Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS

Saari, Anne; Tolonen, U.; Pääkkö, Eija; Suominen, Kalervo; Pyhtinen, J.; Sotaniemi, K. A.; Myllylä, Vilho V.

doi:10.1016/j.clinph.2004.01.012

Cited by 62 publications

(53 citation statements)

References 32 publications

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“…No significant differences were observed in SBP and DBP measures between the 2 groups, which are not in agreement with Saari et al who found significant decrease in blood pressure in patients with MS compared to healthy controls. 8 Although, not significant, there was a trend toward better arterial compliance in the healthy older control group for C1 and C2 compared to RR-MS and older SP-MS groups (although not significantly older).…”

Section: Discussionmentioning

confidence: 93%

“…Several studies have previously reported occurrence of up to as much as 90% of cardiovascular autonomic dysfunction in those diagnosed with MS [6][7][8][26][27][28][29][30][31][32] and has been linked to brainstem lesions, 26,31 particularly in the midbrain. 8 Other documented effects include orthostatic intolerance, 27,33 disease duration, 28 increased Expanded Disability Status Score, 26 progression of clinical disability 6,34 as well as severity of MS. 29 The main limitation of this study is the crosssectional design, which does not establish a cause and effect relationship between arterial compliance and MS. Another limitation is that the PCA is a noninvasive measure of C1 and C2, and an invasive measure would be more precise.…”

Section: Discussionmentioning

confidence: 99%

“…8 Other documented effects include orthostatic intolerance, 27,33 disease duration, 28 increased Expanded Disability Status Score, 26 progression of clinical disability 6,34 as well as severity of MS. 29 The main limitation of this study is the crosssectional design, which does not establish a cause and effect relationship between arterial compliance and MS. Another limitation is that the PCA is a noninvasive measure of C1 and C2, and an invasive measure would be more precise.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 There are few studies done in MS and those have looked almost exclusively at the autonomic system. [6][7][8][9] Changes in the peripheral arterial structure and function, such as thickening of the vessel wall, decreased small (C2) and large arterial compliance (C1), and reduction in distensibility of the large arteries, 5 are associated with aging [10][11][12] even in healthy adults, 13 more seen in women. 14 Arterial compliance is defined as the arteries' ability to expand and recoil along with cardiac pulsation and relaxation.…”

Section: Introductionmentioning

confidence: 99%

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Arterial Compliance in Multiple Sclerosis: A Pilot Study

et al. 2009

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A reduction in arterial compliance in patients with autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus has been previously reported. It is caused by the effect that systemic inflammation has on the cardiovascular system. Multiple sclerosis (MS), an immune-mediated disease that exclusively affects the central nervous system (CNS), has a significant inflammatory component that is limited to that compartment. The potential effects of its inflammatory mediators in the cardiovascular system are largely unknown. Purpose: To examine large (C1) and small arterial compliance (C2) in patients with MS and compare them with healthy age-matched controls. To also determine whether any differences in C1 and C2 indices between participants diagnosed with relapsing remitting MS (RR-MS), secondary progressive MS (SP-MS), and controls exist. Methods: A total of 26 men and women between the ages of 18 and 64 diagnosed with MS and 25 healthy controls volunteered for this study. Arterial compliance was measured by using pulse contour analysis (PCA), which records and analyzes the blood pressure waveform data from the Arterial Pulse Wave Sensors. Results: Significant differences in C1 and C2 were found between young RR-MS and healthy young controls (P < .05), with the MS group showing lower arterial C1 and C2 compliance. No significant differences (P > .05) were seen for C1 or C2 values between older RR-MS, SP-MS, and healthy controls. Conclusion: Arterial compliance is significantly compromised in young individuals with MS, compared with age-matched controls, but not for older individuals, suggesting a systemic effect of an inflammatory process that predominantly affects the CNS.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Arterial Compliance in Multiple Sclerosis: A Pilot Study

et al. 2009

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“…Autonomic dysfunction (AD) in MS is explained by presence of lesions in regions responsible for autonomic regulation, such as nuclei in the periventricular region of fourth ventricle in the brainstem as well as medullar lesions [4,5]. The total MRI brain MS lesion load is another pathologic substrate related to AD incidence as demonstrated by Saari et al [6]. On the other hand, AD has been related to MRI findings of cervical spinal cord atrophy rather than the presence of demyelinating lesions in that region, postulating that AD results not solely from demyelination but from axonal loss as well [7].…”

Section: Introductionmentioning

confidence: 99%

Autonomic dysfunction in multiple sclerosis

Adamec

Habek

2013

Clinical Neurology and Neurosurgery

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Cerebral lesion correlates of sympathetic cardiovascular activation in multiple sclerosis

Winder

Linker

Seifert

et al. 2019

Human Brain Mapping

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Cardiovascular autonomic dysfunction is common in multiple sclerosis (MS) and contributes significantly to disability. We hypothesized that cerebral MS‐lesions in specific areas of the central autonomic network might account for imbalance of the sympathetic and parasympathetic cardiovascular modulation. Therefore, we used voxel‐based lesion symptom mapping (VLSM) to determine associations between cardiovascular autonomic dysfunction and cerebral MS‐related lesion sites. In 74 MS‐patients (mean age 37.0 ± 10.5 years), we recorded electrocardiographic RR‐intervals and systolic and diastolic blood pressure. Using trigonometric regressive spectral analysis, we assessed low (0.04–0.15 Hz) and high (0.15–0.5 Hz) frequency RR‐interval‐and blood pressure‐oscillations and determined parasympathetically mediated RR‐interval–high‐frequency modulation, mainly sympathetically mediated RR‐interval–low‐frequency modulation, sympathetically mediated blood pressure‐low‐frequency modulation, and the ratios of sympathetic and parasympathetic RR‐interval‐modulation as an index of sympathetic‐parasympathetic balance. Cerebral MS‐lesions were analyzed on imaging scans. We performed a VLSM‐analysis correlating parameters of autonomic dysfunction with cerebral MS‐lesion sites. The VLSM‐analysis showed associations between increased RR‐interval low‐frequency/high‐frequency ratios and lesions most prominently in the left insular, hippocampal, and right frontal inferior opercular region, and a smaller lesion cluster in the right middle cerebellar peduncle. Increased blood pressure‐low‐frequency powers were associated with lesions primarily in the right posterior parietal white matter and again left insular region. Our data indicate associations between a shift of cardiovascular sympathetic‐parasympathetic balance toward increased sympathetic modulation and left insular and hippocampal lesions, areas of the central autonomic network. The VLSM‐analysis further distinguished between right inferior fronto‐opercular lesions disinhibiting cardiac sympathetic activation and right posterior parietal lesions increasing sympathetic blood pressure modulation.

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Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS

Cited by 62 publications

References 32 publications

Arterial Compliance in Multiple Sclerosis: A Pilot Study

Arterial Compliance in Multiple Sclerosis: A Pilot Study

Autonomic dysfunction in multiple sclerosis

Cerebral lesion correlates of sympathetic cardiovascular activation in multiple sclerosis

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