Highlights
- •Despite current treatment options, disability progression cannot always be halted in MS.
- •A healthy lifestyle may be crucial in increasing brain reserve and delaying disability in MS.
- •Blood pressure, weight and measures for physical activity and cognitive reserve showed associations with the multiple sclerosis severity score.
Abstract
Objective
To determine the association between lifestyle risk factors with 1/ the Multiple Sclerosis
Severity Score (MSSS) and 2/ ongoing subclinical brain damage in non-active MS patients
on high-efficacy treatment.
Methods
Cross-sectional study in persons with Multiple Sclerosis (PwMS) investigating lifestyle
factors including cognitive reserve (CR), physical activity (PA), smoking status,
alcohol use, dietary habits, body mass index (BMI), blood pressure (BP) and cholesterol
ratio. Data were collected through validated questionnaires, clinical and laboratory
examination. Serum Neurofilament light chain (sNfL) levels were used as a proxy for
ongoing brain damage in a subgroup of persons with non-active MS on high-efficacy
treatment. Multiple regression analysis (MRA) models explored the relationship between
lifestyle factors with the MSSS score and sNfL.
Results
351 PwMS were included (43.04 ± 11.77 years, 69.8% female). Higher CR and PA were
associated with a lower MSSS; overweight or obesity and higher systolic BP with a
higher MSSS. The MRA model explained 22.2% of the variance for MSSS (R².255, adjusted
R².222). Higher BMI and BP were related to lower sNfL. Twenty-3% (R².279, adjusted
R².230) of the variance was explained in the MRA model for sNfL.
Conclusion
Our study suggests an association between a ‘brain healthy lifestyle’ with disability
progression in MS. A cognitive and physical active lifestyle alongside a normal body
weight and blood pressure may help to prevent future disability in MS. Longitudinal
and interventional research is necessary to gain insight in the causal pathway of
these risk factors in preventing disability progression in MS.
Keywords
Abbreviations:
AH (antihypertensive drugs), BMI (body mass index), BP (blood pressure), CI (confidence Interval), CNS (central nervous system), CR (cognitive reserve), CRIq (cognitive reserve index questionnaire), DMT (disease modifying treatment), EDSS (expanded disabilitystatus scale), HDL (high-density lipoprotein IPAQ, international physical activity questionnaire), MD (Mediterranean diet), Medi-Lite (literature based adherence to the MediterraneanDiet score), MRA (multiple regression analysis), MS (multiple sclerosis), MSSS (multiple sclerosis severity scale), PA (physical activity), PIRA (progression independent from relapses), PwMS (persons with MS), sNfL (serum neurofilament light), sNfLz (serum neurofilament light Z-score), UZA (Antwerp University Hospital), UZG (Ghent University Hospital), VIF (variance inflation factor)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 02, 2022
Accepted:
July 1,
2022
Received in revised form:
June 2,
2022
Received:
May 2,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
