Autonomic system and amyotrophic lateral sclerosis
| Autor: | David M. Sletten, Phillip A. Low, Nathan P. Staff, Ezequiel A. Piccione |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Neural Conduction Autonomic Nervous System Lower motor neuron Severity of Illness Index Article Cellular and Molecular Neuroscience Physiology (medical) Internal medicine medicine Humans Amyotrophic lateral sclerosis Motor Neuron Disease Pure autonomic failure Aged Retrospective Studies Aged 80 and over Upper motor neuron Amyotrophic Lateral Sclerosis Autonomic Pathways Middle Aged medicine.disease Sudomotor Autonomic nervous system medicine.anatomical_structure Cross-Sectional Studies Corticospinal tract Cardiology Physical therapy Female Neurology (clinical) Psychology |
| Zdroj: | Musclenerve. 51(5) |
| ISSN: | 1097-4598 |
| Popis: | Introduction: The aim of this study is to characterize autonomic impairment in motor neuron disease. Methods: Neurological evaluations and autonomic testing were analyzed retrospectively in 132 patients: 86 classic amyotrophic lateral sclerosis (ALS), 36 lower motor neuron (LMN), and 10 upper motor neuron (UMN) predominant disease. Results: One-third of patients were symptomatic; urinary urgency and constipation were the most frequent symptoms. Increased Composite Autonomic Severity Score (CASS) was present in 75% with mild impairment (CASS 1–3) in 85% and moderate (CASS 4–7) in 15%. The frequencies of testing abnormalities were: sudomotor 46%, cardiovagal 50%, and adrenergic 14%. The UMN group had significantly higher median CASS scores than the classic ALS (P = 0.021) and LMN group (P = 0.018). Conclusions: We found predominantly mild autonomic impairment in ALS patients, with mostly cardiovagal and sudomotor involvement. Moderate autonomic failure occurred in 1 of 7 patients, especially those with an UMN presentation. Patients with selective corticospinal tract involvement may have more impairment of autonomic pathways. Muscle Nerve 51:676–679, 2015 |
| Databáze: | OpenAIRE |
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