..... from our Canadian friends

Vascular Disease in Patients with Multiple Sclerosis: A Review

"The debate on whether vascular events are the primary cause of neurological diseases or rather a mere participant recruited from a primary neuronal origin of pathology is still open.
The high degree of comorbidity between vascular disease and MS suggests that vascular pathology may be an important factor causing neuronal dysfunction or degeneration in multiple sclerosis.

In our opinion, this review is useful to shed light on a hot topic in which literature is still lacking.

The results in literature are not always consistent, both for the frequency of association between vascular disease and neurological disease, both for the relationship between vascular disease, cerebral damage and clinical disability. Several studies are mostly “case-control” and studies on population are few.

Furthermore, the authors of studies do not always come from centers with expertise in epidemiological assessment. It is possible that many of the changes reported in the literature are a result of bias in the interpretation or e ects of the disease itself, or activation of the immune system or of drug treatment.

Therefore, more rigorous epidemiological and pathophysiological studies are needed to verify the biological plausibility between vascular damage and demyelinating-neurodegenerative diseases."

http://www.esciencecentral.org/journals/vascular-disease-in-patients-with-multiple-sclerosis-a-review-2329-6925-1000259.pdf