New Study Explores Brain Damage in MS Patients with Autoimmune Comorbidities

Patricia Silva, PhD avatar

by Patricia Silva, PhD |

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People with multiple sclerosis (MS) who also suffer from other autoimmune conditions, like thyroid disease orĀ diabetes, have more severeĀ brain damage than MS patients without comorbidities, according to a study fromĀ theĀ University at Buffalo. The study wasĀ recently published in the American Journal of Neuroradiology.

An earlier report from theĀ North American ResearchĀ Committee on Multiple Sclerosis suggested that MS patients withĀ additional diseases have an increased risk for disabilityĀ progression.Ā Researchers had earlier established that there is an association between cardiovascular disease and lesion load in MS, but the impact of other conditions on disease progression is not known.

The study,Ā Autoimmune Comorbidities Are Associated with Brain Injury in Multiple Sclerosis,Ā analyzed the medical records of 815 MS patients, of whom 241 hadĀ comorbid conditions and 574 did not. MostĀ had one comorbid disease, but 42 had two or more conditionsĀ in addition to MS. The research team analyzedĀ comorbid disease in relation to measures of brain tissue injury acquired by magnetic resonance imaging (MRI).

The most frequently encountered conditions wereĀ thyroid disease, present in 11.9 percent of these MS patients,Ā followed by asthma, type 2Ā diabetes mellitus, psoriasis, andĀ rheumatoid arthritis.

Brain tissue injury in these patientsĀ was localized to gray matter,Ā particularly to theĀ cortex, the team found. Psoriasis, thyroid disease, and type 2 diabetes ā€” all conditions with an autoimmune component ā€” were specificallyĀ associated with more severe MRIĀ outcomes.

In addition to analyzingĀ conventional lesion load, the team looked at data ofĀ unconventional MRI measures, such asĀ brain atrophy, magnetization transfer imaging, and diffusivity. ResearchersĀ noted that evidence of brain tissue damage was found mostly with the unconventional techniques, and that anĀ association between comorbidities and brain injury might, therefore, not be detected using onlyĀ lesion burden MRI measures.

Although the team found a link between three autoimmune conditions and brain injury, researchersĀ did not analyze allĀ comorbidities present because of the limited number ofĀ patients. It is possible that also other conditions, such asĀ systemic lupus erythematosus,Ā type 1 diabetes mellitus, Crohn’sĀ disease, and myasthenia gravis areĀ also associated with more severe brain injury in MS.

Since the study analyzed only the presence of comorbidities and brain injury in a cross-sectional manner, the team could notĀ conclude that the comorbidities caused an accelerated disease progression. More research is needed to establish the nature of these relationships.