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Research ArticleExtracranial Vascular
Open Access

Lower Arterial Cross-Sectional Area of Carotid and Vertebral Arteries and Higher Frequency of Secondary Neck Vessels Are Associated with Multiple Sclerosis

P. Belov, D. Jakimovski, J. Krawiecki, C. Magnano, J. Hagemeier, L. Pelizzari, B. Weinstock-Guttman and R. Zivadinov
American Journal of Neuroradiology January 2018, 39 (1) 123-130; DOI: https://doi.org/10.3174/ajnr.A5469
P. Belov
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
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  • ORCID record for P. Belov
D. Jakimovski
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
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J. Krawiecki
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
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C. Magnano
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
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J. Hagemeier
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
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L. Pelizzari
dDepartment of Electronics, Information and Bioengineering (L.P.), Politecnico di Milano, Milan, Italy
eFondazione Don Carlo Gnocchi Organizzazione Non Lucrativa di Utilita' Sociae (L.P.), Milan, Italy.
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B. Weinstock-Guttman
bJacobs MS Center, Department of Neurology (B.W.-G.)
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R. Zivadinov
aFrom the Buffalo Neuroimaging Analysis Center, Department of Neurology (P.B., D.J., J.K., C.M., J.H., R.Z.)
cCenter for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York, Buffalo, New York
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    Fig 1.

    Radar plot representation of the neck vessel differences between patients with multiple sclerosis and healthy controls. Significant correlations are in boldface.

  • Fig 2.
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    Fig 2.

    Comparison of main and secondary vessel number and cross-sectional area on a 2D-MRV sequence at 4 cervical levels in patients with multiple sclerosis (4 corresponding panels on the left) and age- and sex-matched healthy controls (4 corresponding panels on the right). VV indicates vertebral vein; L, left; R, right. Green color represents the secondary vessels, red color represents the CCA, ICA, EAC, and VA, while blue represents the IJV.

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    Table 1:

    Demographic and clinical characteristics of patients with multiple sclerosis (n = 193) and healthy controls (n = 193)a

    MS (n = 193)HC (n = 193)P Value
    Female (No.) (%)130 (67.4)130 (67.4)1.000
    Age (mean) (SD) (yr)42.2 (13.9)42.9 (17.5).676
    BMI (mean) (SD)26.8 (5.8)26.8 (5.7).94
    Disease duration (mean) (SD) (yr)12.0 (9.4)NA–
    EDSS (median) (range)2 (0.0–6.5)NA–
    Smoking history (No.) (%)73 (46.8)58 (32.4).005b
    Heart disease (No.) (%)30 (19.7)20 (12.4).053
    Hypertension (No.) (%)38 (25.3)19 (11.3).001b
    • Note:—EDSS indicates Expanded Disability Status Scale; IQR, interquartile range; NA, not applicable.

    • ↵a χ2 and Student t test were used for comparing variables between groups.

    • ↵b An α level of .05 was considered significant.

    • View popup
    Table 2:

    Correlations of arterial, venous, and secondary neck vessel frequency and the cross-sectional area with age and BMI in study groupsa

    AgeBody Mass Index
    MS (n = 193)HC (n = 193)MS (n = 193)HC (n = 193)
    R ValueP ValueR ValueP ValueR ValueP ValueR ValueP Value
    Arterial CSA (mm2)
        C2/3−0.156.031b−0.163.023b0.130.0850.059.449
        C40.075.2980.045.5340.037.626−0.017.830
        C5/60.103.1560.122.0920.136.0730.095.224
        C7/T1−0.049.502−0.003.9680.085.2660.047.548
    IJV CSA (mm2)
        C2/30.257<.001b0.150.370.098.1980.083.287
        C40.255<.001b0.177.14b0.146.0540.139.075
        C5/60.196.006b0.252<.001b0.339<.001b0.231.003b
        C7/T10.187.009b0.327<.001b0.375<.001b0.344<.001b
    Secondary CSA (mm2)
        C2/30.039.594−0.060.404−0.192.011b−0.074.347
        C40.112.122−0.040.584−0.229.002b−0.121.121
        C5/60.047.5180.028.696−0.214.004b−0.064.417
        C7/T10.061.398−0.049.498−0.078.307−0.065.405
    No. of vessels
        C2/30.013.860−0.149.039b−0.204.007b−0.153.050b
        C4−0.460.527−0.211.003b−0.292<.001b−0.316<.001b
        C5/6−0.076.294−0.141.050b−0.333<.001b−0.251.001b
        C7/T1−0.060.406−0.155.031b−0.180.017b−0.174.025b
    • ↵a Spearman ranked correlations between age/BMI and the corresponding vascular variable were used.

