Cerebrovascular Dynamics in Multiple Sclerosis

Multiple sclerosis (MS) is characterised by immune-mediated demyelination and progressive neurodegeneration within the central nervous system. Beyond inflammatory cell infiltration, mounting evidence points to altered cerebrovascular dynamics as a key factor in lesion evolution and long-term disability. Perfusion imaging studies have revealed a dual pattern: acute plaques often exhibit transient hyperperfusion driven by inflammatory vasodilation, whereas normal-appearing white and grey matter display chronic hypoperfusion that may exacerbate energy deficits and impede repair processes. Regional hypoxia, detected by advanced optical techniques, appears to correlate with neurological impairment and may promote irreversible tissue loss. This emerging understanding of vascular contributions to MS has global relevance for early detection, monitoring cognitive decline and guiding interventions aimed at restoring adequate blood flow and preventing neurodegeneration.

Research from Nature Portfolio

Recent work using quantitative near-infrared spectroscopy has demonstrated significantly reduced cortical microvascular haemoglobin saturation in people with MS compared to healthy controls. These optical measurements reveal focal hypoxia that aligns with clinical disability scores, suggesting that non-invasive assessment of tissue oxygenation can sensitively track disease activity and potentially inform personalised therapeutic strategies.

Cerebrovascular Dynamics in Multiple Sclerosis publication trend

The graph below shows the total number of articles in cerebrovascular dynamics in multiple sclerosis across all publications each year (not limited to Nature Index journals).

Technical terms

Cerebral perfusion: The delivery of blood through the brain’s vascular network, supplying oxygen and nutrients to neural tissue.

Hypoperfusion: A reduction in blood flow below normal physiological levels, potentially leading to cellular energy deficits.

Hypoxia: A state of diminished oxygen availability in tissues, which can impair metabolic function and promote injury.

Near-infrared spectroscopy (NIRS): A non-invasive optical technique for measuring tissue oxygenation by detecting changes in haemoglobin absorption spectra.

Arterial spin labelling (ASL): An MRI method that quantifies cerebral blood flow by magnetically labelling arterial water protons as an endogenous tracer.

References

1. Tissue factor as a potential coagulative/vascular marker in relapsing-remitting multiple sclerosis. Frontiers in Immunology (2023).
2. Investigating cortical hypoxia in multiple sclerosis via time‐domain near‐infrared spectroscopy. Annals of Clinical and Translational Neurology (2024).
3. Pathophysiology of multiple sclerosis damage and repair: Linking cerebral hypoperfusion to the development of irreversible tissue loss in multiple sclerosis using magnetic resonance imaging. European Journal of Neurology (2023).
4. Reduced cortical microvascular oxygenation in multiple sclerosis: a blinded, case-controlled study using a novel quantitative near-infrared spectroscopy method. Scientific Reports (2015).