The Heart–Brain Interplay in Multiple Sclerosis from Pathophysiology to Clinical Practice: A Narrative Review

Author:

Zavarella Matteo12,Villatore Andrea234ORCID,Rocca Maria Assunta125,Peretto Giovanni234ORCID,Filippi Massimo12567ORCID

Affiliation:

1. Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy

2. Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy

3. Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy

4. Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20019 Milan, Italy

5. Neurology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy

6. Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy

7. Neurophysiology Service, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy

Abstract

Multiple sclerosis (MS) is a chronic neurological disorder characterized by inflammation in the central nervous system (CNS) that leads to neurodegeneration. The clinical course is highly variable, but its prevalence is rising worldwide, partly thanks to novel disease-modifying therapies. Additionally, the lifespan of people with MS is increasing, and for this reason, it is fundamental to have a multidisciplinary approach to MS. MS may be associated with cardiovascular diseases (CVD), but there is scarce attention on this issue. In particular, CNS is essential in regulating the autonomic system and heart activity. Moreover, cardiovascular risk factors show a higher prevalence in MS patients. On the other hand, conditions like Takotsubo syndrome are rare complications of MS. The parallelism between MS and myocarditis is also interesting. Finally, cardiac toxicity represents a not infrequent adverse reaction to MS drugs. This narrative review aims to provide an overview of cardiovascular complications in MS and their management to prompt further clinical and pre-clinical research on this topic.

Publisher

MDPI AG

Subject

Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics

Reference120 articles.

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