Progressive multiple sclerosis patients have a higher burden of autonomic dysfunction compared to relapsing remitting phenotype

Adamec, Ivan; Crnošija, Luka; Junaković, Anamari; Skorić, Magdalena Krbot; Habek, Mario

doi:10.1016/j.clinph.2018.05.009

Cited by 44 publications

(45 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the cervical spinal cord is an anatomical center of the sympathetic nervous system, different MRI measures have been used to try to correlate spinal cord damage and ANS abnormalities. Cervical spinal cord lesions on the MRI were not associated with ANS dysfunction in a large cohort on pwCIS , whereas spinal cord atrophy correlated with ANS dysfunction in a heterogeneous population of pwMS , indicating that the way in which we measure spinal cord damage may be responsible for observed differences. Furthermore, in people with neuromyelitis optica spectrum disorder, in whom, unlike in pwMS, disability is totally dependent on the central nervous system locations of lesions, severe sympathetic dysfunction has been associated with spinal cord and/or brainstem lesions , which could explain the lack of association between spinal cord lesion in MS and worsening of ANS dysfunction.…”

Section: Discussionmentioning

confidence: 84%

“…MS usually begins with a first clinical episode called the clinically isolated syndrome (CIS), which usually occurs in young adults and affects the optic nerves, brainstem or spinal cord, the latter two being anatomically responsible for the majority of ANS functions . In line with this, the ANS can frequently be involved in people with CIS (pwCIS) and MS (pwMS) . However, one of the unanswered questions is what happens with ANS functions during the disease course.…”

Section: Introductionmentioning

confidence: 99%

“…: +38512388033; fax: +38512388033; e-mail: mhabek@mef.hr). ANS can frequently be involved in people with CIS (pwCIS) and MS (pwMS) [4][5][6]. However, one of the unanswered questions is what happens with ANS functions during the disease course.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal assessment of autonomic nervous system in patients with first demyelinating event suggestive of multiple sclerosis

Habek

Crnošija

Gabelić

et al. 2019

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose As a high proportion of people with clinically isolated syndrome (pwCIS) exhibit sympathetic adrenergic and sudomotor dysfunction, the aim of this study was to investigate the evolution of autonomic nervous system (ANS) abnormalities in pwCIS over a 2‐year follow‐up. Methods This was a prospective cohort study in which 121 pwCIS were enrolled and followed for 2 years. After 2‐year follow‐up, data were available for 84 pwCIS. ANS symptoms were evaluated with the Composite Autonomic System Score‐31 (COMPASS‐31) and results of the ANS tests were expressed using the Composite Autonomic Scoring Scale (CASS) at baseline and visit at month 24. Symptomatic dysautonomia was defined if the patient had a COMPASS‐31 value above the median of the whole cohort at baseline evaluation (COMPASS‐31 > 6.79) and CASS score >0. Results Complete CASS data at baseline and month 24 were available for 62 patients; in 24 (38.7%) patients there was worsening, in 16 (25.8%) there was improvement and in 22 (35.5%) there was no change in CASS score. In 90% of pwCIS (72 of 80) there was no change in parasympathetic nervous system tests, whereas 47.3% (35 of 74) had either worsening or improvement in sympathetic adrenergic and 28.6% (20 of 70) had either worsening or improvement in sudomotor function. A multivariable regression model identified the total number of T2 lesions as an independent predictor for worsening of symptomatic dysautonomia. No predictors for worsening or improving of CASS score were identified. Conclusion A substantial proportion of pwCIS experienced worsening of ANS abnormalities during the 2‐year follow‐up and magnetic resonance imaging parameters seemed to predict these abnormalities.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal assessment of autonomic nervous system in patients with first demyelinating event suggestive of multiple sclerosis

Habek

Crnošija

Gabelić

et al. 2019

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…Four forms of MS are known: the classic relapsing-remitting form (RRMS) affects 85% of MS patients; it becomes progressive, a stage defined as secondary progressive (SPMS). Fifteen percent of MS patients can present a progressive form from the onset, named primary progressive (PPMS) [3], while the progressive-relapsing form (PRMS) is found in only a few patients [4]. Over the past two decades, the treatment of MS has changed enormously; more than a dozen drugs are currently approved for RRMS, each with different modes of action.…”

Section: Introductionmentioning

confidence: 99%

Differential Transcription of SOCS5 and SOCS7 in Multiple Sclerosis Patients Treated with Interferon Beta or Glatiramer Acetate

Rojas-Morales

Santos‐López

Hernández-Cabañas

et al. 2019

IJMS

View full text Add to dashboard Cite

The participation of proinflammatory cytokines in the progression of Multiple Sclerosis (MS) has been well documented. Cytokines activate the JAK-STAT pathway, in which the suppressors of cytokine signaling (SOCS) exert a negative feedback. This paper analyzes the levels of SOCS5 and SOCS7 transcripts, quantified by RT-qPCR, in MS patients, and the concentrations of proinflammatory cytokines, IFN-γ, IL17, and IL6, determined by ELISA. Samples of peripheral blood were obtained from MS patients in the relapsing-remitting phase, treated with IFN-β or glatiramer acetate (GA), and from healthy individuals. SOCS7 mRNA was significantly higher in patients treated with GA (1.36 ± 0.23) than in those treated with IFN-β (0.65 ± 0.1). Regarding gender, the level of SOCS5 and SOCS7 transcripts were similar between MS and healthy females; in MS males, the level of SOCS7 transcripts were significantly lower (0.59 ± 0.03) than in healthy males (1.008 ± 0.05). Plasmatic levels of IFN-γ were significantly higher in MS patients (60 pg/mL, range 0-160) than in healthy subjects (0 range, 0-106). The same pattern was observed in MS patients treated with IFN-β (68 pg/mL, range 0-160) compared to patients treated with GA (51 pg/mL, range 0-114), and in MS females (64 pg/mL, range 0-161) compared to healthy females (0, range 0-99). We hypothesize that the increase in SOCS7 transcription in patients treated with GA could partially explain the action mechanism of this drug, while the increase in the concentration of IFN-γ in MS patients could help elucidate the immunopathology of the disease.

show abstract

“…In a different article published in Clinical Neurophysiology, Adamec et al [2] analyzed HRV and performed standardized autonomic function testing in 40 patients with RRMS and 30 patients with progressive multiple sclerosis (PMS). Patients with PMS had worse HRV measures and a higher sudomotor index (as measured by quantitative sudomotor axon reflex testing, QSART) and Composite Autonomic Severity Score (CASS) than patients with RRMS.…”

mentioning

confidence: 99%

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

Miglis

Muppidi

2018

Clin Auton Res

View full text Add to dashboard Cite

Progressive multiple sclerosis patients have a higher burden of autonomic dysfunction compared to relapsing remitting phenotype

Cited by 44 publications

References 30 publications

Longitudinal assessment of autonomic nervous system in patients with first demyelinating event suggestive of multiple sclerosis

Longitudinal assessment of autonomic nervous system in patients with first demyelinating event suggestive of multiple sclerosis

Differential Transcription of SOCS5 and SOCS7 in Multiple Sclerosis Patients Treated with Interferon Beta or Glatiramer Acetate

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

Contact Info

Product

Resources

About