis (MS) is a progressive, autoimmune disease of the central nervous system that affects nearly one million Americans. Despite the existence of immunomodulatory therapies to slow physical and cognitive disability progression, interventions to ameliorate common symptoms of MS, including fatigue and pain, remain limited. Poor understanding of risk factors for these symptoms may contribute to treatment challenges. In recent years, childhood stress has been investigated as a risk factor for chronic autoimmune conditions including MS; yet remarkably few studies have investigated the relationship between childhood stressors and chronic MS symptoms. Our aim was to examine clusters of stressors and three key features of MS: fatigue, pain interference, and psychiatric morbidity. Cross-sectional data were collected from a sample of People with MS (PwMS) via a national web-based survey that assessed the presence and type of childhood stressors and MS clinical features. Hierarchical block regression was used to assess associations among emotional, physical, and environmental childhood stressors and three clinical features commonly experienced by PwMS. N = 719 adults with MS (aged 21-85) completed the survey. Childhood emotional and physical stressors were significantly associated with overall presence of fatigue (p = 0.02; p<0.03) and pain interference (p<0.001; p<0.001) in adulthood, as well as the magnitude of both outcomes. Environmental stressors (p<0.001), in addition to emotional (p<0.001) and physical (p<0.001) stressors were significantly associated with psychiatric morbidity in PwMS. Childhood stress may predict fatigue, psychiatric morbidity, and pain in adults with MS. Further research is needed to show cause and effect; however, if an association exists, strategies to mitigate the impact of childhood stress could offer new pathways to reduce the severity of these symptoms. Broadly, this work adds to the body of evidence supporting upstream preventive measures to help address the stress on children and families.

Features of multiple sclerosis in childhood in the Republic of Tatarstan

Multiple sclerosis (MS) in children and adolescents is a genuine concern of pediatric neurology that specialists in all countries are dealing with. To date, neither the causes of onset nor the individual components of the pathogenesis of the disease have been reliably clarified, and the modern, changing picture of the clinical manifestation of the disease sometimes complicates timely diagnosis even in adult patients. There are more such questions in pediatric MS.Objective: to study the prevalence and clinical features of MS in children in the Republic of Tatarstan.Material and methods. We conducted a survey and data analysis of 128 children and adolescents aged 0 to 18 years inclusive. The examination of patients included neurological examination according to the classical scheme, neuroimaging examination, neurophysiological examination and cerebrospinal fluid examination. The diagnosis was based on the current (as of the time of diagnosis) criteria of McDonald and the International Pediatrics MS Study Group criteria. The severity of the patients' clinical condition was assessed using the Expanded Disability Status Scale (EDSS).Results. MS was diagnosed in 99 cases (77.3%), clinically isolated syndrome – in 10 (7.8%), acute disseminated encephalomyelitis – in 5 (3.9%), bilateral optic neuritis – in two patients (1.6%), disseminated encephalomyelitis – in one case (0.8%); other central nervous system diseases were diagnosed in 11 (8.6%) patients. After a detailed examination, the group “other diseases of the central nervous system” included such conditions as cerebral angiopathy, neurofibromatosis, brain mass, structural focal epilepsy, sequelae of viral encephalitis, and hereditary leukodystrophy. Among the patients, girls aged 15–17 years predominated. Monofocal manifestations were more frequently observed at debut. Moreover, the absolute predominance of the remitting type of course was also noted.Conclusion. The data obtained suggest a predominance of the predominantly remitting course type of MS with a monofocal onset, which is consistent with data from other studies of MS in pediatric practice.

