Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis
Objective The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease ac...
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| Veröffentlicht in: | Clinical autonomic research 2016-12, Vol.26 (6), p.385-393 |
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| creator | Habek, Mario Crnošija, Luka Lovrić, Mila Junaković, Anamari Krbot Skorić, Magdalena Adamec, Ivan |
| description | Objective
The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease activity.
Methods
CASS, HRV and plasma catecholamines during supine and tilted phase were performed in 104 CIS patients. MRI findings were analyzed for total number of lesions and the presence of brainstem and cervical spinal cord lesions.
Results
Autonomic dysfunction (CASS >1) was present in 59.8 % of patients, parasympathetic dysfunction in 5 %, sympathetic in 42.6 % and sudomotor in 32.7 % of patients. Patients with autonomic dysfunction on CASS had lower level of norepinephrine in the supine position compared to patients without autonomic dysfunction (1.06 ± 0.53 vs. 1.37 ± 0.86,
p
= 0.048). The CASS score showed positive correlation with s-HF (
r
= 0.226,
p
= 0.031), s-SDNN (
r
= 0.221,
p
= 0.035), t-HF (
r
= 0.225,
p
= 0.032), and t-HFnu (
r
= 0.216,
p
= 0.04), and a negative correlation with t-LF/HF (
r
= −0.218,
p
= 0.038). More patients with MRI brainstem lesions had a positive adrenergic index (
p
= 0.038). Patients with MRI brainstem lesions also had a lower t-SDNN (26.2 ± 14.2 vs. 32 ± 13.3,
p
= 0.036) and a lower t-LF (median 415.0 vs. 575.5,
p
= 0.018) compared to patients without these lesions. Patients with adrenergic index ≥1 had a significantly higher standing heart rate compared to patients with an adrenergic index of 0 (96 ± 13.5 vs. 90 ± 12,
p
= 0.032).
Conclusion
Autonomic (primarily sympathetic) dysfunction is present in a large proportion of early MS patients and it seems to be related to brainstem involvement. |
| doi_str_mv | 10.1007/s10286-016-0370-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1846414210</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826734603</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-f534f06ebfebe02d33bdc49531cbb4ebc32f8b6449583339cf155b85cf1615ed3</originalsourceid><addsrcrecordid>eNqNkUtr3TAQRkVoSW4eP6CbIugmG7ca62F5WUKbBgJZpFkLSR6lDrZ1I8kl999X4aYlFApdiIHRmU8aDiHvgH0ExrpPGVirVcOgHt6x5umAbEBB34BU7A3ZsF72Ta8lHJHjnB8YA6k5HJKjthNCy05tSLjdzVtbfmAZPfU2DWP8abNfJ5uoXQaa1yHOscREw7r4MsYlU5uQhoSPKy5l2lEbAvqCAx0XijbVzrxOZdxOSLOfMMU85lPyNtgp49lLPSF3X798v_jWXN9cXl18vm68YLI0QXIRmEIX0CFrB87d4EUvOXjnBDrP26CdErWlOee9DyCl07JWBRIHfkLO97nbFOv_cjHzmD1Ok10wrtmAFkqAaIH9B9qqjgvFeEU__IU-xDUtdZFK8U73mrVQKdhTvq6cEwazTeNs084AM8--zN6Xqb7Msy_zVGfevySvbsbhz8RvQRVo90CuV8s9pldP_zP1F1dRomw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837898021</pqid></control><display><type>article</type><title>Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Habek, Mario ; Crnošija, Luka ; Lovrić, Mila ; Junaković, Anamari ; Krbot Skorić, Magdalena ; Adamec, Ivan</creator><creatorcontrib>Habek, Mario ; Crnošija, Luka ; Lovrić, Mila ; Junaković, Anamari ; Krbot Skorić, Magdalena ; Adamec, Ivan</creatorcontrib><description>Objective
The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease activity.
Methods
CASS, HRV and plasma catecholamines during supine and tilted phase were performed in 104 CIS patients. MRI findings were analyzed for total number of lesions and the presence of brainstem and cervical spinal cord lesions.
