Vascular ultrasound findings offer clues into disability progression in MS patients

Vascular ultrasound findings could indicate increased risk of disability progression in the future for people with multiple sclerosis (pwMS). 

According to a paper published in the Journal of Medical Imaging and Radiation Sciences in December 2022, MS patients who display increased carotid intima-media thickness (cIMT) and abnormal carotid blood flow on ultrasound are at an increased risk of risk of more aggressive progression of disability. Experts involved in the study indicated that these sonographic findings could be used to prompt earlier interventions in patients most at risk to potentially blunt the impact of disabling symptoms. 

“These findings provide important information for disease management and disability prevention in pwMS,” corresponding author Merlisa Kemp of Cape Peninsula University of Technology in South Africa and colleagues explained. 

Kemp and colleagues described disability progression as one of the most challenging aspects of MS, as it cannot be stopped by medication. However, understanding which patients might be faced with more disabling symptoms of MS before they manifest represents a window of opportunity to be proactive in managing them. 

The team used extracranial vascular ultrasound exams of 51 pwMS and 25 age-matched controls to compare differences in blood flow patterns and cIMT between the two groups. Those findings were considered alongside disability severity, determined using the Expanded Disability Status Scale (EDSS). 

Through this, the experts noted significant positive associations between EDDS and cIMT of the right and left common carotid arteries. Negative associations with peak systolic blood flow velocity of the right vertebral artery and end-diastolic velocity of the left internal carotid artery were also observed. 

These findings were largely governed by biochemical and lifestyle factors, such as diet and physical activity. They were also found to have a greater influence on disability progression than aging. 

“PwMS who had increased cIMT, a surrogate marker for atherosclerosis, and reduced carotid artery blood flow velocities were at risk for greater disability over and above the effect of aging,” the authors stated, adding that interventions catered to improving diet and lifestyle could potentially inhibit disability progression by promoting optimal blood flow to the brain. 

The study abstract is available here

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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