Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

Vieira, Bitia; Costa, Andreia; Videira, Gonçalo; Sá, María José; Abreu, Pedro

doi:10.20344/amp.5562

Cited by 16 publications

(13 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concerning the frequency of DS, we have shown that, using the COMPASS-31 questionnaire in adults, subtle ANS impairment in at least 1 domain is present in the majority (> 98%) of subjects, independently from the diagnosis of MS. On the contrary, the presence of a score > 0 in ≥ 2 domains was more common in MS patients compared with HC (94.8% vs. [15]. The most frequently involved domain in our MS population was the GI (90.7%).…”

Section: Discussionmentioning

confidence: 67%

Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31

et al. 2020

View full text Add to dashboard Cite

Background Dysautonomic symptoms (DS) are frequent but often underrecognized in multiple sclerosis (MS) patients, despite the relevant impact on quality of life and physical performance. Objectives To assess frequency and characteristics of DS in our MS population compared with healthy controls (HC). To investigate the relationship between DS and disease characteristics (MS subtype, disease duration, Expanded Disability Status Scale (EDSS), clinical and/or radiological activity, disability progression). Patients and methods Cross-sectional study includes 324 MS patients (mean age 44.9 ± 10.7 years; 66% female) and 190 HC (mean age 40.60 ± 12.83 years; 63% female). DS were assessed using the Italian validated version of the Composite Autonomic Symptom Score-31 (COMPASS-31). Possible confounding factors were considered. Results More than 94% of enrolled MS patients reported alterations in ≥ 2 domains of the COMPASS-31 scale (score > 0) and significantly higher COMPASS-31 total and single domain median scores compared with HC, independently from possible confounding factors (orthostatic intolerance: p = 0.001; vasomotor: p = 0.017; secretomotor: p = 0.040; gastrointestinal: p = 0.047; bladder: p < 0.001; pupillomotor: p < 0.001; COMPASS-31 total score: p < 0.001). COMPASS-31 total, secretomotor, gastrointestinal, and bladder domain scores showed weak to moderate correlation with disease duration (Rho = 0.19, p < 0.001; Rho = 0.18, p = 0.01; Rho = 0.25, p = 0.030; Rho = 0.28, p < 0.001, respectively). A moderate correlation between EDSS score, COMPASS-31 total, and bladder domain scores (Rho = 0.32, p < 0.001 and Rho = 0.48, p < 0.001, respectively) was observed. Progressive subtypes showed higher COMPASS-31 total (p = 0.025), gastrointestinal (p = 0.07), and bladder (p < 0.001) domain scores vs relapsing-remitting patients. Conclusions Our findings confirm that MS-related DS are frequent and tend to increase paralleling disease duration and clinical worsening, reaching the highest clinical impact in progressive subtypes.

show abstract

Section: Discussionmentioning

confidence: 67%

Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The main clinical symptoms connected with cardiovascular autonomic neuropathy are fatigue [ 59 , 60 ] and pathological responses to orthostatic challenge such as syncope, palpitation, dizziness, nausea, general weakness, hot flashes and sweating [ 61 , 62 , 63 , 64 , 65 , 66 ]. Symptoms associated with orthostatic dysregulation occur in up to 63% of the patients [ 61 , 62 , 63 , 64 , 65 , 66 ]. Postural orthostatic tachycardia syndrome (POTS), vasovagal syncope and orthostatic hypotension can be induced by tilt table test in MS patients [ 64 ].…”

Section: Cardiovascular Dysregulationmentioning

confidence: 99%

“…The area of bowel dysfunction is considered the “Cinderella” of MS research, although 40%–81% of the patients complain about functional loss in the gastrointestinal domain [ 66 , 105 ]. The most frequently reported gastrointestinal (GI) symptoms encompass anorectal dysfunction characterized by constipation (37%–68%) [ 105 , 106 ], fecal incontinence (15%–51%) [ 105 , 107 ] or the combination of these (23%) [ 108 ] and deglutitive problems such as dysphagia (21%) [ 105 ].…”

Section: Gastrointestinal Dysregulationmentioning

confidence: 99%

Autonomic Dysregulation in Multiple Sclerosis

Pintér

Cseh

Sárközi

et al. 2015

IJMS

View full text Add to dashboard Cite

Multiple sclerosis (MS) is a chronic, progressive central neurological disease characterized by inflammation and demyelination. In patients with MS, dysregulation of the autonomic nervous system may present with various clinical symptoms including sweating abnormalities, urinary dysfunction, orthostatic dysregulation, gastrointestinal symptoms, and sexual dysfunction. These autonomic disturbances reduce the quality of life of affected patients and constitute a clinical challenge to the physician due to variability of clinical presentation and inconsistent data on diagnosis and treatment. Early diagnosis and initiation of individualized interdisciplinary and multimodal strategies is beneficial in the management of autonomic dysfunction in MS. This review summarizes the current literature on the most prevalent aspects of autonomic dysfunction in MS and provides reference to underlying pathophysiological mechanisms as well as means of diagnosis and treatment.

show abstract

“…Autonomic dysfunction is common in patients with MS and affects the quality of life of patients 27 . Autonomic dysfunction affects the bowel, bladder and sexual functions as well as the cardiovascular system.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D, vitamin D binding protein, vitamin D receptor levels and cardiac dysautonomia in patients with multiple sclerosis: a cross-sectional study

Aktürk

Turan

Tanık

et al. 2019

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Vitamin D is a pleiotropic steroid hormone that modulates the autonomic balance. Its deficiency has been described as an environmental risk factor for multiple sclerosis (MS). The aim of this study was to investigate the serum levels of vitamin D, vitamin D binding protein (VDBP) and vitamin D receptors (VDR) and to evaluate cardiac dysautonomia in MS patients due to bidirectional interaction between vitamin D and the autonomic nervous system. Methods: The current cross-sectional study was conducted on 26 patients with relapsing-remitting MS and on 24 healthy controls. Twenty-four-hour ambulatory blood pressure variability (BPV) was calculated and the participants were evaluated for orthostatic hypotension and supine hypertension. Serum levels of vitamin D, VDBP and VDR were measured. Results: The mean serum vitamin D level was significantly lower in MS patients than in controls (p = 0.044); however there was no significant difference in terms of VDR and VDBP levels between the groups. Supine hypertension and orthostatic hypotension were significant and the 24-hour systolic BPV was significantly decreased in patients with MS (p < 0.05) compared to controls. No correlation was found between vitamin D, VDBP and VDR with supine hypertension, orthostatic hypotension and systolic BPV values (p > 0.05). Also, there was a negative correlation between VDBP and the EDSS (p = 0.039, r = −0.406). Conclusion: There was no correlation between orthostatic hypotension, supine hypertension and systolic BPV values and serum vitamin D, VDBP and VDR in MS patients. Future prospective studies with large number of patients may help us to better understand the relationship between vitamin D and the autonomic nervous system.

show abstract

Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

Cited by 16 publications

References 26 publications

Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31

Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31

Autonomic Dysregulation in Multiple Sclerosis

Vitamin D, vitamin D binding protein, vitamin D receptor levels and cardiac dysautonomia in patients with multiple sclerosis: a cross-sectional study

Contact Info

Product

Resources

About