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Related Experiment Videos

Autonomic dysfunction in multiple sclerosis: correlation with disease-related parameters.

Dilek I Gunal1, Nazire Afsar, Tulin Tanridag

  • 1Department of Neurology, Marmara University Hospital, Istanbul, Turkey. incegunal@yahoo.com

European Neurology
|July 26, 2002
PubMed
Summary

Cardiovascular autonomic dysfunction is common in multiple sclerosis (MS), affecting nearly all patients symptomatically. Autonomic function testing is crucial for detecting subclinical changes, especially in patients with longer disease duration.

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Area of Science:

  • Neurology
  • Autonomic Neuroscience

Background:

  • Multiple sclerosis (MS) is a chronic neurological disease affecting the central nervous system.
  • Autonomic dysfunction is a recognized complication of MS, impacting cardiovascular regulation.
  • Standard assessments like the Expanded Disability Status Scale (EDSS) may not fully capture autonomic involvement.

Purpose of the Study:

  • To investigate cardiovascular autonomic functions in relapsing-remitting multiple sclerosis (MS) patients.
  • To correlate autonomic dysfunction with disease parameters like EDSS and disease duration.
  • To evaluate the utility of autonomic function testing in MS management.

Main Methods:

  • Prospective, controlled study involving 22 MS patients and 22 healthy controls.
  • Utilized 5 noninvasive cardiovascular autonomic function tests (heart rate response to deep breathing, Valsalva maneuver, standing; blood pressure response to standing, sustained hand grip).

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  • Included sympathetic skin response (SSR) testing and grading using the Ewing and Clark classification.

    • Main Results:

    • 90% of MS patients reported symptoms of autonomic dysfunction.
    • 45.5% of MS patients exhibited abnormal cardiovascular autonomic function test results; 4 also had abnormal SSR.
    • Longer disease duration, rather than higher EDSS scores, was associated with a higher risk of autonomic involvement.

    Conclusions:

    • Both parasympathetic and sympathetic functions are frequently impaired in MS patients.
    • Autonomic dysfunction in MS can be subclinical and may be overlooked by standard EDSS follow-up.
    • Autonomic function testing is essential for detecting subclinical changes and should be considered in MS outcome measures.