Results
Autonomic dysfunction (CASS >1) was present in 59.8 % of patients, parasympathetic dysfunction in 5 %, sympathetic in 42.6 % and sudomotor in 32.7 % of patients. Patients with autonomic dysfunction on CASS had lower level of norepinephrine in the supine position compared to patients without autonomic dysfunction (1.06 ± 0.53 vs. 1.37 ± 0.86,
p
= 0.048). The CASS score showed positive correlation with s-HF (
r
= 0.226,
p
= 0.031), s-SDNN (
r
= 0.221,
p
= 0.035), t-HF (
r
= 0.225,
p
= 0.032), and t-HFnu (
r
= 0.216,
p
= 0.04), and a negative correlation with t-LF/HF (
r
= −0.218,
p
= 0.038). More patients with MRI brainstem lesions had a positive adrenergic index (
p
= 0.038). Patients with MRI brainstem lesions also had a lower t-SDNN (26.2 ± 14.2 vs. 32 ± 13.3,
p
= 0.036) and a lower t-LF (median 415.0 vs. 575.5,
p
= 0.018) compared to patients without these lesions. Patients with adrenergic index ≥1 had a significantly higher standing heart rate compared to patients with an adrenergic index of 0 (96 ± 13.5 vs. 90 ± 12,
p
= 0.032).
Conclusion
Autonomic (primarily sympathetic) dysfunction is present in a large proportion of early MS patients and it seems to be related to brainstem involvement.</description><identifier>ISSN: 0959-9851</identifier><identifier>EISSN: 1619-1560</identifier><identifier>DOI: 10.1007/s10286-016-0370-x</identifier><identifier>PMID: 27448576</identifier><identifier>CODEN: CAURE9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Blood Pressure ; Brain Stem - diagnostic imaging ; Cardiology ; Cardiovascular System - physiopathology ; Catecholamines - blood ; Cross-Sectional Studies ; Diabetes ; Endocrinology ; Female ; Gastroenterology ; Heart Rate ; Humans ; Magnetic Resonance Imaging ; Male ; Medicine ; Medicine & Public Health ; Multiple Sclerosis - complications ; Multiple Sclerosis - diagnostic imaging ; Multiple Sclerosis - physiopathology ; Neurology ; Ophthalmology ; Reflex ; Research Article ; Supine Position - physiology ; Sweat Gland Diseases - etiology ; Sweat Gland Diseases - physiopathology ; Sweat Glands - physiopathology ; Sympathetic Nervous System - physiopathology ; Valsalva Maneuver</subject><ispartof>Clinical autonomic research, 2016-12, Vol.26 (6), p.385-393</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-f534f06ebfebe02d33bdc49531cbb4ebc32f8b6449583339cf155b85cf1615ed3</citedby><cites>FETCH-LOGICAL-c405t-f534f06ebfebe02d33bdc49531cbb4ebc32f8b6449583339cf155b85cf1615ed3</cites><orcidid>0000-0002-3360-1748</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10286-016-0370-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10286-016-0370-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27448576$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Habek, Mario</creatorcontrib><creatorcontrib>Crnošija, Luka</creatorcontrib><creatorcontrib>Lovrić, Mila</creatorcontrib><creatorcontrib>Junaković, Anamari</creatorcontrib><creatorcontrib>Krbot Skorić, Magdalena</creatorcontrib><creatorcontrib>Adamec, Ivan</creatorcontrib><title>Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis</title><title>Clinical autonomic research</title><addtitle>Clin Auton Res</addtitle><addtitle>Clin Auton Res</addtitle><description>Objective
The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease activity.
Methods
CASS, HRV and plasma catecholamines during supine and tilted phase were performed in 104 CIS patients. MRI findings were analyzed for total number of lesions and the presence of brainstem and cervical spinal cord lesions.
