Impaired lung function in multiple sclerosis: a single-center observational study in 371 persons
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology(2023)
Abstract
Introduction Abnormal lung function in people with multiple sclerosis (PwMS) could be considered as the result of muscle weakness or MS-specific structural central nervous system (CNS) abnormalities as a precipitant factor for the worsening of motor impairment or cognitive symptoms. Methods This is a cross-sectional observational study in PwMS. Forced spirometry was conducted, and normative metrics of forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1 ), and the relation FEV1/FVC were calculated. Qualitative and quantitative brain magnetic resonance imaging (MRI) examinations were carried out. Results A total of 371 PwMS were included in the study. Of those, 196 (53%) had RRMS, 92 (25%) SPMS, and 83 (22%) PPMS. Low FVC and FEV 1 was present in 16 (8%), 16 (19%), and 23 (25%) of the patients in the RRMS, PPMS, and SPMS, respectively. PwMS with T2-FLAIR lesions involving the corpus callosum (CC) had a significantly higher frequency of abnormally low FVC and FEV 1 (OR 3.62; 95% CI 1.33–9.83; p = 0.012) than patients without lesions in that region. This association remained significant in the RRMS group (OR 10.1; 95% CI 1.3–67.8; p 0.031) when the model excluded PPMS and SPMS. According to our study, for every increase of 1 z score of FVC, we observed an increase of 0.25 cm 3 of hippocampal volume ( β 0.25; 95% CI 0.03–0.47; p 0.023) and 0.43 cm 3 of left hippocampus volume ( β 0.43; 95% CI 0.16–0.71; p 0.002). Conclusions We observed an incremental prevalence of abnormally low pulmonary function tests that parallels a sequence from more early relapsing courses to long-standing progressive courses (RRMS to PPMS or SPMS).
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Key words
Multiple sclerosis,FVC,FEV1,Deep gray matter,T2-FLAIR
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