engleski

Autonomic nervous system: a key player in prodromal multiple sclerosis?

Multiple sclerosis (MS) is a complex inflammatory autoimmune and neurodegenerative disorder affecting individuals between 20 and 40 years of age, more often women. Given the cumulative number of patients with MS worldwide and the increasing disease-modifying therapies becoming available, early diagnosis is key, as early intervention may arrest disease progression.Autonomic dysfunction, namely gastrointestinal, genitourinary, and cardiovascular abnormalities, is a key feature of the prodromal phase of other neurological disorders, such as Parkinson disease and other synucleinopathies. Analog changes appear to occur in patients with MS, with sexual dysfunction appearing in later stages of disease and among patients with more advanced disability scores. Moreover, autonomic symptoms are present and may also impact the disease course in MS.All these pieces of evidence indicate that the autonomic nervous system might be a key player in prodromal MS and in the development of clinically established MS. Studies ascertaining objective neurophysiologic and molecular markers of autonomic dysfunction in large populations of patients at risk of MS should confirm this.

multiple sclerosis ; autonomic nervous system

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