Public Health and Nutrition

Multiple sclerosis (MS) is one of the world's most common non-traumatic cause of disability in young adults. Recent studies have reported the occurrence of fatigue and autonomic dysfunction (AD) in wide range of patients with MS that might present abnormalities in the regulation of the cardiovascular system, the gastrointestinal system and bladder functions. These non-motor symptoms could be predominant as the disease advances, thereby constituting a major source of disease burden for patients with MS. The primary aim of this study was to investigate the frequency and association of AD in MS patients, assessed by cardiovascular reflex test and a symptoms questionnaire. Sixty diagnosed MS patients were enrolled. The most common autonomic dysfunctions included: orthostatic intolerance (60%), bladder and bowel dysfunctions (28%). Fatigue has been reported by more than 90% of MS patients. Fatigue and cardiovascular disorders in MS are often neglected

during physical examination due to its heterogeneity and overlapping clinical symptoms. Additionally, non-motor symptoms in multiple sclerosis might impact the patient’s life quality greater than the effect of motor symptoms. Our study also highlights the need to monitor cardiac dysfunctions in MS patients where certain autonomic dysfunction symptoms are present.