Oliver W Tolson
Newcastle University, UK
Scientific Tracks Abstracts: J Neurol Neurophysiol
Background: Fatigue is a common debilitating symptom of multiple sclerosis (MS) but its pathophysiology remains poorly understood. Recent studies in a variety of diseases have shown dysfunction of the cardiovascular autonomic nervous system correlates with fatigue severity. Objectives: To investigate the prevalence of fatigue and orthostatic intolerance in a representative MS cohort. To objectively assess fatigued secondary-progressive patients for cardiovascular autonomic dysfunction. Methods: Fatigue severity and orthostatic intolerance were measured using validated questionnaires in 144 patients (85.2% response). Subsequently, 11 fatigued secondary-progressive MS patients underwent objective assessment of resting heart rate variability (HRV) and blood pressure variability (BPV). Results: Fatigue was identified in 74.8% of MS patients, with fatigue severity significantly higher in secondary-progressive patients. Moderate orthostatic intolerance was identified in 54.3% of patients and correlated significantly with fatigue (r=0.49, p<0.0001). Objective assessment revealed significant reductions in low-frequency HRV and BPV in the fatigued secondary-progressive group versus controls. A substantial reduction was seen in low-frequency systolic BPV (33.6% versus 48.9%, p=0.03), an established marker of sympathetic vasomotor function. Furthermore reductions in this parameter correlated significantly with orthostatic symptoms (r=ΓΆΒ?Β?0.87, p=0.0007) and fatigue severity (r=ΓΆΒ?Β?0.66, p=0.03). Conclusions: Fatigue severity correlates significantly with increasing orthostatic intolerance. Additionally, fatigued secondaryprogressive patients have objective evidence of sympathetic vasomotor dysfunction.
Oliver Tolson completed his medical degree at Newcastle University Medical School, following completion of his Masters in Research in 2014. He was awarded a Wolfson Intercalated Award in 2013 to fund this research into fatigue and autonomic dysfunction in multiple sclerosis.
Email: oliver.tolson@doctors.org.uk
