title: Is There a Genetic Correlation between Multiple Sclerosis and Cerebral Aneurysms?
abstract: BACKGROUND
  Multiple sclerosis (MS) is a common autoimmune and neurodegenerative disease of the central nervous system characterized by inflammatory demyelination, axonal degeneration, and neuronal loss. The exact pathogenesis of MS remains uncertain; however, studies have shown that the development of MS is influenced by genetic and environmental factors. Cerebral aneurysms (CAs) are life-threatening lesions of cerebral vessels characterized by a bulge in the intracranial arterial wall that spontaneously ruptures. It has been hypothesized that patients with MS are at increased risk of developing cerebral aneurysms. This hypothesis can be supported by analyzing the pathogenesis and genetics of the development of MS and CA. To our knowledge, no previous studies have shown an association between MS and CA.
  
  
  METHODS
  In this report, we performed middle cerebral artery aneurysm clipping for two patients with MS who were referred to our clinic for CA in the bifurcation of middle cerebral artery that was found incidentally on magnetic resonance imaging. We aim to identify any genetic correlation between MS and CA pathogenesis.
  
  
  CONCLUSIONS
  This report suggests a possible genetic association between MS and CAs. The strongest evidence of association was found for the TNFRSF1A gene, a proinflammatory gene that is involved in mitogen-activated protein kinase (MAPK) and NF-Kappa B signaling pathways, and has been identified as a candidate gene in the development of MS. MAPKs were also found to be elevated in CAs.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA; Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Fatimah M
authors.initials: FM
authors.lastname: Albrekkan
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Suha
authors.initials: S
authors.lastname: Bachir
authors.affiliation: Department of Neurology, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Mouhammed A
authors.initials: MA
authors.lastname: Jumaa
authors.affiliation: Department of Neurology, University of Toledo Medical Center, Toledo, Ohio, USA.
authors.forename: Syed Fazal
authors.initials: SF
authors.lastname: Zaidi
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Toledo Medical Center, Toledo, Ohio, USA. Electronic address: Azedine.Medhkour@utoledo.edu.
authors.forename: Azedine
authors.initials: A
authors.lastname: Medhkour
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D009103:Multiple Sclerosis / Q000150:complications* / Q000235:genetics; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000235:genetics
chemical_list: D047888:Receptors, Tumor Necrosis Factor, Type I; C506235:TNFRSF1A protein, human
keywords: Cerebral aneurysm; Genetics; Multiple sclerosis