Results
Autonomic dysfunction (CASS >1) was present in 59.8 % of patients, parasympathetic dysfunction in 5 %, sympathetic in 42.6 % and sudomotor in 32.7 % of patients. Patients with autonomic dysfunction on CASS had lower level of norepinephrine in the supine position compared to patients without autonomic dysfunction (1.06 ± 0.53 vs. 1.37 ± 0.86,
p
= 0.048). The CASS score showed positive correlation with s-HF (
r
= 0.226,
p
= 0.031), s-SDNN (
r
= 0.221,
p
= 0.035), t-HF (
r
= 0.225,
p
= 0.032), and t-HFnu (
r
= 0.216,
p
= 0.04), and a negative correlation with t-LF/HF (
r
= −0.218,
p
= 0.038). More patients with MRI brainstem lesions had a positive adrenergic index (
p
= 0.038). Patients with MRI brainstem lesions also had a lower t-SDNN (26.2 ± 14.2 vs. 32 ± 13.3,
p
= 0.036) and a lower t-LF (median 415.0 vs. 575.5,
p
= 0.018) compared to patients without these lesions. Patients with adrenergic index ≥1 had a significantly higher standing heart rate compared to patients with an adrenergic index of 0 (96 ± 13.5 vs. 90 ± 12,
p
= 0.032).
Conclusion
Autonomic (primarily sympathetic) dysfunction is present in a large proportion of early MS patients and it seems to be related to brainstem involvement.</description><subject>Adult</subject><subject>Blood Pressure</subject><subject>Brain Stem - diagnostic imaging</subject><subject>Cardiology</subject><subject>Cardiovascular System - physiopathology</subject><subject>Catecholamines - blood</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multiple Sclerosis - complications</subject><subject>Multiple Sclerosis - diagnostic imaging</subject><subject>Multiple Sclerosis - physiopathology</subject><subject>Neurology</subject><subject>Ophthalmology</subject><subject>Reflex</subject><subject>Research Article</subject><subject>Supine Position - physiology</subject><subject>Sweat Gland Diseases - etiology</subject><subject>Sweat Gland Diseases - physiopathology</subject><subject>Sweat Glands - physiopathology</subject><subject>Sympathetic Nervous System - physiopathology</subject><subject>Valsalva Maneuver</subject><issn>0959-9851</issn><issn>1619-1560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkUtr3TAQRkVoSW4eP6CbIugmG7ca62F5WUKbBgJZpFkLSR6lDrZ1I8kl999X4aYlFApdiIHRmU8aDiHvgH0ExrpPGVirVcOgHt6x5umAbEBB34BU7A3ZsF72Ta8lHJHjnB8YA6k5HJKjthNCy05tSLjdzVtbfmAZPfU2DWP8abNfJ5uoXQaa1yHOscREw7r4MsYlU5uQhoSPKy5l2lEbAvqCAx0XijbVzrxOZdxOSLOfMMU85lPyNtgp49lLPSF3X798v_jWXN9cXl18vm68YLI0QXIRmEIX0CFrB87d4EUvOXjnBDrP26CdErWlOee9DyCl07JWBRIHfkLO97nbFOv_cjHzmD1Ok10wrtmAFkqAaIH9B9qqjgvFeEU__IU-xDUtdZFK8U73mrVQKdhTvq6cEwazTeNs084AM8--zN6Xqb7Msy_zVGfevySvbsbhz8RvQRVo90CuV8s9pldP_zP1F1dRomw</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Habek, Mario</creator><creator>Crnošija, Luka</creator><creator>Lovrić, Mila</creator><creator>Junaković, Anamari</creator><creator>Krbot Skorić, Magdalena</creator><creator>Adamec, Ivan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3360-1748</orcidid></search><sort><creationdate>20161201</creationdate><title>Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis</title><author>Habek, Mario ; Crnošija, Luka ; Lovrić, Mila ; Junaković, Anamari ; Krbot Skorić, Magdalena ; Adamec, Ivan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-f534f06ebfebe02d33bdc49531cbb4ebc32f8b6449583339cf155b85cf1615ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Blood Pressure</topic><topic>Brain Stem - diagnostic imaging</topic><topic>Cardiology</topic><topic>Cardiovascular System - physiopathology</topic><topic>Catecholamines - blood</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multiple Sclerosis - complications</topic><topic>Multiple Sclerosis - diagnostic imaging</topic><topic>Multiple Sclerosis - physiopathology</topic><topic>Neurology</topic><topic>Ophthalmology</topic><topic>Reflex</topic><topic>Research Article</topic><topic>Supine Position - physiology</topic><topic>Sweat Gland Diseases - etiology</topic><topic>Sweat Gland Diseases - physiopathology</topic><topic>Sweat