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Oulun yliopiston väitöskirjat

AUTONOMIC DYSFUNCTIONIN MULTIPLE SCLEROSIS AND OPTIC NEURITIS, ACTA UNIVERSITATIS OULUENSIS D Medica 1061

ISBN-13:	978-951-42-6238-8
Kieli:	englanti
Kustantaja:	Oulun yliopisto
Oppiaine:	Lääketiede, farmasia
Painosvuosi:	2010
Sidosasu:	pehmeäkantinen
Sijainti:	Print Tietotalo
Sivumäärä:	110
Tekijät:	SAARI ANNE

20.00 €

Multiple sclerosis (MS) is one of the major causes of disability in the young, mostly affectingpeople between 20–45 years of age. MS is considered as an autoimmune disorder, characterizedby discrete areas of central nervous system inflammation, demyelination and axonal injury.Symptoms related to alterations of the autonomic nervous system are frequent in patients with MS.Bladder dysfunction or impairment of sexual performance is highly distressing for most MSpatients, whereas the clinical relevance of other autonomic symptoms is less clear. The present study was designed to clarify the involvement of cardiovascular and sudomotordysfunctions in patients with MS, to study the sudomotor functions in patients with optic neuritis(optic neuritis being a frequent initial manifestation of MS), and to assess the extent ofdemyelinative lesions in the CNS by using magnetic resonance imaging and by correlating thefindings thus obtained with autonomic nervous system responses. The study showed cardiovascular autonomic regulation failure in MS patients manifestingitself both in the heart rate responses to deep breathing and in the heart rate and blood pressureresponses in the tilt table test. In particular, midbrain lesions were found to be associated withcardiovascular dysfunction. MS patients also showed abnormal sympathetic skin responsesindicating sudomotor failure. Focal MS lesions in the temporal lobe, in the pons and in thecerebellum were also associated with abnormal sympathetic skin responses. MS patients were alsofound to have an impairment in thermoregulatory sweating, which seemed to be related to diseaseseverity and to total lesion volume in the brain. Sympathetic skin responses were also abnormal inoptic neuritis patients, suggesting sudomotor autonomic failure. Patients with optic neuritisshowed no thermoregulatory dysfunction

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