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Cardiovascular autonomic dysfunction in multiple sclerosis is likely related to brainstem lesions
1Clinica Neurologica 2, Università di Messina, Policlinico Universitario, Italy.
Journal of the Neurological Sciences
|December 1, 1993
Summary
Cardiovascular autonomic reflex impairment is common in multiple sclerosis (MS). Autonomic dysfunction in MS is linked to brainstem lesions, identified through Bayesian analysis of autonomic tests and MRI scans.
Area of Science:
- Neurology
- Autonomic Neuroscience
Background:
- Cardiovascular autonomic reflex impairment is a known complication in multiple sclerosis (MS).
- This dysfunction is thought to stem from damage to central nervous system reflex pathways.
Purpose of the Study:
- To investigate cardiovascular autonomic reflex function in patients with definite MS.
- To correlate autonomic dysfunction with clinical and MRI findings, particularly brainstem lesions.
Main Methods:
- 40 patients with definite MS underwent a battery of cardiovascular autonomic function tests.
- Tests included R-R interval variation, deep breathing, Valsalva maneuver, postural responses, and sustained handgrip.
- Bayesian analysis was used for evaluation, alongside brain and cervical spinal cord MRI.
Main Results:
- Deep breathing and sustained handgrip tests showed the highest abnormality rates (17.5% and 40%).
- Bayesian analysis identified definite autonomic dysfunction in 17.5% of patients.
- A significant correlation was found between autonomic dysfunction, clinical scores (Kurtzke brainstem FS), and MRI evidence of brainstem lesions.
Conclusions:
- Autonomic dysfunction is present in a subset of MS patients.
- Bayesian analysis effectively identifies autonomic dysfunction.
- Brainstem lesions are significantly associated with cardiovascular autonomic dysfunction in MS.