Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Autonomic Dysfunction Compared in Patients with MS

Clin Neurophysiol; 2018 Aug; Adamec, Crnošija, et al

There is a significant difference in autonomic function in patients with relapsing remitting multiple sclerosis (pwRRMS) and patients with progressive MS (pwPMS), with pwPMS having a higher burden of autonomic dysfunction (AD), which is particularly evident for sweating dysfunction, according to a recent study. Researchers performed a composite autonomic scoring scale (AD) and heart rate variability (HRV) on 40 pwRRMS and 30 pwPMS. They found:

  • pwPMS had a significantly higher sudomotor index and total CASS score compared to pwRRMS.
  • Disease duration positively correlated with sudomotor index and total CASS (rs = 0.409), while the Expanded Disability Status Scale (EDSS) positively correlated with sudomotor index and total CASS (rs = 0.411 and rs = 0.402, respectively) in all patients.
  • Type of multiple sclerosis (pwRRMS or pwPMS) corrected for age, sex and disease duration, was a statistically significant predictor of CASS value (B = 1.215).
  • Compared to pwRRMS, pwPMS had a significantly lower standard deviation of normal-to-normal intervals (SDNN), low frequency (LF), and high frequency (HF), during both the supine and tilt-up phases.


Adamec I, Crnošija L, Junaković, Skorić MK, Habek M. Progressive multiple sclerosis patients have a higher burden of autonomic dysfunction compared to relapsing remitting phenotype. Clin Neurophysiol. 2018;129(8):1588-1594. doi:10.1016/j.clinph.2018.05.009.

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