Cerebral autoregulation is preserved in multiple sclerosis patients

• Published in: Journal of the neurological sciences 2017-10, Vol.381, p.298-304
• Main Authors: Ferreira, Daniel, Castro, Pedro, Videira, Gonçalo, Filipe, João Pedro, Santos, Rosa, Sá, Maria José, Azevedo, Elsa, Abreu, Pedro
• Format: Article
• Language: English
• Subjects: Adult; Autonomic nervous system; Autonomic Nervous System - physiopathology; Baroreflex - physiology; Brain - physiology; Case-Control Studies; Cerebral autoregulation; Cohort Studies; Female; Heart Rate - physiology; Heart rate variability; Humans; Linear Models; Magnetic Resonance Imaging; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnostic imaging; Multiple Sclerosis - physiopathology; Spontaneous baroreflex sensitivity; Young Adult
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2017.09.009

Multiple sclerosis (MS) is an inflammatory disease that may also be associated with vascular dysfunction. One master component of vascular regulation is cerebral autoregulation (CA). We aimed to investigate the integrity of CA in MS patients and study its relationship with autonomic dysfunction (AD), magnetic-resonance-imaging (MRI) lesion load and hemodynamic parameters. We enrolled 20 relapsing-remitting MS and 20 healthy subjects. CA was assessed by transfer function analysis parameters (coherence, gain and phase), as obtained in the very low, low and high-frequency domains (VLF, LF, HF, respectively). We evaluated the autonomic parameters heart rate variability and spontaneous baroreflex sensitivity (BRS). There were no significant differences in CA parameters between MS and controls (p>0.05). Lesion load was not correlated with any CA parameter. LF gain was positively correlated with BRS in both groups (MS: p=0.017; controls: p=0.025). Brainstem lesion load in MS was associated with higher systolic blood pressure (SBP; p=0.009). Our findings suggest that CA is preserved in our MS cohort. On the other hand, AD in MS patients with brainstem lesions could contribute to the increase of supine SBP. Whether this systemic deregulation could contribute to disease burden remains to be investigated. •Cerebral autoregulation (CA) was studied using TFA method in multiple sclerosis (MS).•MS patients have a preserved CA mechanism in comparison to healthy controls.•Patients seem to present an adaptive mechanism to preserve cerebral blood flow.•Brainstem lesion load was associated with higher systolic blood pressure (BP).•MS physician should monitor cardiovascular risks in these patients, particularly BP.