[Autonomic dysfunction in patients with multiple sclerosis]

Area of Science:

• Neurology
• Autonomic Neuroscience
• Medical Diagnostics

Background:

• Autonomic dysfunction is a common complication in multiple sclerosis (MS).
• Early and accurate diagnosis of autonomic nervous system (ANS) disorders is essential for managing MS patients.
• Current diagnostic methods may not be optimal for widespread screening in MS populations.

Purpose of the Study:

• To optimize the early diagnosis of autonomic dysfunction in patients with multiple sclerosis (MS).
• To evaluate the utility of a specific screening scheme and heart rate variability (HRV) analysis for detecting ANS disorders in MS.

Main Methods:

• Study included 46 MS patients (mean age 33.35±9.9 years, EDSS 2.8±1.17) and 24 healthy controls.
• Autonomic nervous system function was assessed using the Scheme for detection of signs of autonomic disorders and heart rate variability (HRV) analysis.
• HRV was measured at rest and during an active orthostatic test (AOT).

Main Results:

• Autonomic dysfunction was identified in 73% of MS patients.
• MS patients showed significantly higher scores on the screening scheme compared to controls (31.32±9.43 vs. 2.36±4.39, p<0.05).
• HRV analysis revealed reduced brainstem autonomic center contribution during AOT and sympathetic nervous system underactivation in MS patients. Cerebral influences dominated baseline HRV in MS patients.

Conclusions:

• The screening scheme is a valuable tool for outpatient clinics to efficiently screen large numbers of MS patients for autonomic dysfunction.
• Patients identified through screening can be further evaluated using instrumental diagnostic methods.
• Combined use of screening and HRV analysis aids in early detection and characterization of autonomic disorders in MS.