Contributions
Abstract: EP1443
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and aims: Recently it has been suggested that the dysregulation in the neurovisceral integration of cardiovascular modulation can lead to many multiple sclerosis (MS)-related clinical symptoms like depression, fatigue and sleep disorders, migraine, osteoporosis and cerebral hemodynamic impairments. Furthermore, both adrenergic and cholinergic dysfunctions may play roles in the pathology of MS depression. The aim of the present study was to investigate possible association between autonomic dysfunction and depression in MS.
Design/methods: In this study, 44 patients with MS were included (30 females, mean age 37.18±10.93), 37 of them (group 1) had clinically isolated syndrome (CIS) or relapsing remitting MS (RRMS) and 7 (group 2) had primary progressive (PPMS) or secondary progressive (SPMS) MS. All patients filled the Beck depression scale (BDI) and Epworth Sleepiness Scale (ESS). The following autonomic tests were performed: heart rate and blood pressure responses to the Valsalva maneuver, heart rate response to deep breathing (RSA), and blood pressure response to passive tilt. All tests were interpreted in the form of the composite autonomic scoring scale (CASS) through adrenergic and cardiovagal indices.
Results: Patients from group 2 had significantly higher BDI compared to patients from group 1 (median 16 vs. 7, p=0.002). There was no statistically significant difference in two groups between frequencies of pathological values of CASS indices (score >0). Both adrenergic and cardiovagal indices correlated with EDSS (rs 0.394, p< 0.05 and rs 0.495, p=0.001).
Patients with pathological adrenergic index had higher BDI score in comparison with patients with normal index (8 vs. 4.5, p< 0.05), while there was no difference between patients with pathological and normal cardiovagal index.
For group 2, there was statistically significant correlation between BDI scale and adrenergic and cardiovagal indices (rs=0.797, p< 0.05; and rs=0.775, p< 0.05), while there was no correlation for patients from group 1.
Conclusion: These result suggest possible association between autonomic dysfunction and depression in MS patients. Further studies are encouraged in order to further elucidate this association.
Disclosure: Jelena Drulovic serves on scientific advisory boards for Bayer Schering Pharma, Merck Serono, Teva, Genzyme, a Sanofi Company, and received honoraria for speaking from Merck Serono, Teva, Bayer Schering, Genzyme, a Sanofi Company, Medis, Roche; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Darija Kisic-Tepavcevic has received research grant support from the Ministry of Education and Science, Republic of Serbia (projects no. 175031 and 175087).
Irena Dujmovic serves on scientific advisory board for Bayer Schering Pharma, and received honoraria for speaking from Merck Serono, Roche and Medis; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Gorica Maric has received research grant support from the Ministry of Education and Science, Republic of Serbia (projects no. 175087 and 175090).
Vanja Martinovic has received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175087).
Sarlota Mesaros serves on scientific advisory board for Merck Serono, and has received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Tatjana Pekmezovic has received compensation for consulting services, travel expenses for scientific meetings, and speaking honoraria from Bayer Schering Pharma, Merck Serono, Actavis/Teva, Roche, Gedeon Richter, Novartis; supported by a grant of the Ministry of Education, Science and Technological Development, Republic of Serbia (No. 175087 and 175090).
Mario Habek participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals.
Abstract: EP1443
Type: ePoster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background and aims: Recently it has been suggested that the dysregulation in the neurovisceral integration of cardiovascular modulation can lead to many multiple sclerosis (MS)-related clinical symptoms like depression, fatigue and sleep disorders, migraine, osteoporosis and cerebral hemodynamic impairments. Furthermore, both adrenergic and cholinergic dysfunctions may play roles in the pathology of MS depression. The aim of the present study was to investigate possible association between autonomic dysfunction and depression in MS.
Design/methods: In this study, 44 patients with MS were included (30 females, mean age 37.18±10.93), 37 of them (group 1) had clinically isolated syndrome (CIS) or relapsing remitting MS (RRMS) and 7 (group 2) had primary progressive (PPMS) or secondary progressive (SPMS) MS. All patients filled the Beck depression scale (BDI) and Epworth Sleepiness Scale (ESS). The following autonomic tests were performed: heart rate and blood pressure responses to the Valsalva maneuver, heart rate response to deep breathing (RSA), and blood pressure response to passive tilt. All tests were interpreted in the form of the composite autonomic scoring scale (CASS) through adrenergic and cardiovagal indices.
Results: Patients from group 2 had significantly higher BDI compared to patients from group 1 (median 16 vs. 7, p=0.002). There was no statistically significant difference in two groups between frequencies of pathological values of CASS indices (score >0). Both adrenergic and cardiovagal indices correlated with EDSS (rs 0.394, p< 0.05 and rs 0.495, p=0.001).
Patients with pathological adrenergic index had higher BDI score in comparison with patients with normal index (8 vs. 4.5, p< 0.05), while there was no difference between patients with pathological and normal cardiovagal index.
For group 2, there was statistically significant correlation between BDI scale and adrenergic and cardiovagal indices (rs=0.797, p< 0.05; and rs=0.775, p< 0.05), while there was no correlation for patients from group 1.
Conclusion: These result suggest possible association between autonomic dysfunction and depression in MS patients. Further studies are encouraged in order to further elucidate this association.
Disclosure: Jelena Drulovic serves on scientific advisory boards for Bayer Schering Pharma, Merck Serono, Teva, Genzyme, a Sanofi Company, and received honoraria for speaking from Merck Serono, Teva, Bayer Schering, Genzyme, a Sanofi Company, Medis, Roche; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Darija Kisic-Tepavcevic has received research grant support from the Ministry of Education and Science, Republic of Serbia (projects no. 175031 and 175087).
Irena Dujmovic serves on scientific advisory board for Bayer Schering Pharma, and received honoraria for speaking from Merck Serono, Roche and Medis; and has also received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Gorica Maric has received research grant support from the Ministry of Education and Science, Republic of Serbia (projects no. 175087 and 175090).
Vanja Martinovic has received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175087).
Sarlota Mesaros serves on scientific advisory board for Merck Serono, and has received research grant support from the Ministry of Education and Science, Republic of Serbia (project no. 175031).
Tatjana Pekmezovic has received compensation for consulting services, travel expenses for scientific meetings, and speaking honoraria from Bayer Schering Pharma, Merck Serono, Actavis/Teva, Roche, Gedeon Richter, Novartis; supported by a grant of the Ministry of Education, Science and Technological Development, Republic of Serbia (No. 175087 and 175090).
Mario Habek participated as clinical investigator and/or speaker for: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals.