Cardiac autonomic function during postural changes and exercise in people with multiple sclerosis: A cross-sectional study

Elisa Gervasoni, Marco Bove, Mattia Sinatra, Cristina Grosso, Marco Rovaris, Davide Cattaneo, Giampiero Merati

Research output: Contribution to journalArticlepeer-review


Background: People with multiple sclerosis (PwMS) often develop an autonomic dysfunction (AD), which onset should be assessed early at a subclinical level, as it may interfere with pharmacological treatments and exercise. Objective: To evaluate basal cardiac autonomic tone, its modulations during sit-to-stand, sub-maximal exercise and recovery in PwMS without clinical overt AD and its relationships with fatigue perception. Methods: Twenty-three PwMS (55 ± 8 yrs [mean ± SD]; EDSS score 5.7 ± 1.3) and 20 age-matched healthy controls (HC; 55 ± 8yrs) were enrolled. ECG was digitally acquired during:1) sitting at rest (low sympathetic activation); 2) standing (light sympathetic activation); and 3) during light exercise (moderate sympathetic activation) and recovery. Parasympathetic and sympatho-vagal parameters of heart rate (HR) variability in time and frequency domains were calculated from beat series. Results: HR was slightly but not significantly higher in PwMS compared to HC in all experimental conditions. Parasympathetic indexes were significantly lower (p < 0.05) in PwMS compared to HC during baseline sitting and post-exercise recovery, whereas sympathovagal parameters were similar in both groups. No correlation between autonomic tone and perceived fatigue was observed. Conclusion: Parasympathetic tone appears to be impaired in PwMS basal and post-exercise conditions, but not during postural challenge and exercise. In addition, AD does not affect perceived fatigue.

Original languageEnglish
Pages (from-to)85-90
Number of pages6
JournalMultiple Sclerosis and Related Disorders
Publication statusPublished - Aug 1 2018


  • Autonomic dysfunction
  • Exercise
  • Multiple sclerosis
  • Recovery
  • Sit-to-stand

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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