Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, 4200-319 Porto, Portugal.
Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, 4200-319 Porto, Portugal; Department of Neurology, São João Hospital Center, 4200-319 Porto, Portugal.
J Neurol Sci. 2017 Oct 15;381:298-304. doi: 10.1016/j.jns.2017.09.009. Epub 2017 Sep 8.
Multiple sclerosis (MS) is an inflammatory disease that may also be associated with vascular dysfunction. One master component of vascular regulation is cerebral autoregulation (CA). We aimed to investigate the integrity of CA in MS patients and study its relationship with autonomic dysfunction (AD), magnetic-resonance-imaging (MRI) lesion load and hemodynamic parameters. We enrolled 20 relapsing-remitting MS and 20 healthy subjects. CA was assessed by transfer function analysis parameters (coherence, gain and phase), as obtained in the very low, low and high-frequency domains (VLF, LF, HF, respectively). We evaluated the autonomic parameters heart rate variability and spontaneous baroreflex sensitivity (BRS). There were no significant differences in CA parameters between MS and controls (p>0.05). Lesion load was not correlated with any CA parameter. LF gain was positively correlated with BRS in both groups (MS: p=0.017; controls: p=0.025). Brainstem lesion load in MS was associated with higher systolic blood pressure (SBP; p=0.009). Our findings suggest that CA is preserved in our MS cohort. On the other hand, AD in MS patients with brainstem lesions could contribute to the increase of supine SBP. Whether this systemic deregulation could contribute to disease burden remains to be investigated.
多发性硬化症 (MS) 是一种炎症性疾病,也可能与血管功能障碍有关。血管调节的一个主要组成部分是脑自动调节 (CA)。我们旨在研究 MS 患者 CA 的完整性,并研究其与自主神经功能障碍 (AD)、磁共振成像 (MRI) 病变负荷和血液动力学参数的关系。我们纳入了 20 例复发缓解型 MS 患者和 20 例健康对照者。通过传递函数分析参数(相干性、增益和相位)评估 CA,分别在极低、低和高频域(VLF、LF、HF)获得。我们评估了自主神经参数心率变异性和自发性血压反射敏感性 (BRS)。MS 患者和对照组之间的 CA 参数没有显著差异 (p>0.05)。病变负荷与任何 CA 参数均无相关性。LF 增益与两组的 BRS 呈正相关 (MS:p=0.017;对照组:p=0.025)。MS 患者的脑干病变负荷与收缩压 (SBP) 升高相关 (p=0.009)。我们的研究结果表明,我们的 MS 队列中 CA 得到了保留。另一方面,脑干病变的 MS 患者的 AD 可能导致仰卧位 SBP 升高。这种全身失调是否会导致疾病负担增加仍有待研究。