Dossi Daiana E, Chaves Hernán, Heck Evelyn S, Rodriguez Murúa Sofía, Ventrice Fernando, Bakshi Rohit, Quintana Francisco J, Correale Jorge, Farez Mauricio F
Department of Neurology, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina.
Department of Diagnostic Imaging, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina.
Front Neurol. 2018 Jun 25;9:487. doi: 10.3389/fneur.2018.00487. eCollection 2018.
In MS patients, hypertension is associated with a delayed diagnosis and an increased risk of progression. Understanding the mechanisms of this association could potentially lead to improved prevention of disease progression. We aimed to establish whether high blood pressure contributes to white-matter injury and brain atrophy in MS. Cross-sectional study of 95 patients with RRMS. Estimates of fractional anisotropy, gray-matter volume and lesion load were obtained from 3T MRI. We used fractional anisotropy voxel-based statistics to establish the effect of blood pressure on white matter tracts. Additionally, we used voxel-based morphometry (VBM) to study the effect on gray matter integrity. Only 29.5% had normal blood pressure levels, with 52.6% suffering from prehypertension and 17.9% with hypertension. Increasing systolic blood pressure was associated with damage to posterior white-matter tracts as well as greater levels of gray matter atrophy, in particular in the frontal cortex. Age-adjusted linear regression indicated that neither lesion volume (β = 0.002, 95%CI: 0.02-0.02; = 0.85) or lesion number (β = -0.004, 95%CI: 0.03-0.02; = 0.74) were associated with systolic blood pressure. Prehypertension and hypertension are frequent in MS. Increased blood pressure is related to white- and gray-matter integrity, both related to MS disability outcomes. These findings suggest attention to the control of blood pressure in MS patients.
在多发性硬化症（MS）患者中，高血压与诊断延迟及疾病进展风险增加相关。了解这种关联的机制可能会改善对疾病进展的预防。我们旨在确定高血压是否会导致MS患者的白质损伤和脑萎缩。对95例复发缓解型多发性硬化症（RRMS）患者进行横断面研究。通过3T磁共振成像（MRI）获得各向异性分数、灰质体积和病灶负荷的估计值。我们使用基于各向异性分数体素的统计方法来确定血压对白质束的影响。此外，我们使用基于体素的形态学测量（VBM）来研究对灰质完整性的影响。只有29.5%的患者血压水平正常，52.6%的患者患有高血压前期，17.9%的患者患有高血压。收缩压升高与后白质束损伤以及灰质萎缩程度增加有关，尤其是额叶皮质。年龄校正线性回归表明，病灶体积（β = 0.002，95%置信区间：0.02 - 0.02；P = 0.85）或病灶数量（β = -0.004，95%置信区间：0.03 - 0.02；P = 0.74）均与收缩压无关。高血压前期和高血压在MS患者中很常见。血压升高与白质和灰质完整性相关，两者均与MS的残疾结局有关。这些发现提示应关注MS患者的血压控制。
