Cardiovascular autonomic dysregulation and fatigue in multiple sclerosis

Both cardiovascular disturbances and fatigue are frequent in multiple scler osis (MS). We investigated their relationship in 84 MS patients (mean age 3 9.9 +/- 8.9 years) using five established autonomic tests and three differe nt fatigue questionnaires. 64.2% of the patients were categorised as being fatigued. Fatigue perception was weakly related to EDSS. Moderate cardiovas cular disturbances were found in 16.6% of the patients, and 10.7% had sever e cardiovascular autonomic abnormalities. Cardiovascular dysfunction was sl ightly related to age and to EDSS. In 19.4% of all patients signs of autono mic failure and fatigue were co-existent. Using correlation analysis, we fo und only weakly significant correlation coefficients between some single au tonomic test parameters and fatigue scores, which were confounded by age ef fects. The analysis of dichotomised data revealed slightly significant diff erences in fatigue experience between patients with and without abnormaliti es regarding the handgrip test and the Valsalva reaction. Thus, autonomic d isturbances might contribute to fatigue symptoms in a MS subgroup, but the overall influence of the autonomic cardiovascular regulation towards fatigu e experience seems to be of minor relevance.