DuBose Noah G, DeJonge Sydney R, Jeng Brenda, Motl Robert W
Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919W Taylor St, 650 AHSB (MC517), Chicago, IL 60612, USA.
Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, 1919W Taylor St, 650 AHSB (MC517), Chicago, IL 60612, USA.
Mult Scler Relat Disord. 2023 Oct;78:104936. doi: 10.1016/j.msard.2023.104936. Epub 2023 Aug 9.
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.
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.
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the effect of a home-based exercise program on markers of subclinical atherosclerosis; however, the results are unpublished, and there was no literature beyond this surrounding the impact of lifestyle behavior (e.g., diet) or exercise interventions on vascular function.
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.
通过应用诸如脉搏波速度或血流介导的扩张等血管功能测量方法作为整个生命周期中多发性硬化症（MS）身体合并症管理研究的机制终点，可以推进对MS患者血管合并症的研究。我们对MS中血管功能参数和结果的研究进行了范围综述，并制定了未来研究的议程。
我们检索了从创刊到2023年2月的PubMed，以查找涉及MS相关的中枢和外周血管功能数据或血管功能相关因素（动脉僵硬度、内皮功能、血压参数等）以及相关结果（行走功能、认知等）的文章。研究仅限于英文的原创研究文章。
我们的检索及后续筛选确定了10篇相关文章。四篇论文关注动脉僵硬度，报告了MS患者与对照组相比的脉搏波速度和动脉顺应性。两篇论文关注内皮功能，报告了MS患者与对照组相比的血流介导的扩张。有证据表明，动脉僵硬度和内皮功能分别与MS患者的认知和疾病进展相关。一篇论文报告说，体育活动与MS患者的动脉僵硬度相关。有一篇方案论文研究了家庭锻炼计划对亚临床动脉粥样硬化标志物的影响；然而，结果尚未发表，并且除了这篇文章之外，没有关于生活方式行为（如饮食）或运动干预对血管功能影响的文献。
有新证据表明MS存在血管功能障碍，且这与认知和疾病进展相关；我们对MS中血管功能障碍的管理方法知之甚少。为此，我们提供了一个关于MS血管功能测量和结果与疾病属性关系的研究议程，以及可能有助于管理血管功能障碍的潜在机制和生活方式改变。
