Heart rate variability is differentially altered in multiple sclerosis: implications for acute, worsening and progressive disability

Valeria Studer, Camilla Rocchi, Caterina Motta, Benedetta Lauretti, Jacopo Perugini, Laura Brambilla, Lorena Pareja-Gutierrez, Giorgia Camera, Francesca Romana Barbieri, Girolama A Marfia, Diego Centonze, Silvia Rossi

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Sympathovagal imbalance has been associated with poor prognosis in chronic diseases, but there is conflicting evidence in multiple sclerosis.

OBJECTIVES: The objective of this study was to investigate the autonomic nervous system dysfunction correlation with inflammation and progression in multiple sclerosis.

METHODS: Heart rate variability was analysed in 120 multiple sclerosis patients and 60 healthy controls during supine rest and head-up tilt test; the normalised units of low frequency and high frequency power were considered to assess sympathetic and vagal components, respectively. Correlation analyses with clinical and radiological markers of disease activity and progression were performed.

RESULTS: Sympathetic dysfunction was closely related to the progression of disability in multiple sclerosis: progressive patients showed altered heart rate variability with respect to healthy controls and relapsing-remitting patients, with higher rest low frequency power and lacking the expected low frequency power increase during the head-up tilt test. In relapsing-remitting patients, disease activity, even subclinical, was associated with lower rest low frequency power, whereas stable relapsing-remitting patients did not differ from healthy controls. Less sympathetic reactivity and higher low frequency power at rest were associated with incomplete recovery from relapse.

CONCLUSIONS: Autonomic balance appears to be intimately linked with both the inflammatory activity of multiple sclerosis, which is featured by an overall hypoactivity of the sympathetic nervous system, and its compensatory plastic processes, which appear inefficient in case of worsening and progressive multiple sclerosis.

Original languageEnglish
Pages (from-to)2055217317701317
JournalMultiple Sclerosis Journal - Experimental, Translational and Clinical
Issue number2
Publication statusPublished - Jun 14 2017


  • Journal Article


Dive into the research topics of 'Heart rate variability is differentially altered in multiple sclerosis: implications for acute, worsening and progressive disability'. Together they form a unique fingerprint.

Cite this