Morphological evaluation of the basilar artery in patients with multiple sclerosis

Multiple Sclerosis (MS) is a chronic demyelinating disease of the central nervous system, most commonly affecting individuals between the ages of 20 and 40. In MS patients, disruptions in the blood-brain barrier, microbleeds, and reduced cerebral blood flow have been observed. Recent studies suggest the existence of a new subtype referred to as "vascular MS." The brainstem is one of the areas frequently affected by MS, with pontine lesions accounting for 46% of infratentorial lesions. The primary arterial supply of the pons is the basilar artery (BA). This study aims to investigate potential morphometric differences in the BA between MS patients and healthy controls. MR angiography images of patients who visited the Neurology Department of Biruni University Medical Faculty Hospital between 2016 and 2025 were retrospectively analyzed. The study included 60 MS patients and 60 healthy controls over the age of 18. Measurements were performed using the RadiAnt DICOM Viewer software. Normality analyses of BA length, diameter, and age were conducted using the Kolmogorov-Smirnov test. The BA diameter was found to follow a normal distribution. Group comparisons were performed using the Independent T-Test and Mann-Whitney U test. A statistically significant difference in BA diameter was found between MS patients and healthy individuals. Additionally, BA length was significantly higher in males compared to females in both the general and control groups. Our findings suggest that MS affects BA morphometry, supporting the role of vascular factors in the disease process. The observed BA changes highlight the vascular component of MS and contribute to the concept of "vascular MS" laying the groundwork for the development of radiological biomarkers for MS subtypes.