Computational Fluid Dynamic Simulation of the Cerebral Venous System in Multiple Sclerosis and Control Patients: Are Hemodynamic Variances Evident in Multiple Sclerosis?

Objective: An investigation was performed to determine the relevant hemodynamic parameters which could help assess vascular pathology in human diseases. Using these parameters, this study aims to assess if there are any hemodynamic differences in the cerebral veins of multiple sclerosis (MS) patients and controls which could impact the etiology of MS. Methods: 40 MS participants and 20 controls were recruited for this study. Magnetic resonance imaging (MRI) was performed to enable 3D geometries of the anatomy and the blood flow rates at the boundaries to be computed. Computational fluid dynamics (CFD) models were created for each participant and simulated using patient-specific boundary conditions. Results: The pressure drop and vascular resistance did not significantly differ between the groups. The internal jugular vein (IJV) cross-sectional area was larger in the MS group (Right IJV: p = 0.04, Left IJV: p = 0.02) and the straight sinus (ST) flow rate was higher in MS across all ages (p = 0.005) compared to controls. Vascular resistance was shown to indicate regions in the cerebral veins which could correspond to increased venous pressure. Conclusion & Significance: This study shows that the pressure and vascular resistance of the cerebral veins are unlikely to be directly related to the etiology of MS. The finding of higher ST flow could correspond to increased inflammation in the deep venous system. Resistance as a measure of vascular pathology shows promise and could be useful to holistically investigate blood flow hemodynamics in a variety of other diseases of the circulatory system.