Autonomic response to walk tests is useful for assessing outcome measures in people with multiple sclerosis

Frontiers in Physiology

Physiology

Esther Garcia¹  Melinda Magyari²  Per Soelberg Sørensen²  Mathias Due Buron²  Nicholas Cummins³  Zulqarnain Rashid³  Amos A. Folarin⁴  Richard J. B. Dobson⁴  Martinis Matteo⁵  Letizia Leocani⁵  Gloria Dalla Costa⁵  Roselli Lucia⁵  Giancarlo Comi⁶  Matthew Hotopf⁷  Sara Simblett⁷  Spyridon Kontaxis⁸  Estela Laporta⁸  Raquel Bailón⁸  Ana Zabalza⁹  Ana Isabel Guerrero⁹  Carlos Nos⁹  Janice Weyer^1,10  Vaibhav A. Narayan^1,11  Srinivasan Vairavan^1,11  the RADAR-CNS Consortium^1,12 

[1] Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain;Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, Barcelona, Spain;Danish Multiple Sclerosis Centre, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom;Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom;Institute of Health Informatics, University College London, London, United Kingdom;Faculty of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy;Faculty of Medicine and Surgery, Vita Salute San Raffaele University, Milan, Italy;Casa di Cura del Policlinico, Milan, Italy;Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom;Laboratory of Biomedical Signal Interpretation and Computational Simulation (BSICoS), University of Zaragoza, Zaragoza, Spain;Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Barcelona, Spain;Multiple Sclerosis Centre of Catalonia (CEMCAT), Department of Neurology/Neuroimmunology, Hospital Universitari Vall D’Hebron, Universitat Autónoma de Barcelona, Barcelona, Spain;RADAR-CNS Patient Advisory Board, London, United Kingdom;Research and Development Information Technology, London, United Kingdom;The RADAR-CNS Consortium, London, United Kingdom;

关键词: autonomic nervous system;    heart rate variability;    ECG-derived respiration;    relapsing-remitting multiple sclerosis;    secondary progressive multiple sclerosis;    fatigue;    disability;    walking capacity;   

DOI  :  10.3389/fphys.2023.1145818

 received in 2023-01-16, accepted in 2023-03-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

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).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.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.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.

【 授权许可】

Unknown   
Copyright © 2023 Kontaxis, Laporta, Garcia, Guerrero, Zabalza, Matteo, Lucia, Simblett, Weyer, Hotopf, Narayan, Rashid, Folarin, Dobson, Buron, Leocani, Cummins, Vairavan, Costa, Magyari, Sørensen, Nos, Bailón, Comi and the RADAR-CNS Consortium.