    • ↵b An α level of .05 was considered significant.

    • View popup
    Table 3:

    Arterial, venous, and secondary neck vessel frequency and the cross-sectional area in the study groupsa

    Primary Vessel (CSA) (mm2)
    Arterial and VenousArterial (VAs)
    MS (n = 193)HC (n = 193)P ValueMS (n = 193)HC (n = 193)P Value
    Arterial (CCA/ICA/ECA)
        C2/C355.1 (16.4)60.9 (17.9).030b20.1 (4.4)21.8 (5.8).02b
        C460.8 (15.7)63.4 (16.3).22918.6 (4.2)20.3 (5.0).012b
        C5/C650.1 (10.1)53.9 (12.5).026b18.1 (6.9)19.3 (4.7).341
        C7/T147.6 (9.8)52 (9.9).005b16.3 (4.5)18.4 (5.9).006b
    Venous (IJVs)
        C2/C364.9 (27.4)66.0 (31.6).621
        C486.9 (35.9)91.1 (41.0).140
        C5/C692.3 (57.1)97.4 (60.2).418
        C7/T1113.3 (67.0)117.9 (79.3).790
    • ↵a Analysis of covariance adjusted for age and BMI, smoking history, heart disease, and hypertension was used. In the ANCOVA for frequency of vessels, ranked variables were used.

    • ↵b An α level of .05 was considered significant.

    • View popup
    Table 4:

    Secondary neck vessel frequency and the cross-sectional area in the study groupsa

    No. of VesselsCSA (mm2)
    MS (n = 193)HC (n = 193)P ValueMS (n = 193)HC (n = 193)P Value
    Secondary vessels
        C2/C312.9 (5.4)10 (4.2)<.001b92.1 (40.6)81.6 (35.5).016b
        C49.1 (4.2)7.5 (3.3)<.001b71.0 (33.7)65.3 (28.7).022b
        C5/C67.8 (3.9)6.8 (3.4).012b61.9 (32.2)57.2 (28.2).028b
        C7/T18.8 (4.9)6 (3.5)<.001b71.1 (40.5)56.7 (32.5)<.001b
    • ↵a Analysis of covariance adjusted for age and BMI, smoking history, heart disease, and hypertension was used. In the ANCOVA for frequency of vessels, ranked variables were used.

    • ↵b An α level of .05 was considered significant.

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P. Belov, D. Jakimovski, J. Krawiecki, C. Magnano, J. Hagemeier, L. Pelizzari, B. Weinstock-Guttman, R. Zivadinov
Lower Arterial Cross-Sectional Area of Carotid and Vertebral Arteries and Higher Frequency of Secondary Neck Vessels Are Associated with Multiple Sclerosis
American Journal of Neuroradiology Jan 2018, 39 (1) 123-130; DOI: 10.3174/ajnr.A5469

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Lower Arterial Cross-Sectional Area of Carotid and Vertebral Arteries and Higher Frequency of Secondary Neck Vessels Are Associated with Multiple Sclerosis
P. Belov, D. Jakimovski, J. Krawiecki, C. Magnano, J. Hagemeier, L. Pelizzari, B. Weinstock-Guttman, R. Zivadinov
American Journal of Neuroradiology Jan 2018, 39 (1) 123-130; DOI: 10.3174/ajnr.A5469
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