Hilty Marc, Oldrati Pietro, Barrios Liliana, Müller Tamara, Blumer Claudia, Foege Magdalena, Consortium Phrt, Holz Christian, Lutterotti Andreas
University and University Hospital of Zürich, Department of Neurology, Zürich, 8091, Switzerland.
ETH Zürich, Department of Computer Science, Zürich, 8092, Switzerland.
Mult Scler J Exp Transl Clin. 2022 Jun 1;8(2):20552173221103436. doi: 10.1177/20552173221103436. eCollection 2022 Apr-Jun.
Dysfunction of the autonomic nervous system is common in multiple sclerosis patients, and probably present years before diagnosis, but its role in the disease is poorly understood.
To study the autonomic nervous system in patients with multiple sclerosis using cardiac autonomic regulation measured with a wearable.
In a two-week study, we present a method to standardize the measurement of heart rate variability using a wearable sensor that allows the investigation of circadian trends. Using this method, we investigate the relationship of cardiac autonomic dysfunction with clinical hallmarks and subjective burden of fatigue and autonomic symptoms.
In 55 patients with multiple sclerosis and 24 healthy age- and gender-matched controls, we assessed the cumulative circadian heart-rate variability trend of two weeks. The trend analysis revealed an effect of inflammation ( = 0.0490, SMD = -0.5466) and progressive neurodegeneration ( = 0.0016, SMD = 1.1491) on cardiac autonomic function. No association with subjective symptoms could be found.
Trend-based heart rate variability measured with a wearable provides the opportunity for unobtrusive long-term assessment of autonomic functions in patients with multiple sclerosis. It revealed a general dysregulation in patients with multiple sclerosis.
自主神经系统功能障碍在多发性硬化症患者中很常见，可能在诊断前数年就已出现，但其在该疾病中的作用尚不清楚。
使用可穿戴设备测量心脏自主调节功能，研究多发性硬化症患者的自主神经系统。
在一项为期两周的研究中，我们提出了一种使用可穿戴传感器标准化心率变异性测量的方法，该方法可用于研究昼夜节律趋势。使用这种方法，我们研究了心脏自主神经功能障碍与临床特征、疲劳主观负担和自主神经症状之间的关系。
在55例多发性硬化症患者和24例年龄及性别匹配的健康对照者中，我们评估了两周的累积昼夜心率变异性趋势。趋势分析显示炎症（P = 0.0490，标准化均值差 = -0.5466）和进行性神经退行性变（P = 0.0016，标准化均值差 = 1.1491）对心脏自主神经功能有影响。未发现与主观症状有相关性。
使用可穿戴设备测量基于趋势的心率变异性为多发性硬化症患者自主神经功能的非侵入性长期评估提供了机会。它揭示了多发性硬化症患者普遍存在的调节异常。
