Cardiovascular Autonomic Dysfunction: Link Between Multiple Sclerosis Osteoporosis and Neurodegeneration

Area of Science:

• Neurology
• Endocrinology
• Bone Biology

Background:

• Multiple sclerosis (MS) is frequently associated with osteoporosis, often attributed to immobility or medications.
• Emerging evidence suggests a link between cardiovascular autonomic nervous system (ANS) dysfunction and reduced bone mass density (BMD) in MS.
• The complex interplay between MS, ANS function, and bone metabolism warrants further investigation.

Purpose of the Study:

• To review the intricate regulation of bone homeostasis in the context of multiple sclerosis.
• To explore the potential role of autonomic nervous system (ANS) dysfunction in the development of low bone mass density (BMD) in MS patients.
• To examine the relationship between ANS dysfunction, bone remodeling, and other MS-related comorbidities.

Main Methods:

• Literature review synthesizing current research on MS, ANS function, and bone metabolism.
• Analysis of the mechanisms by which ANS dysfunction may influence bone remodeling mediators.
• Correlation of ANS dysfunction and low BMD with MS inflammatory and neurodegenerative processes.

Main Results:

• Autonomic nervous system (ANS) dysfunction is identified as a significant factor potentially contributing to reduced bone mass density (BMD) in multiple sclerosis (MS).
• ANS dysfunction is intricately linked with MS-related inflammation, neurodegeneration, and comorbidities such as depression, fatigue, and migraine.
• Alterations in neuronal, systemic, and local mediators of bone remodeling are implicated in the MS-osteoporosis relationship.

Conclusions:

• Autonomic nervous system (ANS) dysfunction is a critical, under-recognized factor in the high prevalence of osteoporosis among multiple sclerosis (MS) patients.
• Targeting ANS dysfunction presents a promising therapeutic strategy to mitigate MS-related osteoporosis and potentially slow disease progression.
• Improving ANS function could significantly enhance the quality of life for individuals living with multiple sclerosis.