Skip to main content

Advertisement

SpringerLink
Log in

Autonomic Nervous System Response to Stressors in Newly Diagnosed Patients with Multiple Sclerosis

  • Original Research
  • Published:
Cellular and Molecular Neurobiology Aims and scope Submit manuscript

Abstract

Autonomic dysfunction is commonly detected in patients with multiple sclerosis (MS). However, data evaluating autonomic nervous system function in early MS are limited. Present study investigates response to two different stressors in newly diagnosed MS patients, looking for the signs of autonomic dysfunction at the beginning of the disease. We examined 19 MS patients and 19 age, sex, and body mass index matched healthy controls. MS patients were newly diagnosed, untreated, and with low expanded disability status scale (EDSS) values [median 1.0 (interquartile range 1.0–1.5)]. Two stressors were used to evaluate the response of autonomic nervous system: Stroop word-color interference mental stress test and orthostasis. Plasma levels of epinephrine and norepinephrine, blood pressure (BP), and heart rate variability (HRV) parameters were evaluated. At the end of Stroop test MS patients had lower systolic BP (121 ± 15 vs. 132 ± 17 mmHg, p = 0.044), lower heart rate (79 ± 9 vs. 88 ± 16 1/min, p = 0.041), and lower epinephrine increment (10 ± 22 vs. 30 ± 38 pg/ml; p = 0.049) compared to healthy controls. Norepinephrine response was unaffected in MS, however, with lower norepinephrine levels during the test (p = 0.036). HRV parameters were similar in both groups. No differences in BP, heart rate, catecholamines, and HRV parameters between groups during orthostatic testing were found. We found slightly diminished sympathetic response to mental stress test, but unchanged response to orthostasis, in newly diagnosed untreated MS patients. The results suggest that autonomic dysfunction in MS is connected with more developed disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adamec I, Habek M (2013) Autonomic dysfunction in multiple sclerosis. Clin Neurol Neurosurg 115(Suppl 1):S73–S78. doi:10.1016/j.clineuro.2013.09.026

    Article  PubMed  Google Scholar 

  • Adamec I, Bach I, Barusic AK, Mismas A, Habek M (2013) Assessment of prevalence and pathological response to orthostatic provocation in patients with multiple sclerosis. J Neurol Sci 324:80–83. doi:10.1016/j.jns.2012.10.006

    Article  PubMed  Google Scholar 

  • Compston A, Coles A (2008) Multiple sclerosis Lancet 372:1502–1517. doi:10.1016/S0140-6736(08)61620-7

    CAS  PubMed  Google Scholar 

  • Cosentino M, Marino F (2013) Adrenergic and dopaminergic modulation of immunity in multiple sclerosis: teaching old drugs new tricks? J Neuroimmune Pharmacol 8:163–179. doi:10.1007/s11481-012-9410-z

    Article  PubMed  Google Scholar 

  • Crnosija L, Adamec I, Lovric M, Junakovic A, Krbot Skoric M, Lusic I, Habek M (2016) Autonomic dysfunction in clinically isolated syndrome suggestive of multiple sclerosis. Clin Neurophysiol 127:864–869. doi:10.1016/j.clinph.2015.06.010

    Article  PubMed  Google Scholar 

  • de Seze J et al (2001) Autonomic dysfunction in multiple sclerosis: cervical spinal cord atrophy correlates. J Neurol 248:297–303

    Article  PubMed  Google Scholar 

  • Domingues RB, Carvalho TH, Vassallo DV, Domingues SC, Teixeira AL (2014) Altered cardiovascular reactivity to mental stress in patients with multiple sclerosis. Neurol Sci 35:965–967. doi:10.1007/s10072-014-1704-x

    Article  PubMed  Google Scholar 

  • Flachenecker P, Wolf A, Krauser M, Hartung HP, Reiners K (1999) Cardiovascular autonomic dysfunction in multiple sclerosis: correlation with orthostatic intolerance. J Neurol 246:578–586

    Article  CAS  PubMed  Google Scholar 

  • Freeman R et al (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72. doi:10.1007/s10286-011-0119-5

    Article  PubMed  Google Scholar 

  • Garafova A, Penesova A, Cizmarova E, Marko A, Vlcek M, Jezova D (2014) Cardiovascular and sympathetic responses to a mental stress task in young patients with hypertension and/or obesity. Physiol Res 63(Suppl 4):S459–S467

    PubMed  Google Scholar 

  • Habek M, Crnosija L, Lovric M, Junakovic A, Krbot Skoric M, Adamec I (2016) Sympathetic cardiovascular and sudomotor functions are frequently affected in early multiple sclerosis. Clin Auton Res 26:385–393. doi:10.1007/s10286-016-0370-x

    Article  PubMed  Google Scholar 

  • Habek M, Krbot Skoric M, Crnosija L, Gabelic T, Barun B, Adamec I (2017) Postural orthostatic tachycardia predicts early conversion to multiple sclerosis after clinically isolated syndrome. Eur Neurol 77:253–257. doi:10.1159/000469707

    Article  PubMed  Google Scholar 

  • Heesen C, Schulz H, Schmidt M, Gold S, Tessmer W, Schulz KH (2002) Endocrine and cytokine responses to acute psychological stress in multiple sclerosis. Brain Behav Immun 16:282–287. doi:10.1006/brbi.2001.0628

    Article  CAS  PubMed  Google Scholar 

  • Heesen C et al (2003) Endocrine and cytokine responses to standardized physical stress in multiple sclerosis. Brain Behav Immun 17:473–481

    Article  CAS  PubMed  Google Scholar 

  • Jezova D, Jurankova E, Mosnarova A, Kriska M, Skultetyova I (1996) Neuroendocrine response during stress with relation to gender differences. Acta Neurobiol Exp (Wars) 56:779–785

