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Cardiac autonomic function in patients with early multiple sclerosis.

Richard Imrich1, Miroslav Vlcek2,3, Adela Penesova2

  • 1Institute of Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Dúbravská cesta 9, 84505, Bratislava, Slovakia. richard.imrich@savba.sk.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|March 5, 2021
PubMed
Summary

Early multiple sclerosis (MS) patients show normal cardiac autonomic function. This study investigated cardiac sympathetic and baroreflex cardiovagal responses in early MS, finding no significant differences compared to healthy controls.

Keywords:
DysautonomiaMultiple sclerosisParasympatheticSpectroscopySympathetic

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Area of Science:

  • Neurology
  • Cardiology
  • Autonomic Neuroscience

Background:

  • Cardiac autonomic dysfunction is known in advanced multiple sclerosis (MS).
  • Limited data exists on autonomic function in early MS.
  • White matter metabolic changes in MS may impact autonomic brain centers.

Purpose of the Study:

  • To evaluate cardiac autonomic function in early, treatment-naïve relapsing-remitting MS patients.
  • To correlate autonomic function with white matter metabolic status using MRSI.
  • To assess sympathetic and baroreflex cardiovagal responses.

Main Methods:

  • 16 early MS patients and 14 healthy controls underwent Valsalva maneuver, orthostatic testing, and Stroop test.
  • Proton magnetic resonance spectroscopic imaging (MRSI) assessed brain white matter metabolism.
  • Norepinephrine levels, heart rate, stroke volume, and blood pressure were monitored.

Main Results:

  • Valsalva maneuver results were similar between groups.
  • Early MS patients had lower baseline norepinephrine and higher heart rate, but similar blood pressure and cardiac output during orthostatic testing.
  • MRSI revealed altered brain white matter metabolite ratios (NAA/Cr, mI/Cr) in MS lesions.

Conclusions:

  • Early relapsing-remitting MS patients exhibit normal cardiac sympathetic and baroreflex cardiovagal function.
  • Autonomic function appears preserved in the early stages of MS, despite detectable white matter metabolic changes.