A DGReview of :"Autonomic
dysfunction in multiple sclerosis: cervical spinal cord atrophy correlates"
Journal of Neurology
By Veronica Rose
The frequency of autonomic dysfunction in multiple sclerosis has been underestimated, particularly among patients with primary progressive disease, say French researchers.
In addition, there is a closer relationship between autonomic dysfunction and axonal loss, illustrated by spinal cord atrophy rather than demyelinating lesions.
There are no studies in existence specifically relative to autonomic dysfunction in multiple sclerosis (MS) and lesions of the spinal cord, the researchers aver, although some hypotheses suggest a spinal cord origin.
Consequently, researchers in various neurologic departments of the Hospital R. Salengro in Lille designed a prospective study to assess the frequency of autonomic dysfunction occurrence in MS. In addition they questioned its correlation to spinal cord magnetic resonance imaging (MRI) findings.
Participants included 75 patients with MS. These were subdivided into three groups of 25, one with the relapsing-remitting form, the second with secondary progressive form, and the third with primary progressive disease.
Sympathetic skin response was undertaken, together with R-R interval variability and orthostatic hypotension testing. A spinal cord MRI was undertaken to detect demyelinating lesions (sagittal and axial plane) or spinal cord atrophy
Both clinical and laboratory evidence of autonomic dysfunction was found in 84 percent and 56 percent of patients, respectively.
The Extended Disability
Status Scale evaluated the correlation of the latter with disability. Autonomic
dysfunction correlated with spinal cord cross-sectional area reduction,
but not with spinal cord hyperintensities.
Journal of Neurology 2001 Vol 248 No 4 pp 297-303. "Autonomic dysfunction in multiple sclerosis: cervical spinal cord atrophy correlates"