Evaluation of Multiple Sclerosis from the Perspective of Conventional Medicine and Traditional Persian Medicine, Considering the Concept of Hemorheology
Abstract
Multiple sclerosis (MS) is a persistent inflammatory disorder of uncertain etiology. Certain observations suggest that the pathology might not solely stem from primary immune dysregulation. Advanced imaging techniques reveal decreased cerebral blood flow in MS subjects compared to healthy controls, suggesting a widespread cerebral hypoperfusion present from early to advanced disease stages. One of the effective factors in reducing tissue perfusion is a change in the rheological properties of blood, which has been mentioned in recent articles. By attention to this concept in complementary and traditional medicine, including Persian medicine, this can be a common point that connects the view of Traditional Persian Medicine (TPM) on MS to the existing hypotheses about the role of hemorheology in the development of MS. For this study, a two-step literature search was conducted. The initial search focused on concepts related to MS disease and changes in blood consistency in most important TPM texts. For the second inquiry, the PubMed, ScienceDirect, Scopus, and Google Scholar databases were explored using the keywords related to MS and blood viscosity concepts. TPM, believes that the imbalance of the four Humors in the body, changes the physical properties of blood, leading to changes in the tissues blood supply and can cause nerve injury in the long run. On the other hand, in modern physiology, some evidence shows that circulatory disorders precede immune responses in the development of MS and the reaction of the immune system is actually secondary to the ischemia created as a result of reduced blood supply. We believe that discussing Hemorheology, not only in MS, but also in many other diseases, can open new horizons for knowing the root cause of the disease and thus discovering better treatments.
Haki M, Al-Biati HA, Al-Tameemi ZS, Ali IS, Al-Hussaniy HA. Review of multiple sclerosis: epidemiology, etiology, pathophysiology, and treatment. Medicine 2024;103:e37297.
Silva RV, Biskup K, Zabala-Jouvin JK, Batzdorf CS, Stellmach C, et al. Brain inflammation induces alterations in glycosaminoglycan metabolism and subsequent changes in CS-4S and hyaluronic acid. Int J Biol Macromol 2023;230:123214.
Hunter SF. Overview and diagnosis of multiple sclerosis. Am J Manag Care 2016;22:s141-150.
Ward M, Goldman MD. Epidemiology and pathophysiology of multiple sclerosis. Continuum 2022;28:988-1005.
Henderson AP, Barnett MH, Parratt JD, Prineas JW. Multiple sclerosis: distribution of inflammatory cells in newly forming lesions. Ann Neurol 2009;66:739-753.
Barnett MH, Prineas JW. Relapsing and remitting multiple sclerosis: pathology of the newly forming lesion. Ann Neurol 2004;55:458-468.
D'haeseleer M, Hostenbach S, Peeters I, Sankari SE, Nagels G, et al. Cerebral hypoperfusion: a new pathophysiologic concept in multiple sclerosis?. J Cereb Blood Flow Metab 2015;35:1406-1410.
Varga AW, Johnson G, Babb JS, Herbert J, Grossman RI, et al. White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis. J Neurol Sci 2009;282:28-33.
Adhya S, Johnson G, Herbert J, Jaggi H, Babb JS, et al. Pattern of hemodynamic impairment in multiple sclerosis: dynamic susceptibility contrast perfusion MR imaging at 3.0 T. Neuroimage 2006;33:1029-1035.
Law M, Saindane AM, Ge Y, Babb JS, Johnson G, et al. Microvascular abnormality in relapsing-remitting multiple sclerosis: perfusion MR imaging findings in normal-appearing white matter. Radiology 2004;231:645-652.
Ibn Sina A. Al-qanun fit-tib [The canon of medicine]. Vol 2. Alaalami Beirut lib Press. Beirut 2005; p 331.
Ibn Sina A. Al-qanun fit-tib [The canon of medicine]. Vol 2. Alaalami Beirut lib Press. Beirut 2005; p 311.
Secomb TW, Pries AR. Basic principles of hemodynamics. Biomedical and Health Research-Commission of the European Communities Then IOS Press 2007;69:289.
Isbister JP. Hyperviscosity: clinical disorders. biomedical and health research-commission of the european communities Then IOS Press. 2007;69:371.
Sousa PC, Pinho FT, Alves MA, Oliveira MS. A review of hemorheology: Measuring techniques and recent advances. Korea Aust Rheol J 2016;28:1-22.
Baskurt OK, Meiselman HJ. Blood Rheology and Hemodynamics. Semin Thromb Hemost 2003;29:435-450.
Heron CJ, Wright SL, Melzer TR, Myall DJ, MacAskill MR, et al. Comparing cerebral perfusion in Alzheimer's disease and Parkinson's disease dementia: an ASL-MRI study. J Cereb Blood Flow Metab 2014;34:964-970.
Mazza M, Marano G, Traversi G, Bria P, Mazza S. Primary cerebral blood flow deficiency and Alzheimer's disease:shadows and lights. J Alzheimer’s Dis 2011;23:375-389.
Shulman MH, Alexander L, Ehrentheil OF, Gross R. Capillary resistance studies in multiple sclerosis. J Neuropathol Exp Neurol 1950;9:420-429.
McMillan DE, Utterback NG, Baldridge JB. Thixotropy of blood and red blood cell suspensions. Biorheology 1980;17:445-454.
Karlov VA, Savin AA, Smertina LP, Redchits EG, Seleznev AN, et al. Changes in rheological properties of blood in multiple sclerosis and their correction. Zh Nevropatol Psikhiatr Im S S Korsakova 1990;90:47-50.
