Circadian Activity Rhythm in Early Relapsing–Remitting Multiple Sclerosis

Abstract

While relapsing–remitting is the most prevalent course of multiple sclerosis, the prognostic/predictive markers of the worsening of symptomatology are still debated. With reference to other diseases, the study of the circadian activity rhythm, according to the theoretical framework of the two-process model of sleep regulation and applying functional linear modeling, proved to be useful to identify a possible marker. The usefulness of the study of circadian activity rhythm in multiple sclerosis is strengthened by recent findings indicating a potential involvement of circadian factors in the multifactorial etiopathology of the disorder. The aim of the present study was to verify whether circadian activity rhythm of early relapsing–remitting multiple sclerosis patients presents specific alterations, through functional linear modeling. Thirty-five relapsing–remitting multiple sclerosis patients (24 females; mean age ± SD = 31.51 ± 7.74) and 35 healthy controls (24 females; mean age ± SD = 31.29 ± 8.02) were enrolled. They wore an actigraph around the non-dominant wrist for one week. Relapsing–remitting multiple sclerosis patients showed a peak in motor activity around 5:00 a.m., higher than that of healthy controls. The timing of the peak in motor activity in the patients could be explained according to the hyperactive hypothalamus-pituitary-adrenal axis and higher cortisol awakening response reported in these patients.

Relationship between circadian rhythm characteristics and chronotypes with multiple sclerosis: literature review

“…IS pa to ge ne zës gran di mi. Ðia hi po te ze bû tø ga li ma pa aið kin ti ir di des ná IS pa pli ti mà ge og ra fi në se pla tu mo se, ku rio se nau do ja mas "va sa ros laikas" -vie nas ið cir ka di ná rit mà trik dan èiø fak to riø [32].…”

A Pilot Study of 24-h Motor Activity Patterns in Multiple Sclerosis: Pre-Planned Follow-Up at 2 Years

“…The main general aim of the current prospective study was to determine whether the peculiar hyperactivity, previously reported in newly diagnosed patients with early RRMS [ 7 ], was related to a different disease course. Therefore, the main question we were trying to answer with the current study was: can this peculiar hyperactivity represent a prognostic/predictive motor marker of disease progression?…”

“…To compute some of the most commonly used sleep/wake measures, the definition of which can be found elsewhere [ 7 ], we examined the actigraphic files through the Action W 2.7.1150 software (Ambulatory Monitoring, Inc., Ardsley, NY, USA).…”

“…Based on these findings, we recently chose to perform a study aimed at verifying whether the 24-h motor activity pattern, recorded through actigraphy, of 35 early RRMS patients (less than 24 months from the diagnosis), presented specific alterations through a comparison with the 24-h motor activity pattern of 35 healthy controls matched for sex and age [ 7 ]. We chose to examine the 24-h motor activity pattern, through a statistical framework specifically developed for the analysis of actigraphic data (functional linear modeling, FLM) [ 8 ], because a previous study [ 9 ], examining the 24-h motor activity pattern through FLM, detected a potential trait marker of a different disease, namely the attention-deficit hyperactivity disorder.…”

Sleep disorders in patients with multiple sclerosis

“…The most common form of sleepdisordered breathing (SDB) is obstructive sleep apnoea (OSA). OSA is a con dition consisting of multiple episodes of apnoea during CAR in patients with MS, conflicting results were obtained (Tonetti et al 2019). The study by Taphoorn et al (1993) therapy modulating the course of the disease over 6 months, no exacerbations and steroid therapy during the last month, no night shift work, no coexisting chronic and psychiatric diseases, no observed sleep disorders, no motor disorders, no use of psychoactive substances.…”