@article{ref1,
title="Autonomic response to walk tests is useful for assessing outcome measures in people with multiple sclerosis",
journal="Frontiers in physiology",
year="2023",
author="Kontaxis, Spyridon and Laporta, Estela and Garcia, Esther and Guerrero, Ana Isabel and Zabalza, Ana and Matteo, Martinis and Lucia, Roselli and Simblett, Sara and Weyer, Janice and Hotopf, Matthew and Narayan, Vaibhav A. and Rashid, Zulqarnain and Folarin, Amos A. and Dobson, Richard J. B. and Buron, Mathias Due and Leocani, Letizia and Cummins, Nicholas and Vairavan, Srinivasan and Costa, Gloria Dalla and Magyari, Melinda and Sørensen, Per Soelberg and Nos, Carlos and Bailón, Raquel and Comi, Giancarlo and Consortium, The Radar-Cns",
volume="14",
number="",
pages="e1145818-e1145818",
abstract="OBJECTIVE: The aim of this study was to evaluate the association between changes in the autonomic control of cardiorespiratory system induced by walk tests and outcome measures in people with Multiple Sclerosis (pwMS). <br><br>METHODS: Electrocardiogram (ECG) recordings of 148 people with Relapsing-Remitting MS (RRMS) and 58 with Secondary Progressive MS (SPMS) were acquired using a wearable device before, during, and after walk test performance from a total of 386 periodical clinical visits. A subset of 90 participants repeated a walk test at home. Various MS-related symptoms, including fatigue, disability, and walking capacity were evaluated at each clinical visit, while heart rate variability (HRV) and ECG-derived respiration (EDR) were analyzed to assess autonomic nervous system (ANS) function. Statistical tests were conducted to assess differences in ANS control between pwMS grouped based on the phenotype or the severity of MS-related symptoms. Furthermore, correlation coefficients (r) were calculated to assess the association between the most significant ANS parameters and MS-outcome measures. <br><br>RESULTS: People with SPMS, compared to RRMS, reached higher mean heart rate (HRM) values during walk test, and larger sympathovagal balance after test performance. Furthermore, pwMS who were able to adjust their HRM and ventilatory values, such as respiratory rate and standard deviation of the ECG-derived respiration, were associated with better clinical outcomes. Correlation analyses showed weak associations between ANS parameters and clinical outcomes when the Multiple Sclerosis phenotype is not taken into account. Blunted autonomic response, in particular HRM reactivity, was related with worse walking capacity, yielding r = 0.36 r = 0.29 (RRMS) and r > 0.5 (SPMS). A positive strong correlation r > 0.7 r > 0.65 between cardiorespiratory parameters derived at hospital and at home was also found. <br><br>CONCLUSION: Autonomic function, as measured by HRV, differs according to MS phenotype. Autonomic response to walk tests may be useful for assessing clinical outcomes, mainly in the progressive stage of MS. Participants with larger changes in HRM are able to walk longer distance, while reduced ventilatory function during and after walk test performance is associated with higher fatigue and disability severity scores. Monitoring of disorder severity could also be feasible using ECG-derived cardiac and respiratory parameters recorded with a wearable device at home.<p /> <p>Language: en</p>",
language="en",
issn="1664-042X",
doi="10.3389/fphys.2023.1145818",
url="http://dx.doi.org/10.3389/fphys.2023.1145818"
}