RESPIRATORY DYSFUNCTION IN MULTIPLE-SCLEROSIS - A PROSPECTIVE ANALYSIS OF 60 PATIENTS

This study aimed to determine the relationship between pulmonary funct ion, respiratory muscle function and neurological function in multiple sclerosis (MS).Sixty patients (27 males and 33 females) aged 27-75 yr s (mean+/-SD 48+/-12 yrs) were prospectively studied. The Kurtzke Expa nded Disability Status Scale (EDSS; range 0-10) score was 6.5+/-1.5; a nd the different Functional Systems Scores (FSS; ranges 0-5 and 0-6) w ere: pyramidal 3.4+/-1.1; brain stem 1.9+/-1.2; mental 1.3+/-0.9; cere bellar 2.2+/-1.0; sphincter 1.8+/-1.5; visual 1.4+/-1.4; and sensory 2 .0+/-1.5. Results of lung function tests were: vital capacity (VC) 80/-23% of predicted; single-breath transfer factor of the lung for carb on monoxide (TL,CO,sb) 83+/-17% pred; maximal static expiratory mouth pressure (MEP) 30+/-16% pred; and maximal static inspiratory mouth pre ssure (MIP) 47+/-23% pred, indicating a marked respiratory muscle dysf unction, with a minor restrictive defect. In 70% of the patients, a tr anscutaneous oxygen saturation (Stc,O-2) of less than 92% at night was found. Comparison of lung function and disability scores showed that the abnormalities in both tended to be correlated to each other, and t hat this was significant for EDSS versus lung volumes, for most FSS wi th VC, and also for some FSS with MEP and/or IMP. Duration of disease was significantly correlated with the EDSS, but not with the different FSS scores (with the exception of mental status) and not with lung fu nction. Multiple sclerosis leads to lung function abnormalities attrib utable to respiratory pump dysfunction.