Heart rate variability analysis in patients with multiple sclerosis

Ozbek, Damla; Çinçin, Altuğ; Pinar, Kahraman Koytak; Kepez, A.; Dilek, Ince Gunal; Ağan, Kadriye

doi:10.1016/j.msard.2018.06.012

Cited by 28 publications

(27 citation statements)

References 21 publications

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“…Furthermore, in a prospective study of patients with CIS, a 2-year follow-up of autonomic function using CASS (n = 62) MRI activity was linked to CAD [17]. However, no significant relationship between location of MRI lesions and HRV analysis was seen in a Turkish study [50].…”

Section: Spinal Cord Lesionsmentioning

confidence: 90%

“…CAD has been associated with lesions in the brain, especially the brainstem. However, the data are partly contradictory and the currently available data are not sufficient for a generally valid statement [2,17,43,[46][47][48]50,53,64,80,85,86]. There is evidence that MS-related atrophy of the spinal cord correlates with CAD [46].…”

Section: Discussionmentioning

confidence: 99%

“…Impairment of autonomic control of HR was also found to be associated with disease duration (≤5 vs. >5 years: p ≤ 0.01 for all HRV variables except low-to high-frequency ratio) in a study including 39 patients with RRMS [49]. However, another study showed that HRV was already decreased in 51 patients with newly diagnosed RRMS compared with 44 age-and sex-matched controls [50]. On the other hand, a slightly diminished sympathetic response to a mental stress test, but unchanged response to orthostasis, was seen in 19 newly diagnosed untreated MS patients compared with 19 age-, sex-and body mass index-matched controls [51].…”

Section: Association With Ms Type and Disease Characteristicsmentioning

confidence: 90%

See 2 more Smart Citations

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Findling

Hauer

Pezawas

et al. 2020

JCM

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Cardiac autonomic dysfunction (CAD) has been reported in patients with multiple sclerosis (MS). This systematic review summarizes the evidence for the types and prevalence of CAD in MS patients, as well as its association with MS type, disease characteristics, fatigue and immunotherapies used to treat MS. The analysis revealed that CAD is correlated with pathophysiological processes of MS, can trigger serious cardiovascular complications that may reduce life expectancy, and may have implications for treatment with immunotherapies, especially fingolimod. Numerous mainly small case-control or cohort studies have reported various measures of CAD (particularly heart rate variation) in MS patients, showing higher rates of abnormality versus controls. A smaller number of studies have reported on cardiac autonomic symptoms in MS, including orthostatic intolerance/dizziness in around 50% of patients. CAD also appears to be associated with disease duration and to be more common in progressive than relapsing-remitting MS. However, although a substantial evidence base suggests that assessing CAD in people with MS may be important, standardised methods to evaluate CAD in these patients have not yet been established. In addition, no studies have yet looked at whether treating CAD can reduce the burden of MS symptoms, disease activity or the rate of progression.

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Section: Spinal Cord Lesionsmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Association With Ms Type and Disease Characteristicsmentioning

confidence: 90%

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Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Findling

Hauer

Pezawas

et al. 2020

JCM

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“…Heart rate variability (HRV), reflecting instantaneous parasympathetic modulation of cardiac conduction, was shown to be a potent and reliable tool to examine ANS function in vivo with strong correlations with vagal activity [11]. Several studies found lower HRV in MS patients than in healthy controls (HC) [10,12,13], while others found more pronounced (para)sympathetic dysfunction in progressive than in relapsing-remitting phenotypes [10,14,15]. Most studies did not account for the effect of age on HRV [16,17].…”

Section: Introductionmentioning

confidence: 99%

Relation between Heart Rate Variability and Disease Course in Multiple Sclerosis

Reynders

Gidron

Ville

et al. 2019

JCM

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Little is known about the interplay between the autonomic nervous system and disease activity in multiple sclerosis (MS). We examined the relationship between heart rate variability (HRV), a reliable measure of vagal nerve function, and disease characteristics in a prospective MS cohort. Standard deviation of each normal-to-normal inter-beat interval (SDNN) and root mean square of successive differences (RMSSD), global indices of HRV, were measured in 114 MS patients, which included four predefined subgroups, and 30 age and sex-matched healthy controls (HC). We assessed group differences at baseline, HRV reproducibility at month 3, and used logistic regression modeling to relate baseline HRV with relapse occurrence. No significant HRV differences were found between MS and HC and between MS subgroups. In MS patients, both HRV indices correlated with age (r = −0.278, p = 0.018 and r = −0.319, p < 0.001, respectively) and with month 3 assessments (r = 0.695 and r = 0.760, p < 0.001). Higher SDNN and RMSSD at baseline were associated with self-reported relapses at month 3 (OR = 1.053, 95% CI (1.013–1.095), p = 0.009 and OR = 1.065, 95% CI (1.016–1.117), p = 0.009), and SDNN at baseline with relapses at month 12 (OR = 1.034, 95% CI (1.009–1.059), p = 0.008; ROC, AUC = 0.733, p = 0.002). There were no baseline HRV differences between MS and HC or between subgroups. Post-hoc analysis showed an association with an increased relapse risk.

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“…Two recent publications have attempted to address this important topic. In an article published in Multiple Sclerosis & Related Disorders, Damla et al [1] measured heart rate variability (HRV) in 51 patients recently diagnosed with relapsing-remitting multiple sclerosis (RRMS) and 44 matched healthy controls. All patients were evaluated before any immunomodulatory therapy was started.…”

mentioning

confidence: 99%

Autonomic dysfunction in multiple sclerosis and other updates on recent autonomic research

Miglis

Muppidi

2018

Clin Auton Res

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Heart rate variability analysis in patients with multiple sclerosis

Cited by 28 publications

References 21 publications

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Cardiac Autonomic Dysfunction in Multiple Sclerosis: A Systematic Review of Current Knowledge and Impact of Immunotherapies

Relation between Heart Rate Variability and Disease Course in Multiple Sclerosis

Autonomic dysfunction in multiple sclerosis and other updates on recent autonomic research

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