Estimating the disutility of relapse in relapsing–remitting and secondary progressive multiple sclerosis using the EQ-5D-5L, AQoL-8D, EQ-5D-5L-psychosocial, and SF-6D: implications for health economic evaluation models

Background and aimsRelapses are an important clinical feature of multiple sclerosis (MS) that result in temporary negative changes in quality of life (QoL), measured by health state utilities (HSUs) (disutilities). We aimed to quantify disutilities of relapse in relapsing remitting MS (RRMS), secondary progressive MS (SPMS), and relapse onset MS [ROMS (including both RRMS and SPMS)] and examine these values by disability severity using four multi-attribute utility instruments (MAUIs).MethodsWe estimated (crude and adjusted and stratified by disability severity) disutilities (representing the mean difference in HSUs of ‘relapse’ and ‘no relapse’ groups as well as ‘unsure’ and ‘no relapse’ groups) in RRMS (n = 1056), SPMS (n = 239), and ROMS (n = 1295) cohorts from the Australian MS Longitudinal Study’s 2020 QoL survey, using the EQ-5D-5L, AQoL-8D, EQ-5D-5L-Psychosocial, and SF-6D MAUIs.ResultsAdjusted mean overall disutilities of relapse in RMSS/SPMS/ROMS were − 0.101/− 0.149/− 0.129 (EQ-5D-5L), − 0.092/− 0.167/− 0.113 (AQoL-8D), − 0.080/− 0.139/− 0.097 (EQ-5D-5L-Psychosocial), and − 0.116/− 0.161/− 0.130 (SF-6D), approximately 1.5 times higher in SPMS than in RRMS, in all MAUI. All estimates were statistically significant and/or clinically meaningful. Adjusted disutilities of RRMS and ROMS demonstrated a U-shaped relationship between relapse disutilities and disability severity. Relapse disutilities were higher in ‘severe’ disability than ‘mild’ and ‘moderate’ in the SPMS cohort.ConclusionMS-related relapses are associated with substantial utility decrements. As the type and severity of MS influence disutility of relapse, the use of disability severity and MS-type-specific disutility inputs is recommended in future health economic evaluations of MS. Our study supports relapse management and prevention as major mechanisms to improve QoL in people with MS.

Correspondence among gray matter atrophy and atlas-based neurotransmitter maps is clinically relevant in multiple sclerosis.

In multiple sclerosis (MS), gray matter (GM) atrophy progresses in a non-random manner, possibly in regions with a high distribution of specific neurotransmitters involved in several relevant central nervous system functions. We investigated the associations among regional GM atrophy, atlas-based neurotransmitter distributions and clinical manifestations in a large MS patients' group. Brain 3 T MRI scans, neurological examinations and neuropsychological evaluations were obtained from 286 MS patients and 172 healthy controls (HC). Spatial correlations among regional GM volume differences and atlas-based nuclear imaging-derived neurotransmitter maps, and their associations with MS clinical features were investigated using voxel-based morphometry and JuSpace toolbox. Compared to HC, MS patients showed widespread GM atrophy being spatially correlated with the majority of neurotransmitter maps (false discovery rate [FDR]-p ≤ 0.004). Patients with a disease duration ≥ 5 vs < 5 years had significant cortical, subcortical and cerebellar atrophy, being spatially correlated with a higher distribution of serotoninergic and dopaminergic receptors (FDR-p ≤ 0.03). Compared to mildly-disabled patients, those with Expanded Disability Status Scale ≥ 3.0 or ≥ 4.0 had significant cortical, subcortical and cerebellar atrophy being associated with serotonergic, dopaminergic, opioid and cholinergic maps (FDR-p ≤ 0.04). Cognitivelyimpaired vs cognitivelypreserved patients had widespread GM atrophy being spatially associated with serotonergic, dopaminergic, noradrenergic, cholinergic and glutamatergic maps (FDR-p ≤ 0.04). Fatigued vs non-fatigued MS patients had significant cortical, subcortical and cerebellar atrophy, not associated with neurotransmitter maps. No significant association between GM atrophy and neurotransmitter maps was found for depression. Regional GM atrophy with specific neurotransmitter systems may explain part of MS clinical manifestations, including locomotor disability, cognitive impairment and fatigue.

