Introduction
Recents studies have led to a new understanding of where there is correlation between the brain and the bone system. It is believed that when the brain health is affected by neurological disorders such as multiple sclerosis, it will later also affect bone health in patients. There is clinical evidence that indicates that neurophysiology changes can also affect bone physiology changes through impacted immune and molecular pathways. In most cases, it will result in decreasing bone mineral density (BMD) and bone mineral content (BMC). This condition has also been proven to potentially lead to another risk of bone disease such as osteoporosis especially in patients with neurological disorders.
Osteoporosis is known to be one of the most common types of metabolic bone disease. Osteoporosis is commonly identified as a low bone mass that can weaken the fractures. Moreover, osteoporosis is also described as low bone mineral density (BMD) that is caused by microstructure-altered condition and other potential risk factors. Furthermore, mineral loss and osteoporosis can also be caused by a lack of physical activity in degenerative neurological conditions in patients. Therefore, this article will later discuss more about how neurological diseases, specifically multiple sclerosis, can affect bone health in patients.
Multiple Sclerosis Disease Overview
Multiple sclerosis (MS) is a non-traumatic disease commonly known to be impacting young adults. Generally, multiple sclerosis is divided into two stages such as the inflammatory phase that leads to demyelinating plaques in the central nervous system and prolonged neurodegeneration. Patients with MS usually experience fatigue, numbness, and vision loss. The cause of MS is still unknown, but there is evidence that MS is caused by an immune system that attacks the brain and the nerves. However, genetic and environmental factors can also cause MS.
Multiple Sclerosis affects Bone Health
These days, there has been clinical evidence that shows that MS is related to detrimental bone effects such as osteoporosis. Based on the analyses, it shows that patients with MS have reduced BMD in several locations such as the lumbar spine. Generally, it is found that osteoporosis is higher in patients with MS by approximately 16-26%. Some potential factors cause MS patients to have reduced BMD such as lack of vitamin D, disease severity and duration, and inflammation.
Another study shows that female patients with MS show lower BMD in lumbar spine and femoral neck compared to the healthy controls. Further research also indicates that both female and male MS patients experience significant bone loss in the femoral neck. On another hand, severity and MS duration are also associated with bone loss in patients. For instance, a study shows that patients with moderate MS disease indicate lower BMD and BMC in total compared to mild disease MS patients.
Conclusion
Therefore, it is understandable that neurological disorders, specifically multiple sclerosis can impact bone health, especially osteoporosis due to low bone mineral density (BMD). MS patients have been observed to have lower BMD compared to the healthy controls which results in a higher risk of experiencing osteoporosis. Lack of vitamin D is also known to have caused MS patients to have low BMD. Additionally, disease severity and duration can also reduce BMD in MS patients.
However, some potential treatment suggestions can be done to help overcome this. This includes estrogen replacement therapy, bisphosphonates, antiresorptive therapies, anabolic therapies, and targeted immunotherapy. Lifestyle factors including exercise, muscle training, a sufficient amount of vitamin D, and a well-balanced diet will also help to improve bone health. Clinical monitoring such as DXA scans routine, FRAX, BMI, and muscle mass may also be suggested to improve bone health. Understanding better the relation between neurological disorders and bone health will definitely help to develop better treatment approaches later in the near future for patients. Further study is still highly needed to provide more evidence that corresponds with how neurological disorders can have impacts on bone health.
References
Kelly, R.R., Sidles, S.J., laRue, A.C. 2020. Effects of Neurological Disorders on Bone Health. Front Psychol(11). DOI: 10.3389/fpsyg.2020.612366.
Porter, J.L., Varacallo, M. 2024. Osteoporosis. StatPearls Publishing.
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