Vascular dysfunction in multiple sclerosis: Scoping review of current evidence for informing future research directions

Noah G DuBose; Sydney R DeJonge; Brenda Jeng; Robert W Motl

doi:10.1016/j.msard.2023.104936

Vascular dysfunction in multiple sclerosis: Scoping review of current evidence for informing future research directions

Mult Scler Relat Disord. 2023 Oct:78:104936. doi: 10.1016/j.msard.2023.104936. Epub 2023 Aug 9.

Authors

Noah G DuBose¹, Sydney R DeJonge², Brenda Jeng², Robert W Motl²

Affiliations

¹ Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919W Taylor St, 650 AHSB (MC517), Chicago, IL 60612, USA. Electronic address: ndubos3@uic.edu.
² Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919W Taylor St, 650 AHSB (MC517), Chicago, IL 60612, USA.

PMID: 37619375
DOI: 10.1016/j.msard.2023.104936

Abstract

Background: The research involving vascular comorbidity in people with multiple sclerosis (MS) could be advanced through investigations applying measurements of vascular function such as pulse wave velocity or flow mediated dilation as mechanistic endpoints in the study of physical comorbidity management in MS across the lifespan. We conducted a scoping review of research on vascular function parameters and outcomes in MS and developed a research agenda for future inquiry.

Methods: We searched PubMed from inception through February 2023 for articles involving relevant central and peripheral vascular function data or correlates of vascular function (arterial stiffness, endothelial function, blood pressure parameters, etc.) in conjunction with relevant outcomes (walking function, cognition, etc.) in MS. Studies were limited to English-language and primary research articles.

Results: Our search and subsequent screening identified 10 relevant articles. Four papers focused on arterial stiffness and reported pulse wave velocity and arterial compliance in MS compared with controls. Two papers focused on endothelial function and reported flow-mediated dilation in MS compared with controls. There was evidence that arterial stiffness and endothelial function were associated with cognition and disease progression in MS, respectively. One paper reported that physical activity was associated with arterial stiffness in MS. There was one protocol paper examining the effect of a home-based exercise program on markers of subclinical atherosclerosis; however, the results are unpublished, and there was no literature beyond this surrounding the impact of lifestyle behavior (e.g., diet) or exercise interventions on vascular function.

Conclusion: There is emerging evidence for vascular dysfunction in MS, and this is associated with cognition and disease progression; we know very little about approaches for managing vascular dysfunction in MS. To that end, we offer an agenda for research on measurements and outcomes of vascular function in relation to MS and disease attributes, along with proposed mechanisms and lifestyle changes that could aid in managing vascular dysfunction.

Keywords: Arterial stiffness; Endothelial function; Multiple sclerosis; Physical activity; Vascular function.

Publication types

Review