Involvement of Autonomic Nervous System and its Relationship With Cranial and Cervical Spinal MRI Findings In Patients With Multiple Sclerosis

摘要

Background and Purpose: Multiple Sclerosis (MS) can be accompanied by autonomic dysfunction which has an important impact on the disability. The aim of this study was to compare the frequency of autonomic abnormalities in MS patients and controls using standard autonomic tests and heart rate variability. It was also aimed to seek any relationship between cranial and cervical spinal magnetic resonance imaging (MRI) findings with autonomic tests and heart rate variability.Methods: Twenty-four (68.6%) relapsing-remitting, eleven (31.4%) secondary progressive MS patients and 21 age matched controls were enrolled in the study. All subjects underwent standard autonomic function tests assessing parasympathetic (heart rate responses to Valsalva maneuver, deep breathing, and active change of posture) and sympathetic function (blood pressure responses to active change of posture) as well as heart rate variability analysis both for a 24-hour period and during tilt testing using Holter monitoring. To assess the relationship between autonomic abnormalities and MRI all the patients underwent cranial and cervical spinal MRI.Results: Our results showed that MS patients have decreased heart rate variability and diminished parasympathetic component of autonomic nervous system compared to controls. No significant association has been found between autonomic impairment in MS and the type and duration of the disease. There has been no significant relationship between MRI findings and autonomic involvement in MS.Conclusion: MS patients have autonomic dysregulation against parasympathetic component, a condition which has no significant relationship with cranial and cervical spinal MRI findings.