Clinical factors and response to therapy with disease-modifying drugs for multiple sclerosis: the experience of the Tomsk region

To investigate a disease-modifying drugs (DMD) response in multiple sclerosis (MS) in the Tomsk region population and detect clinical factors associated with the treatment response. A 5-year prospective clinical study included 363 MS patients of the Tomsk region taking DMDs of the «first-line» and «second-line treatments». The response to DMDs therapy and the impact of MS clinical characteristics on response to treatment were assessed. Clinical factors associated with resistance to DMD are male gender, partial reduce of the MS onset symptoms, short period of the first remission, severe neurological impairment, high relapse rate and disease progression rate. Clinical features of MS are crucial factors associated with DMD response and should be used to prescribe DMD. This factor assessment can improve efficacy of the personalized MS treatment.

A CSF biomarker of intrathecal B cells activation correlates with memory impairment in multiple sclerosis

Cognitive impairment (CI) is a common clinical feature of multiple sclerosis (MS), but its pathophysiology is only partially known. Cerebrospinal fluid (CSF) biomarkers, by reflecting the ongoing pathology, may help in better understanding the determinants of CI in MS. Kappa free light chain index (k-index) is a sensitive biomarker of intrathecal B cells activation. Herein, we investigated the association between k-index and cognitive performance in MS patients.

Comparison of the effectiveness of motor and cognitive rehabilitation alone compared to the combination of the two in patients with multiple sclerosis

Motor and cognitive impairments (CI) are the main clinical features of Multiple Sclerosis (MS) with an incidence of around 85% for the former and 65% for the latter. Aim of the present study was to compare three formats of cognitive and motor rehabilitation programs in order to understand which is the most efficient in reducing cognitive deficits in MS patients.

Elevated mycobacterium avium subsp. paratuberculosis (MAP) antibody titer in Japanese multiple sclerosis

To investigate whether antibody production against mycobacterium avium subsp. paratuberculosis (MAP) is related to clinical characteristics of multiple sclerosis (MS) and human leukocyte antigen (HLA) alleles, IgG antibody against three MAP peptides and two human peptides homologous to MAP were measured in sera from 103 MS patients and 50 healthy controls (HCs). MS patients had higher IgG levels against MAP2694295–303 (MAP2694-IgG) than HCs, while the other antibodies were comparable. Multivariate analysis demonstrated that higher MAP2694-IgG titers were associated with higher EDSS scores, but not with HLA alleles or dairy product consumption. Immune response against MAP may worsen MS disability.

Demographic and clinical profile of multiple sclerosis in Qena governorate, Egypt

Background: Multiple sclerosis (MS) MS is a demyelinating and neurodegenerative inflammatory disorder of the brain and the spinal cord that is one of the most frequent neurological disorders ata young age. Several MS centers have established MS registries to estimate the prevalence of the disease in the general community and to investigate the clinical characteristics of MS patients. Objectives: Determining the demographic and clinical patients with MS referred to Qena University Hospital. Patients and methods: In a descriptive cross-sectional study on thirty patients clinically diagnosed to have MS according to 2017 McDonald criteria were included. They were diagnosed in the neuropsychiatry departmentfrom November 2018 to April 2020. Results: There were 17 (56.6%) females, 13 (43.3%) males, the mean age was 31.65 (± 8.08 SD), the mean duration of illness was 58.98 (± 44.78 SD). Conclusion: This is the first MS register from the governorate of Qena. The clinical features of MS in Qena is comparable to those seen in other Arab and Western countries. Females are more likely to develop MS than males, and visual symptoms were the most frequent manifestations. Our results also illustrate the importance of developing registries in Egypt so that the clinical path of the disease can be studied prospectively.

Anomalously warm weather and acute care visits in patients with multiple sclerosis: A retrospective study of privately insured individuals in the US.

