Cardiac Autonomic Modulation in Subjects with Amyotrophic Lateral Sclerosis (ALS) during an Upper Limb Virtual...

Area of Science:

• Neuroscience
• Cardiology
• Rehabilitation Medicine

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease impacting functionality and independence.
• Autonomic dysfunction is a recognized comorbidity in ALS patients.
• Virtual reality (VR) is increasingly used in healthcare, but its application in ALS intervention is novel and requires investigation.

Purpose of the Study:

• To evaluate the autonomic function of individuals with ALS during a VR task.
• To compare the autonomic responses of ALS patients and a healthy control group (CG) before, during, and after VR exposure.

Main Methods:

• Autonomic function analysis using heart rate variability (HRV) measurements via Polar® RS800CX.
• Participants completed the ALS Functional Rating Scale-Revised (ALSFRS) and Fatigue Severity Scale (FSS).
• Measurements were taken in a sitting position over three 10-minute periods: rest, VR activity, and recovery.

Main Results:

• The ALS group demonstrated significantly reduced HRV compared to the CG, with indices suggesting sympathetic nervous system dominance.
• The CG exhibited vagal withdrawal and heart rate changes indicative of autonomic adaptation during VR and recovery.
• Individuals with ALS showed no significant alterations in HRV or heart rate across rest, VR activity, and recovery phases.

Conclusions:

• Patients with ALS present with diminished HRV and sympathetic predominance compared to healthy individuals.
• ALS patients lack the autonomic nervous system adaptability observed in the CG during VR therapy and subsequent recovery.
• These findings highlight potential autonomic system deficits in ALS that may impact responses to novel therapeutic interventions like VR.