Cardiovascular autonomic dysfunction and fatigue syndrome in multiple sclerosis
Keywords:
multiple sclerosis, cardiovascular dysfunction, fatigue syndromeAbstract
Introduction: Fatigue syndrome occurs in up to 90% of patients with multiple sclerosis (MS). Often it is the first symptom of the disease. The relationship between cardiovascular dysfunction and fatigue in MS is supposed but not well understood.
The aim of the study was to evaluate cardiovascular dysfunction in patients with MS and it relationship with fatigue syndrome.
Contingent and methods: Eighty-two MS patients (60 women, 22 males, mean age 41.7 ± 10 years), 57 (69.5%) with relapsing-remitting and 25 (30.5%) - with secondary-progressive form of the disease were investigated. The control group includes 38 healthy subjects (mean age 40.8±8.4). Arterial pressure and heart rate were monitored. Standardized cardiovascular tests were applied and the heart rate variability was evaluated at rest and during orthostatic test by a power spectral analysis. Questionnaires for Fatigue (FSS), for depression (BDI II) and for assessing the autonomic symptoms (COMPASS 31-BG) were used.
Results: The significant difference between FSS scores for MS patients (4.42 ±1.53) and controls (3.3±1.1) were observed. Sixty-three percent of the patients have fatigue and 20.7% of them have mild and moderate depression, which correlates with FSS scores. Patients with fatigue have autonomic impairment, with prevalence of abnormalities in sympathetic cardiovascular tests. Spectral analysis shows low sympathetic reactivity with a small rise in low frequencies in orthostatic test for the patients with fatigue that indicated a sympathetic dysfunction.
Conclusion: The results of the study show cardiovascular autonomic dysfunctions in MS and a relationship between sympathetic cardiovascular dysfunction and fatigue syndrome.
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