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Autonomic and peripheral nervous system function in acute tick-borne encephalitis.

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Acute tick-borne encephalitis (TBE) affects the autonomic nervous system (ANS) and peripheral nervous system (PNS). TBE patients show signs of sympathovagal imbalance and reduced nerve function, similar to diabetic polyneuropathy.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Virology

Background:

  • Tick-borne encephalitis (TBE) is a growing flaviviral zoonosis in Europe.
  • TBE can manifest as meningitis, meningoencephalitis, or meningoencephalomyelitis.
  • Autonomic (ANS) and peripheral nervous system (PNS) dysfunction may cause acute and long-term TBE complications.

Purpose of the Study:

  • To investigate ANS and PNS involvement in acute TBE.
  • To compare TBE neurological effects with diabetic polyneuropathy (d-PNP) and healthy controls (HC).

Main Methods:

  • Prospective study of 14 acute TBE patients, 17 d-PNP patients, and 30 HC.
  • Assessed ANS/PNS function via heart rate variability (HRV) and sural/tibial nerve neurography.
  • Primary endpoint: HRV at rest (RMSSD). Autonomic symptoms and quality of life (QoL) were surveyed.

Main Results:

  • TBE patients exhibited significantly lower resting HRV (RMSSD) and increased sympathetic activity (LF/HF ratio), similar to d-PNP.
  • Reduced nerve conduction velocities and action potential amplitudes were observed in TBE patients compared to HC.
  • TBE patients reported more autonomic symptoms and lower QoL.

Conclusions:

  • Acute TBE impacts both the ANS and, to a lesser extent, the PNS.
  • This neurological involvement may contribute to TBE's short- and long-term morbidity.