Multiple Sclerosis Progression and Menopause
Summary:
The study explored the potential influence of menopause on the progression of multiple sclerosis (MS), from both clinical and neuroradiological viewpoints. It particularly scrutinized the probable association between menopause and brain atrophy. Involving women with MS aged 45-55 years, it categorized them into non-menopausal and menopausal based on their final menstrual period. Measures included MS activity through the annualized relapse rate (ARR) and MRI activity, along with volume assessments of the brain's segments using SIENAX software. Menopausal women were found to have a lower ARR and less MRI activity than non-menopausal women. Menopause seemed to contribute to reduced cortical grey matter (GM) volumes, suggesting menopause might intensify cortical GM atrophy, possibly due to diminished neuroprotective effects of estrogen, negatively impacting MS progression.
Extended Explanation:
This study provides intriguing insights into the potentially substantial role menopause plays in the progression of multiple sclerosis (MS), a disabling disease of the brain and spinal cord. It peels back the layers of complexity around this issue by examining it from both clinical and neuroradiological perspectives, primarily focusing on the plausible connection between menopause and brain atrophy.
Encompassing a sample of women with MS who were aged between 45 and 55, the research demarcated the subjects into two categories: non-menopausal and menopausal. The distinction was based on the timing of their final menstrual period. Various parameters were used to evaluate the effects of menopause, such as MS activity gauged through the annualized relapse rate (ARR) and MRI activity reflecting the appearance of new T2 lesions or gadolinium-enhancing lesions.
A critical part of the study's methodology was the volume measurements of various brain components. The researchers utilized SIENAX software to calculate the volume of the whole brain, white matter, grey matter, and cortical grey matter. Following this, they deployed regression analysis to investigate the potential association between menopausal status and these volume measurements.
The study's results presented intriguing evidence. Among the 147 women with MS who participated, a majority (57.1%) were menopausal, with menopause onset around 48.5 years on average. When scrutinized for ARR, menopausal women reported a lower rate than their non-menopausal counterparts. Furthermore, MRI activity was detected in a smaller percentage of menopausal women. Another crucial finding was that menopausal women showed lower cortical GM volumes.
Finally, a multivariate analysis adjusted for chronological age and other variables, demonstrated a significant correlation of lower ARR and cortical GM volume with menopausal status. The evidence implies that menopause could facilitate cortical GM atrophy, probably linked to a reduction in estrogen's neuroprotective effects.
These preliminary results suggest that menopause may have negative repercussions on the progression of MS. It could be an unfavorable prognostic factor, which is a noteworthy discovery for healthcare professionals seeking to understand the disease's trajectory and improve the quality of life for women with MS. Further studies should focus on corroborating these findings and exploring ways to counteract the potential adverse effects of menopause on MS progression.
Front. Neurol. Sec. Multiple Sclerosis and Neuroimmunology Volume 14 - 2023 | doi: 10.3389/fneur.2023.1251667
If you have MS, it appears that keeping your hormones balanced may provide brain protection over the long haul, we see this with Parkinson's disease and Alzheimer's disease as well. Jason & Rita...aka Dr. De Leon and Dr. Gillespie
