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Neurorehabilitation and Neural Repair
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Multiple Sclerosis Patients with Fatigue: Relationship Among Temperature Regulation, Autonomic Dysfunction, and Exercise Capacity

Jeffrey A. Cohen

Departments of Neurology and Medicine, University of Health Sciences Center

Kenneth F. Hossack

Division of Cardiology, University of Health Sciences Center

Gary M. Franklin

Departments of Neurology and Medicine, University of Health Sciences Center, The Rocky Mountain Multiple Sclerosis Center, Denver, CO, U.S.A.

Sixteen well-characterized MS patients with a prominent complaint of fatigue underwent exercise testing, with temperature monitoring, and autonomic nervous system (ANS) testing. It was postulated that defective temperature regulation, as the result of ANS dysfunction, would limit exercise capacity. When MS patients were compared to a control group, ANS dysfunction of both the sympathetic and parasympathetic components was present. However, in MS patients, there was no evidence of excessive heat accumulation during exercise. An Expanded Disability Scale Score of greater than 2.5 predicted patients with markedly impaired exercise capacity. This study suggests that ANS influence on exercise capacity in MS patients is more complex than simple temperature regulation.

Key Words: Multiple sclerosis • Autonomic nervous system • Parasympathetic • Sympathetic • Fatigue • Temperature regulation.

Neurorehabilitation and Neural Repair, Vol. 3, No. 4, 193-198 (1989)
DOI: 10.1177/136140968900300404
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