Blair GS, Matchett RH. Blood viscosity in multiple sclerosis. Journal of Neurology, Neurosurg Psychiatry 1972;35:730-371.
Broman T. Supravital analysis of disorders in the cerebral vascular permeability II. Two cases of multiple sclerosis. Acta Psychiatr Scand 1947;22:58-71.
Sears ES, Tindall RS, Zarnow H. Active multiple sclerosis: enhanced computerized tomographic imaging of lesions and the effect of corticosteroids. Arch Neurol 1978;35:426-434.
Roizin L, Abell RC, Winn J. Preliminary studies of sludged blood in multiple sclerosis. Neurology 1953;3:250.
Jorjani SI. Al-Aghraz al-Tibbia val Mabahess al-Alaiia. Tehran University Press. p 103.
Arzani HMA. Medicine. In: institute ETT, 1 ed. Jalal al-Din. Qom 2008; p 15.
Ibn Sina A. Al-qanun fit-tib [The canon of medicine]. Alaalami Beirut lib Press. Beirut 2005; p 48.
Ibn Sina A. Al-qanun fit-tib [The canon of medicine]. Alaalami Beirut lib Press. Beirut 2005; p 46.
Ahmad T, Anwar M. Clinical importance of leech therapy. Indian J Tradit Knowl 2009;8:443-445.
Ahwazi A. Kamel-al-Sanaat al-Tibbiah. Vol 2. Jalaloddin. Qom 2008; p 365.
Jorjani SE. Zakhireh Kharazmshahi (Treasure of Kharazmshahi). Vol 6. The lranian Culture Foundation. Tehran 1976; p 133.
Gomatos Elias L, Scott C. Dulebohn, and Anis Rehman. "Sensory neuropathy." In StatPearls [Internet]. StatPearls Publishing 2024.
Ibn Sina A. Al-qanun fit-tib [The canon of medicine]. Vol 1. Alaalami Beirut lib Press. Beirut 2005; pp 100-101.
Azam Khan M. Exir Azam (Persian). Vol 1. Institute of Meical History, Islamic Medicine and Complementary Medicine. Tehran 2008. p 283.
Jorjani SE. Zakhireh Kharazmshahi (Treasure of Kharazmshahi). The lranian Culture Foundation. Vol 1. Tehran 1976; p 171.
Jorjani SI, Al-Aghraz al-Tibbia val Mabahess al-Alaiia. Tehran University Press. Tehran. p 491.
Késmárky G, Kenyeres P, Rábai M, Tóth K. Plasma viscosity: a forgotten variable. Clin Hemorheol Microcirc 2008;39:243-246.
Alizadeh Vaghasloo M, Naghizadeh A, Babashahi N. The concept of the Haar-re-Gharizi and Hararate Gharizi: The innate hot [Substance] and heat. Trad Integr Med 2017;2:3-8.
Ibn Sina A. The Canon of Medicine. AlMayi. Vol 1. Tehran 2014; p 5; pp 67-71; p87; pp 301-304; p326; p362 [In Ara-bic].
Shirbeigi L, Zarei A, Naghizadeh A, Vaghasloo MA. The concept of temperaments in traditional Persian medicine. Trad Integr Med 2017;2:143-156.
Ibn Roshd, [Kulliyat or Colliget]. Dar al-kotob aliilmiyah: Lebanon 2005. p 141.
Parviz M, Sahraian MA, Rezaeizadeh H. Historical issues of optic neuritis and sensory disorder in Persian traditional medicine. Iran J Public Health 2013;42:644.
Saeid ibn Hebatollah, [Al-Mughni fi-l-Tibb: the sufficient of Medicine]. Dar Al-Nafaes press. Lebanon 1999.pp 65-59.
Wuerfel J, Bellmann‐Strobl J, Brunecker P, Aktas O, McFarland H, et al. Changes in cerebral perfusion precede plaque formation in multiple sclerosis: a longitudinal perfusion MRI study. Brain 2004;127:111-119.
Rosso C, Remy P, Creange A, Brugieres P, Cesaro P, et al. Diffusion-weighted MR imaging characteristics of an acute strokelike form of multiple sclerosis. Am J Neuroradiol 2006;27:1006-1008.
Macchi G. The pathology of the blood vessels in multiple sclerosis. J Neuropathol Exp Neurol 1954;13:378-384.
Swank RL, Roth JG, Woody Jr DC. Cerebral blood flow and red cell delivery in normal subjects and in multiple sclerosis. Neurol Res 1983;5:37-59.
Freal JE, Kraft GH, Coryell JK. Symptomatic fatigue in multiple sclerosis. Arch Phys Med Rehabil 1984;65:135-138.
Swank RL. Subcutaneous hemorrhages in multiple sclerosis. Neurology 1958;8:497.
Valleroy ML, Kraft GH. Sexual dysfunction in multiple sclerosis. Arch Phys Med Rehabil 1984;65:125-128.
Ierusalimskiĭ AP, Kunitsyn VG, Nekrasova MF, Predtechenskaia AV, Chetvertakova TN. A rheological method of diagnosis of multiple sclerosis. Lab Delo 1989;10:39-41.
Keegan M, König F, McClelland R, Brück W, Morales Y, et al. Relation between humoral pathological changes in multiple sclerosis and response to therapeutic plasma exchange. Lancet 2005;366:579-582.
Issue | Vol 10, No 2, 2025 (In Press) | |
Section | Review Article(s) | |
Keywords | ||
Multiple Sclerosis Traditional Persian Medicine Hemorheology |
Rights and permissions | |
![]() |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |