The autonomic dysfunction in patients with lupus disease: An electrophysiological study

Abstract

Background:The aim of this study was to investigate autonomic nervous system (ANS) function by using electrophysiological tests in patients with systemic lupus erythematosus (SLE).Materials and Methods:This descriptive analytical study was done on 28 individuals with a history of lupus and ten age- and sex-matched healthy objects were being selected randomly. The autonomy questionnaire has been used to determine clinical symptom of ANS involvement. The electrophysiological assessments of ANS function were performed by sympathetic skin response (SSR). The mean values of sympathetic (SSR latency and amplitude) parameters were compared to determine any correlations between SSR parameters and clinical characteristics of ANS.Results:28 SLE patients (3 males, 25 females) with a mean age of 34.6 ± 9.74 years and 10 control subjects (4 males, 6 females) with a mean age of 36.8 ± 6.43 years were included in the study. Among patients 17 (60.7%) exhibited autonomic symptoms. Headache was the most common issue with the highest percentage rate (41.17%). The mean latency and amplitude of SSR were increased (1.52 ± 0.16 vs. 1.39 ± 0.16 and 107 ± 15.6 vs. 110 ± 15.6, respectively), compared to control. A significant difference was observed between the SSR test results of patients with lupus compared to normal healthy objects (P < 0.05). R = 0.43 correlation was found between autonomy questionnaire scores and SSR (P < 0.05).Conclusion:It could be concluded that latency measures in SSR test can be used as a valuable and accurate evaluation guideline for autonomic system assessment.

Sympathetic Nerve Hyperactivity in the Spleen: Causal for Nonpathogenic-Driven Chronic Immune-Mediated Inflammatory Diseases (IMIDs)?

“…These systems work together to coordinate basic biological activities of organ systems and to direct or redirect energy resources to organ systems to meet changing energy demands [ 3 , 4 , 5 ]. Dysautonomia is a hallmark of many IMIDs, often associated with low parasympathetic and high sympathetic nerve activity (SNA) [ 6 , 7 , 11 , 18 , 22 , 23 , 24 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ], although other profiles have been reported, such as high parasympathetic and low sympathetic activity in asthma [ 55 , 56 , 57 ] and high parasympathetic and sympathetic activity in the murine chronic colitis model [ 58 ].…”

“…Research supports severe life stressors commonly precede the onset of many IMIDs, including those with autoimmune-mediated mechanisms, with reports of up to 80% of patients reporting a severe life stressor before disease onset [ 42 , 43 , 44 ]. Dysautonomia, particularly high SNA, is linked to many age-related autoimmune and metabolic IMIDs (e.g., [ 6 , 7 , 11 , 18 , 22 , 23 , 24 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]). Despite this strong linkage, it remains unknown how stress and high SNA trigger disease onset and chronic inflammation.…”

“…ANS dysregulation is a key feature of many IMIDs [ 5 , 6 , 7 , 8 , 9 ]. Aberrant ANS responses or SNS-immune cross-talk in patients with IMIDs, such as RA, or between the sympathetic nervous system (SNS) provide support for triggering, and/or exacerbating effects in many IMIDs [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ].…”

Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases

“…The 1999 American College of Rheumatology provided definitions for seven peripheral manifestations (acute inflammatory demyelinating polyradiculopathy, autonomic disorder, mononeuropathy, myasthenia gravis, cranial neuropathy, plexopathy and polyneuropathy) related to SLE [129]. Abnormal HRV indices on the 24-h ambulatory electrocardiogram (ECG) and standard 12-lead ECG monitoring [130][131][132], abnormal sympathetic skin response [133], and pupillary autonomic disturbance [88] have been detected in patients with SLE. The prevalence of autonomic dysfunction ranged widely from 6 to 93% in patients with SLE [113,130].…”

Is Silicone Breast Implant Toxicity an Extreme Form of a More Generalized Toxicity Adversely Affecting the Population as a Whole?

“…Dysautonomia has been documented to exist in many acquired disorders such as fibromyalgia and systemic lupus erythematosus (SLE) (22,23) . When present in SLE or any other systemic connective tissue disease, the symptoms of dysautonomia do not usually correlate with overall disease activity and/or remission (23) . Indeed, remission of inflammatory phenomena is often accompanied by vague residual complaints (especially fatigue and weakness), which in turn are often diagnosed as comorbid fibromyalgia.…”