    CAS  Google Scholar 

  • Kale N, Magana S, Agaoglu J, Tanik O (2009) Assessment of autonomic nervous system dysfunction in multiple sclerosis and association with clinical disability. Neurol Int 1:e5. doi:10.4081/ni.2009.e5

    Article  PubMed  PubMed Central  Google Scholar 

  • Keller DM, Fadel PJ, Harnsberger MA, Remington GM, Frohman EM, Davis SL (2014) Reduced spontaneous sympathetic nerve activity in multiple sclerosis patients. J Neurol Sci 344:210–214

    Article  PubMed  PubMed Central  Google Scholar 

  • Kern S, Rohleder N, Eisenhofer G, Lange J, Ziemssen T (2014) Time matters—acute stress response and glucocorticoid sensitivity in early multiple sclerosis. Brain Behav Immun 41:82–89

    Article  CAS  PubMed  Google Scholar 

  • Kodounis A, Stamboulis E, Constantinidis TS, Liolios A (2005) Measurement of autonomic dysregulation in multiple sclerosis. Acta Neurol Scand 112:403–408. doi:10.1111/j.1600-0404.2005.00446.x

    Article  CAS  PubMed  Google Scholar 

  • Mahovic D, Lakusic N (2007) Progressive impairment of autonomic control of heart rate in patients with multiple sclerosis. Arch Med Res 38:322–325. doi:10.1016/j.arcmed.2006.11.009

    Article  PubMed  Google Scholar 

  • McDougall AJ, McLeod JG (2003) Autonomic nervous system function in multiple sclerosis. J Neurol Sci 215:79–85

    Article  CAS  PubMed  Google Scholar 

  • Monge-Argiles JA, Palacios-Ortega F, Vila-Sobrino JA, Matias-Guiu J (1998) Heart rate variability in multiple sclerosis during a stable phase. Acta Neurol Scand 97:86–92

    Article  CAS  PubMed  Google Scholar 

  • Nasseri K, Uitdehaag BM, van Walderveen MA, Ader HJ, Polman CH (1999) Cardiovascular autonomic function in patients with relapsing remitting multiple sclerosis: a new surrogate marker of disease evolution? Eur J Neurol 6:29–33

    Article  CAS  PubMed  Google Scholar 

  • Prokopova B et al (2017) Early cognitive impairment along with decreased stress-induced BDNF in male and female patients with newly diagnosed multiple sclerosis. J Neuroimmunol 302:34–40. doi:10.1016/j.jneuroim.2016.11.007

    Article  CAS  PubMed  Google Scholar 

  • Racosta JM, Kimpinski K (2016) Autonomic dysfunction, immune regulation, and multiple sclerosis. Clin Auton Res 26:23–31. doi:10.1007/s10286-015-0325-7

    Article  PubMed  Google Scholar 

  • Saari A, Tolonen U, Paakko E, Suominen K, Pyhtinen J, Sotaniemi K, Myllyla V (2004) Cardiovascular autonomic dysfunction correlates with brain MRI lesion load in MS. Clin Neurophysiol 115:1473–1478. doi:10.1016/j.clinph.2004.01.012

    Article  CAS  PubMed  Google Scholar 

  • Senaratne MP, Carroll D, Warren KG, Kappagoda T (1984) Evidence for cardiovascular autonomic nerve dysfunction in multiple sclerosis. J Neurol Neurosurg Psychiatry 47:947–952

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Vlcek M, Radikova Z, Penesova A, Kvetnansky R, Imrich R (2008) Heart rate variability and catecholamines during hypoglycemia and orthostasis. Auton Neurosci 143:53–57. doi:10.1016/j.autneu.2008.08.001

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the Slovak Research and Development Agency (Grant APVV-0028-10), Grant agency of Ministry of Education, Science, Research and Sport (VEGA 2/0161/16), and ERA net NEURON II (MELTRA-BBB).

Author information

Authors and Affiliations

  1. Institute for Clinical and Translational Research, Biomedical Research Center, Slovak Academy of Sciences, Dúbravská cesta 9, 84505, Bratislava, Slovakia

    Miroslav Vlcek, Adela Penesova, Richard Imrich, Milada Meskova & Martina Mravcova

  2. Slovak Medical University in Bratislava, Limbová 12, 83303, Bratislava, Slovakia

    Miroslav Vlcek & Alexandra Garafova

  3. 1st Department of Neurology, Faculty of Medicine, Comenius University, Mickiewiczova 13, 81369, Bratislava, Slovakia

    Lucia Grunnerova, Monika Sivakova, Peter Turcani & Branislav Kollar

  4. Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Dúbravská cesta 9, 84505, Bratislava, Slovakia

    Alexandra Garafova & Daniela Jezova

Authors
  1. Miroslav Vlcek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adela Penesova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard Imrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Milada Meskova
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Martina Mravcova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lucia Grunnerova
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexandra Garafova
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Monika Sivakova
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Peter Turcani
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Branislav Kollar
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Daniela Jezova
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Author contribution

The authors’ responsibilities were as follow: AP, BK, and DJ conceived and designed the study; MV, AP, RI, MMe, MMr, LG, AG, and MS contributed to sample and data collection and data analysis; MV and AP wrote the manuscript; MV, RI, PT, BK, and DJ researched data and contributed to the discussion. All authors reviewed and edited the manuscript.

Corresponding author

Correspondence to Miroslav Vlcek.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vlcek, M., Penesova, A., Imrich, R. et al. Autonomic Nervous System Response to Stressors in Newly Diagnosed Patients with Multiple Sclerosis. Cell Mol Neurobiol 38, 363–370 (2018). https://doi.org/10.1007/s10571-017-0511-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10571-017-0511-3

Keywords

Search

Navigation