Sympathetic dysfunction is related to the clinical activity of multiple sclerosis.
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Biomedical subjects
Publications and source records attributed to J A Monge-Argilés.
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OBJECTIVES: Multiple sclerosis (MS) frequently causes disturbances of autonomic functions. Cardiovascular dysautonomia has been studied by classic autonomic tests and, recently, by heart rate variability analysis in some isolated periods. Multiple authors recommended performing heart rate variability analysis with a 24 h ECG recording to increase its sensitivity. MATERIAL AND METHODS: We analyzed the heart rate variability in time and frequency domains in 34 MS patients and 24 age and sex-matched healthy control subjects, in order to evaluate the effects of MS on sympathetic and parasympathetic cardiovascular regulatory functions measured from 24-h electrocardiogram. RESULTS: Low frequency power (0.01) and low frequency/high frequency power (0.01) were significantly higher in multiple sclerosis patients independently, all together or in subgroups. Very low frequency (0.01) and high frequency (0.001) power were higher in less affected multiple sclerosis patients. Variability in time domain (0.05) were lower in most affected multiple sclerosis patients. CONCLUSIONS: These results suggest that multiple sclerosis causes cardiovascular autonomic dysregulation manifesting as impaired heart rate variability. This illness seems to cause an increase in sympathetic cardiovascular tone; the parasympathetic tone is most variable and depends on clinical and paraclinical findings, but the illness progression seems to provoke a decrease in it.
INTRODUCTION: Multiple sclerosis (MS) can cause alterations in autonomic cardiovascular functioning. Some authors attribute these anomalies detected in MS patients to brain stem lesions, due to the fact that important autonomic nuclei are located in this region of the brain. Other studies, however, have been unable to prove such a relation. AIMS. The purpose of this study was to analyse whether these alterations had an exclusive relation with the brain stem lesions that usually appear in the course of this disease. PATIENTS AND METHODS: We compared the spectral analysis of the heart rate variability (SAHRV) in the frequency domain between a group of 34 patients with MS and another group of 14 patients with isolated brain stem lesions (IBSL) of a non inflammatory origin, which were measured using a 24 hour Holter recording. RESULTS: Heart rate, very low rates, low rates and the low rate/high rate quotient are significantly higher in the MS group than in the IBSL group, even when the former present brain stem lesions. Results in the high rate component, however, depend on the presence of brain stem lesions in the MS group. CONCLUSION: These findings suggest that autonomic cardiovascular dysfunction in MS is only related with brain stem lesions, although we obtained results that confirm the importance of this area in cardiovascular innervation.
A patient suffering from Faconi's anemia presented multifocal neurologic complications, initially with an exacerbating-remitting clinical presentation, next followed by chronic progressive course. Both as a nosologic association or as neurologic complication of Fanconi's anemia, this case is un unpublished observation, to our knowledge.
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