Glands - physiopathology</topic><topic>Sympathetic Nervous System - physiopathology</topic><topic>Valsalva Maneuver</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Habek, Mario</creatorcontrib><creatorcontrib>Crnošija, Luka</creatorcontrib><creatorcontrib>Lovrić, Mila</creatorcontrib><creatorcontrib>Junaković, Anamari</creatorcontrib><creatorcontrib>Krbot Skorić, Magdalena</creatorcontrib><creatorcontrib>Adamec, Ivan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical autonomic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Habek, Mario</au><au>Crnošija, Luka</au><au>Lovrić, Mila</au><au>Junaković, Anamari</au><au>Krbot Skorić, Magdalena</au><au>Adamec, Ivan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis</atitle><jtitle>Clinical autonomic research</jtitle><stitle>Clin Auton Res</stitle><addtitle>Clin Auton Res</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>26</volume><issue>6</issue><spage>385</spage><epage>393</epage><pages>385-393</pages><issn>0959-9851</issn><eissn>1619-1560</eissn><coden>CAURE9</coden><abstract>Objective
The aim of this study was to determine the prevalence of autonomic dysfunction using the composite autonomic scoring scale (CASS) and heart rate variability (HRV) in patients with clinically isolated syndrome (CIS) and to correlate autonomic dysfunction with other measures of MS disease activity.
Methods
CASS, HRV and plasma catecholamines during supine and tilted phase were performed in 104 CIS patients. MRI findings were analyzed for total number of lesions and the presence of brainstem and cervical spinal cord lesions.
Results
Autonomic dysfunction (CASS >1) was present in 59.8 % of patients, parasympathetic dysfunction in 5 %, sympathetic in 42.6 % and sudomotor in 32.7 % of patients. Patients with autonomic dysfunction on CASS had lower level of norepinephrine in the supine position compared to patients without autonomic dysfunction (1.06 ± 0.53 vs. 1.37 ± 0.86,
p
= 0.048). The CASS score showed positive correlation with s-HF (
r
= 0.226,
p
= 0.031), s-SDNN (
r
= 0.221,
p
= 0.035), t-HF (
r
= 0.225,
p
= 0.032), and t-HFnu (
r
= 0.216,
p
= 0.04), and a negative correlation with t-LF/HF (
r
= −0.218,
p
= 0.038). More patients with MRI brainstem lesions had a positive adrenergic index (
p
= 0.038). Patients with MRI brainstem lesions also had a lower t-SDNN (26.2 ± 14.2 vs. 32 ± 13.3,
p
= 0.036) and a lower t-LF (median 415.0 vs. 575.5,
p
= 0.018) compared to patients without these lesions. Patients with adrenergic index ≥1 had a significantly higher standing heart rate compared to patients with an adrenergic index of 0 (96 ± 13.5 vs. 90 ± 12,
p
= 0.032).
Conclusion
Autonomic (primarily sympathetic) dysfunction is present in a large proportion of early MS patients and it seems to be related to brainstem involvement.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27448576</pmid><doi>10.1007/s10286-016-0370-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3360-1748</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0959-9851 |
| ispartof | Clinical autonomic research, 2016-12, Vol.26 (6), p.385-393 |
| issn | 0959-9851 1619-1560 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1846414210 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Blood Pressure Brain Stem - diagnostic imaging Cardiology Cardiovascular System - physiopathology Catecholamines - blood Cross-Sectional Studies Diabetes Endocrinology Female Gastroenterology Heart Rate Humans Magnetic Resonance Imaging Male Medicine Medicine & Public Health Multiple Sclerosis - complications Multiple Sclerosis - diagnostic imaging Multiple Sclerosis - physiopathology Neurology Ophthalmology Reflex Research Article Supine Position - physiology Sweat Gland Diseases - etiology Sweat Gland Diseases - physiopathology Sweat Glands - physiopathology Sympathetic Nervous System - physiopathology Valsalva Maneuver |
| title | Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis |
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