Omid Mirmosayyeb, Mohammad Yazdan Panah, Mohammadreza Alinejadfard, Soroush Oraee, Saeed Vaheb, Vahid Shaygannejad
{"title":"Heart rate variability in people with multiple sclerosis: A systematic review and meta-analysis.","authors":"Omid Mirmosayyeb, Mohammad Yazdan Panah, Mohammadreza Alinejadfard, Soroush Oraee, Saeed Vaheb, Vahid Shaygannejad","doi":"10.1007/s13760-025-02829-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a neurodegenerative disease with diverse symptoms, including autonomic nervous system impairment. While autonomic dysfunction is well-documented in MS, debate continues over its extent and whether it primarily affects the sympathetic or parasympathetic divisions. This review aimed to investigate heart rate variability (HRV) as an indicator of cardiac autonomic function in people with MS (PwMS).\"</p><p><strong>Methods: </strong>PubMed/MEDLINE, Web of Science, Embase, and Scopus were systematically searched up to August 2024 to identify observational studies that assessed HRV in PwMS and healthy controls (HCs). The standard mean difference (SMD) of HRV parameters, along with its 95% confidence interval (CI), between PwMS and HCs was estimated utilizing R version 4.4.0 within the random-effects model.</p><p><strong>Results: </strong>This study combined data from 43 studies on 1518 PwMS and 1062 HCs. The meta-analysis revealed significant autonomic dysfunction in PwMS compared to HCs. Specifically, the time-domain measures such as root mean square of successive differences (RMSSD) (SMD = -0.81, p < 0.01) and pNN50 (SMD = -0.63, p < 0.001) showed significant reductions in PwMS, compared to HCs. Furthermore, among frequency domains, high frequency (HF) power (SMD = -0.51, p < 0.01) and low frequency (LF) power were significantly lower in PwMS (SMD = -0.44, p < 0.05) than HCs.</p><p><strong>Conclusion: </strong>This review revealed that PwMS exhibited different HRV than healthy individuals. Additionally, HRV findings demonstrated greater sympathetic dominance in PwMS compared to healthy individuals. Future studies are needed to explore HRV in PwMS across varying severity levels, subtypes, and treatments to understand autonomic dysfunction in this population better.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta neurologica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13760-025-02829-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Multiple sclerosis (MS) is a neurodegenerative disease with diverse symptoms, including autonomic nervous system impairment. While autonomic dysfunction is well-documented in MS, debate continues over its extent and whether it primarily affects the sympathetic or parasympathetic divisions. This review aimed to investigate heart rate variability (HRV) as an indicator of cardiac autonomic function in people with MS (PwMS)."
Methods: PubMed/MEDLINE, Web of Science, Embase, and Scopus were systematically searched up to August 2024 to identify observational studies that assessed HRV in PwMS and healthy controls (HCs). The standard mean difference (SMD) of HRV parameters, along with its 95% confidence interval (CI), between PwMS and HCs was estimated utilizing R version 4.4.0 within the random-effects model.
Results: This study combined data from 43 studies on 1518 PwMS and 1062 HCs. The meta-analysis revealed significant autonomic dysfunction in PwMS compared to HCs. Specifically, the time-domain measures such as root mean square of successive differences (RMSSD) (SMD = -0.81, p < 0.01) and pNN50 (SMD = -0.63, p < 0.001) showed significant reductions in PwMS, compared to HCs. Furthermore, among frequency domains, high frequency (HF) power (SMD = -0.51, p < 0.01) and low frequency (LF) power were significantly lower in PwMS (SMD = -0.44, p < 0.05) than HCs.
Conclusion: This review revealed that PwMS exhibited different HRV than healthy individuals. Additionally, HRV findings demonstrated greater sympathetic dominance in PwMS compared to healthy individuals. Future studies are needed to explore HRV in PwMS across varying severity levels, subtypes, and treatments to understand autonomic dysfunction in this population better.
期刊介绍：
Peer-reviewed and published quarterly, Acta Neurologica Belgicapresents original articles in the clinical and basic neurosciences, and also reports the proceedings and the abstracts of the scientific meetings of the different partner societies. The contents include commentaries, editorials, review articles, case reports, neuro-images of interest, book reviews and letters to the editor.
Acta Neurologica Belgica is the official journal of the following national societies:
Belgian Neurological Society
Belgian Society for Neuroscience
Belgian Society of Clinical Neurophysiology
Belgian Pediatric Neurology Society
Belgian Study Group of Multiple Sclerosis
Belgian Stroke Council
Belgian Headache Society
Belgian Study Group of Neuropathology
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