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Published on: January 29, 2016
Is fatigue in patients with multiple sclerosis related to autonomic dysfunction?
L Keselbrener1, S Akselrod, A Ahiron
1Abramson Center of Medical Physics, Tel Aviv University, Israel.
Summary
Patients with multiple sclerosis (MS) and fatigue show impaired sympathovagal balance when standing, unlike healthy controls. This suggests an earlier age-related decline in vagal activity in MS patients, impacting autonomic responses.
Area of Science:
- Cardiovascular Physiology
- Autonomic Nervous System Function
- Neuroimmunology
Background:
- Cardiovascular signal analysis offers noninvasive autonomic function assessment.
- Multiple Sclerosis (MS) patients often experience fatigue, potentially linked to autonomic dysfunction.
- Understanding autonomic responses in MS is crucial for managing fatigue.
Purpose of the Study:
- To investigate autonomic nervous system (ANS) responses to postural change in MS patients with fatigue.
- To compare sympathovagal balance between MS patients and healthy controls during the transition from supine to standing.
- To explore age-related differences in autonomic regulation within the MS group.
Main Methods:
- Employed time-dependent frequency decomposition of cardiovascular signals (heart rate, blood pressure, blood flow).
- Assessed autonomic activity during a supine-to-standing maneuver in MS patients and age-matched controls.
- Analyzed spectral estimates, including low-frequency (LF) and high-frequency (HF) components, and their ratio (LF/HF) for sympathovagal balance.
Main Results:
- No significant differences in mean cardiovascular parameters or LF/HF ratio were found between groups at rest or immediately upon standing.
- Control subjects exhibited a significant increase in LF/HF ratio and normalized LF power upon standing, indicating a healthy sympathovagal response.
- MS patients showed a blunted increase in these sympathovagal balance indicators, suggesting impaired autonomic adjustment to postural change.
- An age-dependent reduction in vagal activity was observed in the MS group, but not in controls, implying accelerated aging of the autonomic system in MS.
Conclusions:
- Patients with MS and fatigue exhibit an impaired sympathovagal balance response to standing.
- This impairment may stem from an age-related decline in vagal activity occurring earlier in MS patients.
- Findings highlight potential autonomic dysregulation contributing to fatigue in MS and suggest further research in larger, diverse cohorts.
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