As the global climate changes in response to anthropogenic greenhouse gas emissions, weather and temperature are expected to become increasingly variable. Although heat sensitivity is a recognized clinical feature of multiple sclerosis (MS), a chronic demyelinating disorder of the central nervous system, few studies have examined the implications of climate change for patients with this disease. We conducted a retrospective cohort study of individuals with MS ages 18-64 years in a nationwide United States patient-level commercial and Medicare Advantage claims database from 2003 to 2017. We defined anomalously warm weather as any month in which local average temperatures exceeded the long-term average by ≥1.5°C. We estimated the association between anomalously warm weather and MS-related inpatient, outpatient, and emergency department visits using generalized log-linear models. From 75,395,334 individuals, we identified 106,225 with MS. The majority were women (76.6%) aged 36-55 years (59.0%). Anomalously warm weather was associated with increased risk for emergency department visits (risk ratio [RR] = 1.043, 95% CI: 1.025-1.063) and inpatient visits (RR = 1.032, 95% CI: 1.010-1.054). There was limited evidence of an association between anomalously warm weather and MS-related outpatient visits (RR = 1.010, 95% CI: 1.005-1.015). Estimates were similar for men and women, strongest among older individuals, and exhibited substantial variation by season, region, and climate zone. Limitations of the present study include the absence of key individual-level measures of socioeconomic position (i.e., race/ethnicity, occupational status, and housing quality) that may determine where individuals live-and therefore the extent of their exposure to anomalously warm weather-as well as their propensity to seek treatment for neurologic symptoms. Our findings suggest that as global temperatures rise, individuals with MS may represent a particularly susceptible subpopulation, a finding with implications for both healthcare providers and systems.

Confirmed disability progression provides limited predictive information regarding future disease progression in multiple sclerosis

BackgroundAlthough confirmed disability progression (CDP) is a common outcome in multiple sclerosis (MS) clinical trials, its predictive value for long-term outcomes is uncertain.ObjectiveTo investigate whether CDP at month 24 predicts subsequent disability accumulation in MS.MethodsThe Comprehensive Longitudinal Investigation of Multiple Sclerosis at Brigham and Women’s Hospital includes participants with relapsing-remitting MS or clinically isolated syndrome with Expanded Disability Status Scale (EDSS) scores ≤5 (N = 1214). CDP was assessed as a predictor of time to EDSS score 6 (EDSS 6) and to secondary progressive MS (SPMS) using a Cox proportional hazards model; adjusted models included additional clinical/participant characteristics. Models were compared using Akaike’s An Information Criterion.ResultsCDP was directionally associated with faster time to EDSS 6 in univariate analysis (HR = 1.61 [95% CI: 0.83, 3.13]). After adjusting for month 24 EDSS, CDP was directionally associated with slower time to EDSS 6 (adjusted HR = 0.65 [0.32, 1.28]). Models including CDP had worse fit statistics than those using EDSS scores without CDP. When models included clinical and magnetic resonance imaging measures, T2 lesion volume improved fit statistics. Results were similar for time to SPMS.ConclusionsCDP was less predictive of time to subsequent events than other MS clinical features.

Clinical and radiological features of MS, NMOSD, and MOGAD, and evolution of the diagnostic processes in Thailand

AbstractThe prevalence and clinical features of multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody‐associated disease (MOGAD) are similar in the Thai population to those of other Asian countries. These disorders share common features and mimic other conditions, emphasizing the importance of helpful diagnostic tools, including serologic testing and imaging study. Since the establishment of the first laboratory center in Thailand for aquaporin‐4 antibody (AQP4‐Ab) in 2010, seven centers nationwide have provided testing and increased the diagnostic rate in the past decade. The Thai Clinical Practice Guideline for MS and NMOSD was published in 2018, incorporating AQP4‐Ab testing and magnetic resonance imaging of the brain in all patients suspected of demyelinating diseases. Herein, we summarize the evolution of processes and obstacles in the diagnosis of demyelinating diseases in Thailand.

Bipolar disorders and deep grey matter in multiple sclerosis: A preliminary quantitative MRI study

BackgroundBipolar disorder (BD) is frequently observed in patients affected by multiple sclerosis (MS), presenting a lifetime estimate of around 8%. However, uncertainty exists on the brain damage associated with this psychiatric comorbidity. This study aimed to investigate the effect of brain atrophy, particularly that of the subcortical grey matter (scGM) structures that notoriously regulate the affective functioning, on the co-occurrence of BD in patients with MS. MethodsA group of patients with MS affected by BD and a control group of patients with MS without any mood/psychiatric disorder, as defined using standardised diagnostic tools (Advanced Neuropsychiatric Tools and Assessment Schedule), were recruited. The patients underwent brain MRI, and the volumes of the whole brain (WB), white matter (WM), and grey matter (GM) were estimated using SIENAX. Thus, the scGM volumes of the putamen, caudate, thalamus, hippocampus, amygdala, nucleus accumbens, and pallidus were estimated using the FIRST tool. ResultsThe sample included 61 patients with MS, amongst whom 15 (24.6%) had BD. No differences in the WB, WM, and cortical GM volumes were observed between the patients with MS with and without BD. Conversely, the multiple regression analysis revealed a significant association of BD with lower volumes of the putamen (p = 0.032), nucleus accumbens (p = 0.029), and pallidus (p = 0.061; with a trend towards significance), independently from the demographic and MS clinical features. ConclusionsOur preliminary results indicated that the nucleus accumbens and putamen are smaller in MS patients with BD. Further investigations in larger cohorts of MS patients with affective disorders are necessary to confirm these data and understand the structural brain damage underlying this psychiatric comorbidity.

Regional cerebral hypoperfusion as a cause of symptoms and progression of multiple sclerosis

Background. Neurodegenerative processes play an important role in the development of clinical features of multiple sclerosis (MS) as well as in the progression of the disease. At the same time, neurodegenerative mechanisms of MS are not completely clear, which makes researchers pay special attention to pathogenetic aspects of the disease that have not been studied before. Previously it was shown that MS patients can have alterations in the local cerebral blood flow, however, the meaning of the detected abnormalities is still not clear.The aim of our workis to evaluate the perfusion character in the demyelinating lesions and normalappearing brain structures, and to determine their relation to clinical features of MS.Material and methods. 49 patients with relapsing-remitting and secondary progressive MS with clinical and MRI remission were included in the study. The patients underwent contrast-enhanced MR perfusion of the brain on the 3 Tesla MR-tomograph, as well as the Functional System Score, Expanded Disability Status Score and Fatigue Status Score evaluation. The data analysis included automatic construction of perfusion maps of the cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) values in the normal-appearing brain structures and in the demyelinating lesions and statistical analysis.Results. The received results allow to presume that variation of CBV values in MS lesions can indicate heterogeneity of processes in these lesions – from reactivation of inflammation to remyelination.Significant reduction of perfusion in nucleus lenticularis was revealed. This reduction did not depend on the severity of the disease and correlated negatively with the fatigue score. This allows to suppose that the therapy focused on brain perfusion improvement can be used as symptomatic therapy of MS. Considering the fact that regional hypoperfusion precedes the development of brain structure atrophy, it is hypothesized that the improvement of perfusion may prevent neurodegeneration in MS. The obtained findings need further investigation.

Olfactory identification associates with cognitive function and the third ventricle width in patients with relapsing-remitting multiple sclerosis

BackgroundOlfactory dysfunction is a known clinical feature of multiple sclerosis (MS). Some studies have shown that odor identification impairment is an essential feature associated with cognitive function in MS. This study investigates the relationship between olfactory identification and the disease state, including cognitive function and central brain volume, to evaluate the utility of olfactory identification in the clinical assessment of relapsing-remitting (RR) MS. MethodsForty patients with RRMS and 40 healthy controls (HCs) were included. Their olfactory identification was measured using the Odor Stick Identification Test for the Japanese (OSIT-J). Cognitive function was evaluated by the Japanese version of the Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III), and depressive mood was evaluated by the Center for Epidemiologic Studies Depression Scale. Magnetic resonance imaging was used to measure the third ventricle width (3rd VW) as a marker of central brain atrophy. ResultsRRMS patients had a significantly lower OSIT-J score than HCs. The OSIT-J score was significantly lower in RRMS patients with low processing speed (PS) and working memory (WM) scores than RRMS patients with normal PS or WM scores. The OSIT-J score was significantly related to the PS, WM, and the 3rd VW. The OSIT-J score also showed a mild correlation with the expanded disability status scale and disease duration, but not with the number of clinical attacks or patient's age. ConclusionsOur results suggest that olfactory identification impairment occurs in association with cognitive dysfunction and central brain atrophy. Thus, olfactory identification is a possible disease marker of RRMS as with cognitive impairment, especially PS, reflecting the diffuse neurodegeneration in RRMS.

Clinical features of multiple sclerosis in third central hospital, Mongolia

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system characterized by inflammatory demyelinating and secondary axonal degeneration. The disease usually begins between the ages of 20 and 50 and is twice as common in women as in men. The aim of the study is to determine the clinical characteristics and features of the MS. The study was carried out in the patient history of the Neurology Department, The Third Central Hospital, Mongolia January 2014 to January 2017 by using a retrospective cohort study. In total, 37 patients were diagnosed with MS. Out of total 86.5% (32) patients are females and 13.5% (5) are male. In ages, the youngest of the patients is 23 years old, the oldest is 69 years old and the average age is 47.4 ± 13.3. The first symptom of the disease is 27% of all patients with one side optic neuritis, 18.9% of the pyramidal syndrome, 16.2% changes in the sensory symptoms, 13.5% ocular-motor dysfunction, 10.8% with bladder dysfunction, bulbar and ataxic syndromes were fewer. By the clinical type, cerebra-spinal form is 56.8%, the spinal form is 27%, the cerebral form is 13.5%, and the optical form is 2.7%. In the future, we will study the clinical characteristics of MS and establish the clinical database of the disease among the Mongolian population.

P4136Neurogenic stunned myoacardium in multiple sclerosis patients

Abstract A wide spectrum of topics regarding Multiple Sclerosis (MS) have been thoroughly studied, like immunology, nature of demyelinating lesions (DL's), therapeutics, etc. However, little is known about the influence of MS DL's on the cardiovascular system and especially in the coronary vasculature although few reports mention coronary vasospasm due to autonomic nervous system (ANS) abnormalities. Aim of this study was the detection the presence of Neurogenic Stunned Myocardium (NSM) through perfusion test. Method We enrolled 50 asymptomatic fulfilling the criteria MS patients, aged 45±7 years old and disease in our study duration of 6±13 years with EDSS= 2,5. After echocardiography and clinical examination as primary screening, pharmacologic stress thallium 201 scintigraphy and/or coronary angiography were performed to identify the incidence of NSM. Clinical characteristics of MS, type of disease, treatments as well as localization of demyelinating plaques (DP) were noted. Results 13 patients (26%) had abnormal scintigraphy test although clinical profile was not indicative. Cardiac ultrasound showed that 2 patients from this group had a critical ejection fraction (around 50%). All positive patients that underwent for coronary angiogram were negative implying coronary artery spasm as a potential mechanism for the stress positive result. A common finding of all positive patients was the localization of DP which was in the lateral horn of the lower cervical part (C5–7) and upper thoracic part (Th1–4). No correlation seems to have the presence of CAD with disease duration, EDSS and treatment approaches. Discussion Our study shows a high incidence of NSM. This finding due to the location of the DP seems to correlate with ANS disturbance and might help to distinguish patients at higher risk.