Cerebral Hemodynamics in Patients with Multiple Sclerosis: Role of Polymorphisms in Immune-Response Genes
Study Objective: To identify specific features of cerebral hemodynamics in patients with multiple sclerosis (MS) who have different alleles in the polymorphic loci of IL-18, KIF1B, TNF-α, and CD40 genes. Study Design: This was an open-label, cross-sectional study. Materials and Methods: This paper summarizes the examination data of 132 patients with remitting and secondary-progressive MS. Neurological status was evaluated in all patients, using the Kurtzke scale. Other study methods included molecular-genetic testing, Doppler ultrasound examination of extra- and intracranial arteries and duplex scanning of extracranial arteries. Study Results: The study showed that some quantitative blood-flow parameters were altered in the anterior cerebral arteries (ACA) and middle cerebral arteries (MCA): Blood-flow velocity was increased in ACA and MCA, and pulsatility index was increased in MCA. In patients with secondary-progressive MS, faster disease progression was associated with a reduced blood-flow velocity in the intracranial portions of the vertebral arteries. The presence of G allele in polymorphic locus rs187238 of the IL-18 gene was shown to be associated with increased blood-flow velocities in ACA and MCA. Conclusion: The study data helped assess cerebral hemodynamics in patients with MS, depending on the type of its progression. The observed association between polymorphism in locus rs187238 of the IL-18 gene and blood-flow velocity parameters can be used to adopt an individually-tailored approach to treating patients with MS.