Naslov
Short- and long-term effects of siponimod on autonomic nervous system in secondary progressive multiple sclerosis
(Short- and long-term effects of siponimod on autonomic nervous system in secondary progressive multiple sclerosis)

Autori
Habek, Mario ; Junaković, Anamari ; Karić, Antea ; Crnošija, Luka ; Barun, Barbara ; Gabelić, Tereza ; Adamec, Ivan ; Krbot Skorić, Magdalena

Izvornik
Multiple Sclerosis and Related Disorders (2211-0348) 64 (2022); 103966, 6

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
secondary progressive multiple sclerosis ; autonomic nervous system ; siponimod.

Sažetak
Objectives: The aim of this study was to investigate the short- and long-term effects of siponimod on autonomic nervous system (ANS) function, in people with secondary progressive multiple sclerosis (pwSPMS) METHODS: The following ANS tests were performed in 26 pwSPMS: a 10 min supine resting position, Valsalva maneuver, deep breathing test and a 10 min tilt-up table test. Heart rate variability (HRV) was performed for the 10 min in supine resting position (M0) and for a 3 h period after siponimod treatment initiation (M0s1-6). All ANS tests were repeated after at least 6 months of treatment with siponimod (M6). Results: In all 6 intervals after siponimod ingestion (M0s1-6), standard deviation of NN intervals (SDNN) was higher compared to M0. After 6 months of continuous treatment with siponimod, SDNN was significantly lower compared to M0. At M6, Valsalva ratio and respiratory sinus arrhythmia were lower compared to M0 values (1.510±0.338 vs 1.864±0.456, p=0.003 and 7.969±2.865 vs 13.091±4.687, p<0.001, respectively). Cardiovagal index was significantly higher at M6 compared to M0 (1 (range 0-2) vs 0 (range 0-1), p=0.008, respectively). Active Magnetic Resonance Imaging (MRI) one year prior to starting siponimod was a positive predictor of M6 SDNN and Adrenergic Index (AI) at M0 was a negative predictor of M6 SDNN. Conclusion: This study has shown an inverse relationship in short- versus long-term effects of siponimod on ANS function. A shift towards parasympathetic predominance was observed during the first three hours after ingestion, while after 6 or more months of continuous treatment with siponimod, a shift towards sympathetic predominance was observed.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Interdisciplinarne biotehničke znanosti

POVEZANOST RADA