Sweating impairment in patients with multiple sclerosis

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

doi:10.1111/j.1600-0404.2009.01164.x

Cited by 27 publications

(22 citation statements)

References 25 publications

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“…Furthermore, more than half of the patients from this group had secretomotor symptoms, such as trouble with general body sweating, dry eyes or dry mouth, which is consistent with sudomotor regulation failure found in other studies. 20,21 Bladder disturbances were also common as expected, since they occur frequently during the course of the disease. 18,22 These symptoms often cause social embarrassment and may have a severe impact on quality of life.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

et al. 2015

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(1):51-55 RESUMOIntrodução: A disfunção do sistema nervoso autónomo é comum na esclerose múltipla e deveria ser explorada na avaliação de rotina. O questionário Composite Autonomic Symptom Score foi validado como instrumento de auto-avaliação de sintomas autonómicos. Objetivos: Determinar a frequência de sintomas autonómicos em doentes com esclerose múltipla através de uma versão portuguesa do Composite Autonomic Symptom Score; comparar os resultados do questionário entre um grupo de doentes e um grupo controlo; avaliar a viabilidade da aplicação deste questionário em doentes portugueses. Material e Métodos: Neste estudo caso-controlo utilizou-se uma tradução portuguesa do questionário para determinar a frequência de sintomas autonómicos em doentes com esclerose múltipla. Resultados: Incluíram-se 103 doentes com esclerose múltipla surto-remissão -idade média 41 anos, mediana de duração da doença 6 anos, EDSS médio 1 -e 80 indivíduos saudáveis. Dos doentes, 97,1% tinham alterações da função autonómica, com significado estatístico nos domínios intolerância ortostática e gastrointestinal. Não encontramos diferenças estatísticas entre doentes (41,7%) sem fatores de confundimento que podiam interferir com a função autonómica (i.e. comorbilidades ou medicações) e o grupo controlo. Discussão: Os resultados obtidos podem estar relacionados com a curta duração de doença, idade jovem e baixo grau de incapacidade dos doentes sem fatores de confundimento. O questionário utilizado não foi desenhado especificamente para a esclerose múltipla e pode não ser tão sensível para sintomas autonómicos mais precoces como para manifestações mais graves da doença. Conclusões: Outros estudos serão necessários para obter resultados mais robustos, validar este questionário e avaliar a sua aplicação nos doentes portugueses. Palavras-chave: Esclerose Múltipla; Portugal; Questionários; Sistema Nervoso Autónomo. ABSTRACT Background:Autonomic nervous system dysfunction is commonly seen in multiple sclerosis patients and should be explored in the routine evaluation. Composite Autonomic Symptom Score questionnaire was validated as a self-assessment instrument of autonomic symptoms. Objectives: Determine the frequency of autonomic symptoms in multiple sclerosis patients through a Portuguese version of Composite Autonomic Symptom Score; compare questionnaire results between patients and a control group; assess the feasibility of this questionnaire application in multiple sclerosis Portuguese patients. Material and Methods:This case-control study used a Portuguese translated version of Composite Autonomic Symptom Score to determine the frequency of autonomic symptoms in multiple sclerosis patients. Results: One-hundred and three relapsing-remitting multiple sclerosis patients -median age 41 years, median disease duration 6 years, median EDSS score 1 -and 80 healthy subjects were included. Alterations in autonomic function were reported in 97.1% of the cases, with statistical significance in orthostatic intolerance and gastrointestinal domain scores....

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Section: Discussionmentioning

confidence: 99%

Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

et al. 2015

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“…Saari and colleagues (65) have reported impaired sweating responses in the lower limbs of MS patients compared with healthy controls during a 15-min passive heat stress of the upper torso. Alternatively, no sweating impairments were reported in a group of MS patients with optic neuritis exposed to the same passive heating paradigm (64).…”

Section: Thermoregulatory Effector Responses In Msmentioning

confidence: 99%

Thermoregulation in multiple sclerosis

Davis

Wilson

White

et al. 2010

Journal of Applied Physiology

149

147

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Davis SL, Wilson TE, White AT, Frohman EM. Thermoregulation in multiple sclerosis. J Appl Physiol 109: 1531-1537. First published July 29, 2010 doi:10.1152/japplphysiol.00460.2010.-Multiple sclerosis (MS) is a progressive neurological disorder that disrupts axonal myelin in the central nervous system. Demyelination produces alterations in saltatory conduction, slowed conduction velocity, and a predisposition to conduction block. An estimated 60 -80% of MS patients experience temporary worsening of clinical signs and neurological symptoms with heat exposure. Additionally, MS may produce impaired neural control of autonomic and endocrine functions. This review focuses on five main themes regarding the current understanding of thermoregulatory dysfunction in MS: 1) heat sensitivity; 2) central regulation of body temperature; 3) thermoregulatory effector responses; 4) heat-induced fatigue; and 5) countermeasures to improve or maintain function during thermal stress. Heat sensitivity in MS is related to the detrimental effects of increased temperature on action potential propagation in demyelinated axons, resulting in conduction slowing and/or block, which can be quantitatively characterized using precise measurements of ocular movements. MS lesions can also occur in areas of the brain responsible for the control and regulation of body temperature and thermoregulatory effector responses, resulting in impaired neural control of sudomotor pathways or neural-induced changes in eccrine sweat glands, as evidenced by observations of reduced sweating responses in MS patients. Fatigue during thermal stress is common in MS and results in decreased motor function and increased symptomatology likely due to impairments in central conduction. Although not comprehensive, some evidence exists concerning treatments (cooling, precooling, and pharmacological) for the MS patient to preserve function and decrease symptom worsening during heat stress. demyelination; core temperature; sweating; skin blood flow; fatigue MULTIPLE SCLEROSIS (MS) is a disabling progressive neurological disorder affecting ϳ400,000 individuals in the United States. The pathophysiology of MS results in a disruption or loss of axonal myelin in the central nervous system (CNS), leading to the formation of scar tissue (sclerosis). MS is thought to involve a number of autoimmune injury cascades that appear to be dependent on the interaction of complex epigenetic and environmental factors. Immune responses in individuals with MS are skewed toward a proinflammatory state, resulting in inflammation, demyelination, and ultimately loss of axons and disorganization of normal tissue architecture within the CNS (23). Demyelination is associated with corresponding changes in axonal physiology, including a loss of saltatory properties of electrical conduction, reduction in conduction velocity, and a predisposition to conduction block. These pathophysiological mechanisms underlie the myriad of symptoms (Table 1) in individuals with MS and are contingent on the neuroanatomic l...

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“…A number of techniques, including water perfusion suit, hot baths, heat lamps, thermoelectronic blankets, or thermo packages have been used to induce temperature-related alterations in MS subjects [9,[11][12][13]. In Finland, the entire population is accustomed to regular short-term heat stress in the form of sauna-bathing.…”

Section: Introductionmentioning

confidence: 99%