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Autonomic and peripheral nervous system function in acute tick‐borne encephalitis

OBJECTIVES: Tick‐borne encephalitis (TBE) is an emerging flaviviral zoonosis in Central and Eastern Europe. TBE can present as meningitis, meningoencephalitis, or meningoencephalomyelitis. Dysfunction of the autonomic (ANS) and peripheral motoric and sensory nervous system (PNS) might contribute to...

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Autores principales: Neumann, Bernhard, Schulte‐Mattler, Wilhelm, Brix, Sophie, Pöschl, Peter, Jilg, Wolfgang, Bogdahn, Ulrich, Steinbrecher, Andreas, Kleiter, Ingo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864130/
https://www.ncbi.nlm.nih.gov/pubmed/27247855
http://dx.doi.org/10.1002/brb3.485
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author Neumann, Bernhard
Schulte‐Mattler, Wilhelm
Brix, Sophie
Pöschl, Peter
Jilg, Wolfgang
Bogdahn, Ulrich
Steinbrecher, Andreas
Kleiter, Ingo
author_facet Neumann, Bernhard
Schulte‐Mattler, Wilhelm
Brix, Sophie
Pöschl, Peter
Jilg, Wolfgang
Bogdahn, Ulrich
Steinbrecher, Andreas
Kleiter, Ingo
author_sort Neumann, Bernhard
collection PubMed
description OBJECTIVES: Tick‐borne encephalitis (TBE) is an emerging flaviviral zoonosis in Central and Eastern Europe. TBE can present as meningitis, meningoencephalitis, or meningoencephalomyelitis. Dysfunction of the autonomic (ANS) and peripheral motoric and sensory nervous system (PNS) might contribute to acute and long‐term complications. We aimed to examine, whether the ANS and PNS are affected in acute TBE. METHODS: Fourteen patients with acute TBE, 17 with diabetic polyneuropathy (d‐PNP), and 30 healthy controls (HC) were examined in our single‐center, prospective study. ANS and PNS function was assessed by time‐ and frequency‐domain parameters of the heart rate (HR) variability at rest and deep respiration, and by sural and tibial nerve neurography. Primary endpoint was the HR variability at rest measured by root mean square of the successive differences (RMSSD). Autonomic symptoms and quality of life (QoL) were assessed by questionnaires. RESULTS: Tick‐borne encephalitis patients had a lower RMSSD at rest (TBE 13.1 ± 7.0, HC 72.7 ± 48.3; P < 0.001) and deep respiration (TBE 42.8 ± 27.0, HC 109.7 ± 68.8; P < 0.01), an increased low‐frequency to high‐frequency power component ratio at rest (TBE 4.0 ± 4.0, HC 0.8 ± 0.5; P < 0.001), and a higher minimal heart rate at rest (TBE 85.4 ± 7.0, HC 69.5 ± 8.5; P < 0.001), all similar to patients with d‐PNP, indicating sympathovagal imbalance with increased sympathetic activation. Compared to HC, sural and tibial nerve conduction velocities and action potential amplitudes were reduced, ANS symptoms were more frequent, and QoL was lower in patients with TBE. CONCLUSIONS: The ANS and to a lesser degree the PNS are affected by acute TBE, which could potentially contribute to short‐ and long‐term morbidity.
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spelling pubmed-48641302016-05-31 Autonomic and peripheral nervous system function in acute tick‐borne encephalitis Neumann, Bernhard Schulte‐Mattler, Wilhelm Brix, Sophie Pöschl, Peter Jilg, Wolfgang Bogdahn, Ulrich Steinbrecher, Andreas Kleiter, Ingo Brain Behav Original Research OBJECTIVES: Tick‐borne encephalitis (TBE) is an emerging flaviviral zoonosis in Central and Eastern Europe. TBE can present as meningitis, meningoencephalitis, or meningoencephalomyelitis. Dysfunction of the autonomic (ANS) and peripheral motoric and sensory nervous system (PNS) might contribute to acute and long‐term complications. We aimed to examine, whether the ANS and PNS are affected in acute TBE. METHODS: Fourteen patients with acute TBE, 17 with diabetic polyneuropathy (d‐PNP), and 30 healthy controls (HC) were examined in our single‐center, prospective study. ANS and PNS function was assessed by time‐ and frequency‐domain parameters of the heart rate (HR) variability at rest and deep respiration, and by sural and tibial nerve neurography. Primary endpoint was the HR variability at rest measured by root mean square of the successive differences (RMSSD). Autonomic symptoms and quality of life (QoL) were assessed by questionnaires. RESULTS: Tick‐borne encephalitis patients had a lower RMSSD at rest (TBE 13.1 ± 7.0, HC 72.7 ± 48.3; P < 0.001) and deep respiration (TBE 42.8 ± 27.0, HC 109.7 ± 68.8; P < 0.01), an increased low‐frequency to high‐frequency power component ratio at rest (TBE 4.0 ± 4.0, HC 0.8 ± 0.5; P < 0.001), and a higher minimal heart rate at rest (TBE 85.4 ± 7.0, HC 69.5 ± 8.5; P < 0.001), all similar to patients with d‐PNP, indicating sympathovagal imbalance with increased sympathetic activation. Compared to HC, sural and tibial nerve conduction velocities and action potential amplitudes were reduced, ANS symptoms were more frequent, and QoL was lower in patients with TBE. CONCLUSIONS: The ANS and to a lesser degree the PNS are affected by acute TBE, which could potentially contribute to short‐ and long‐term morbidity. John Wiley and Sons Inc. 2016-05-05 /pmc/articles/PMC4864130/ /pubmed/27247855 http://dx.doi.org/10.1002/brb3.485 Text en © 2016 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Neumann, Bernhard
Schulte‐Mattler, Wilhelm
Brix, Sophie
Pöschl, Peter
Jilg, Wolfgang
Bogdahn, Ulrich
Steinbrecher, Andreas
Kleiter, Ingo
Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title_full Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title_fullStr Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title_full_unstemmed Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title_short Autonomic and peripheral nervous system function in acute tick‐borne encephalitis
title_sort autonomic and peripheral nervous system function in acute tick‐borne encephalitis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864130/
https://www.ncbi.nlm.nih.gov/pubmed/27247855
http://dx.doi.org/10.1002/brb3.485
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