de Bernardo Nieves, de la Rubia Ortí José Enrique, Villarón-Casales Carlos, Privado Jesús, Maset-Roig Rosa, Cañabate Montse, Sancho-Cantus David, Sanz Inmaculada Orrit, Fernández Raquel Fernández, Proaño Belén, Tvarijonaviciute Asta, Rubio Camila Peres, Benlloch María, Menargues-Ramírez Rubén, Alarcón-Jiménez Jorge
Department of Physiotherapy, Catholic University San Vicente Mártir, 46001, Valencia, Spain.
Department of Basic Biomedical Sciences, Catholic University of Valencia, 46001, Valencia, Spain.
Sci Rep. 2025 Mar 27;15(1):10513. doi: 10.1038/s41598-025-94844-y.
Patients with Amyotrophic Lateral Sclerosis (ALS) exhibit altered patterns of respiratory rate and heart rhythm that are directly related to autonomic nervous system (ANS) activity. This study aimed to analyze the role of the ANS in respiratory function, cognition, functionality, and antioxidant capacity in patients with ALS through a predictive model that assesses the mediating activity of respiration. This quantitative, observational, analytical, and cross-sectional clinical study was conducted using a sample of 75 patients diagnosed with ALS. ANS activity, respiratory function, cognition, functionality, and antioxidant capacity were also measured. Using these values, a structural equation model was developed using AMOS V.23 software. The mediational predictive model showed that increased sympathetic nervous system (SNS) activity, in turn, increased respiratory function, whereas the role of the parasympathetic nervous system in respiration was very weak and had the opposite effect. Furthermore, SNS activity increased respiratory function values, which, in turn, improved functional capacity, cognition, and antioxidant power in patients with ALS, with respiratory function playing a mediating role. The mediating effect of respiratory function was observed primarily between ANS and functional disability. For oxidative stress, respiratory function showed a high mediating effect, such that greater respiratory function corresponded to greater antioxidant capacity. Additionally, for cognitive activity, a moderate direct effect of the ANS was observed; however, it was greatly enhanced by respiratory disability. Finally, differences were only found based on sex, with respiratory capacity and antioxidant power being higher in men.
肌萎缩侧索硬化症（ALS）患者表现出呼吸频率和心律模式的改变，这些改变与自主神经系统（ANS）活动直接相关。本研究旨在通过一个评估呼吸中介活动的预测模型，分析ANS在ALS患者呼吸功能、认知、功能和抗氧化能力中的作用。这项定量、观察性、分析性和横断面临床研究使用了75名被诊断为ALS的患者样本。还测量了ANS活动、呼吸功能、认知、功能和抗氧化能力。利用这些值，使用AMOS V.23软件建立了结构方程模型。中介预测模型显示，交感神经系统（SNS）活动增加反过来会提高呼吸功能，而副交感神经系统在呼吸中的作用非常微弱且具有相反的效果。此外，SNS活动增加了呼吸功能值，进而改善了ALS患者的功能能力（体能）、认知和抗氧化能力，呼吸功能起到了中介作用。呼吸功能的中介作用主要在ANS和功能残疾之间观察到。对于氧化应激，呼吸功能显示出较高的中介作用，即呼吸功能越强，抗氧化能力越强。此外，对于认知活动，观察到ANS有适度的直接作用；然而，呼吸功能障碍极大地增强了这种作用。最后，仅根据性别发现了差异，男性的呼吸能力和抗氧化能力更高。
