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Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?

BACKGROUND: Fatigue is a disabling symptom of multiple sclerosis. Its biological causes are still poorly understood. Several years ago, we proposed that fatigue might be the subjective representation of inflammatory processes. An important step for a straight-forward evaluation of our model would be...

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Autores principales: Garis, Guadalupe, Haupts, Michael, Duning, Thomas, Hildebrandt, Helmut
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816295/
https://www.ncbi.nlm.nih.gov/pubmed/36125573
http://dx.doi.org/10.1007/s10072-022-06385-1
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author Garis, Guadalupe
Haupts, Michael
Duning, Thomas
Hildebrandt, Helmut
author_facet Garis, Guadalupe
Haupts, Michael
Duning, Thomas
Hildebrandt, Helmut
author_sort Garis, Guadalupe
collection PubMed
description BACKGROUND: Fatigue is a disabling symptom of multiple sclerosis. Its biological causes are still poorly understood. Several years ago, we proposed that fatigue might be the subjective representation of inflammatory processes. An important step for a straight-forward evaluation of our model would be to show that the level of fatigue is associated with vagal activation. The heart rate is under partial control of the vagus nerve. Using power spectrum analysis allows to separate, at least partly, sympathetic and parasympathetic impact on heart rate variability. METHODS: This narrative review summarizes the evidence for heart rate variability changes in MS patients, their relationship with fatigue and disease course. To do this, we conducted a literature search, including 45 articles relevant to the topic treated in this review. RESULTS: We illustrate that (1) inflammation leads to a change in cardiac behavior during acute and chronic phases, both in animals and in humans; (2) MS patients show changes of heart rate variability (HRV) that resemble those during acute and chronic inflammation due to multiple causes; (3) existing evidence favors a set of specific predictions about fatigue and parallel HRV changes; and (4) that MS-related brainstem lesions or neurological impairments do not completely explain HRV changes, leaving enough place for an explanatory relation between HRV and fatigue. DISCUSSION: We discuss the results of this review in relation to our model of fatigue and propose several observational and experimental studies that could be conducted to gain a better insight into whether fatigue and HRV can be interpreted as a common pathway, both reflecting activated autoimmune processes in MS patients.
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spelling pubmed-98162952023-01-07 Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes? Garis, Guadalupe Haupts, Michael Duning, Thomas Hildebrandt, Helmut Neurol Sci Review Article BACKGROUND: Fatigue is a disabling symptom of multiple sclerosis. Its biological causes are still poorly understood. Several years ago, we proposed that fatigue might be the subjective representation of inflammatory processes. An important step for a straight-forward evaluation of our model would be to show that the level of fatigue is associated with vagal activation. The heart rate is under partial control of the vagus nerve. Using power spectrum analysis allows to separate, at least partly, sympathetic and parasympathetic impact on heart rate variability. METHODS: This narrative review summarizes the evidence for heart rate variability changes in MS patients, their relationship with fatigue and disease course. To do this, we conducted a literature search, including 45 articles relevant to the topic treated in this review. RESULTS: We illustrate that (1) inflammation leads to a change in cardiac behavior during acute and chronic phases, both in animals and in humans; (2) MS patients show changes of heart rate variability (HRV) that resemble those during acute and chronic inflammation due to multiple causes; (3) existing evidence favors a set of specific predictions about fatigue and parallel HRV changes; and (4) that MS-related brainstem lesions or neurological impairments do not completely explain HRV changes, leaving enough place for an explanatory relation between HRV and fatigue. DISCUSSION: We discuss the results of this review in relation to our model of fatigue and propose several observational and experimental studies that could be conducted to gain a better insight into whether fatigue and HRV can be interpreted as a common pathway, both reflecting activated autoimmune processes in MS patients. Springer International Publishing 2022-09-20 2023 /pmc/articles/PMC9816295/ /pubmed/36125573 http://dx.doi.org/10.1007/s10072-022-06385-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Garis, Guadalupe
Haupts, Michael
Duning, Thomas
Hildebrandt, Helmut
Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title_full Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title_fullStr Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title_full_unstemmed Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title_short Heart rate variability and fatigue in MS: two parallel pathways representing disseminated inflammatory processes?
title_sort heart rate variability and fatigue in ms: two parallel pathways representing disseminated inflammatory processes?
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9816295/
https://www.ncbi.nlm.nih.gov/pubmed/36125573
http://dx.doi.org/10.1007/s10072-022-06385-1
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