The goal of this interventional non-pharmacological study is to evaluate the involvement of the autonomic nervous system in patients with relapsing-remitting and primary progressive multiple sclerosis. The main questions it aims to answer are: * Is it possible to define the characteristics of dysautonomia to improve treatment on patients with multiple sclerosis through the management of conditions such as orthostatic hypotension or thermoregulation disorders that inevitably condition the patient's life and the response to rehabilitation ? * Does the severity of the functional alterations correlate with impairment of small somatic and autonomic cutaneous nerve fibers in patients with multiple sclerosis ? * How much the involvement of the autonomic nervous system affects the clinical history and progression of the disease ? * Do different clinical variants of multiple sclerosis manifest with different patterns of involvement of the sensory-autonomic nervous system ? Participants will be hospitalized in Maugeri Clinical Institute of Telese Terme for a rehabilitation treatment. Patients will perform a sensory and autonomic functional study and a morphological analysis of cutaneous nerves through skin biopsy. Researchers will compare results between the two groups (relapsing-remitting and primary progressive) and between patients and data from control subjects.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
60
We'll perform a punch skin biopsy of 3mm from thigh, leg and fingertip and we'll quantify peripheral sensory and autonomic nerve fibers.
Cardiovascular reflex tests including deep breathing, head-up Tilt, standing, isometric exercises, mental arithmetic and Valsalva maneuver.
We'll characterize patients' symptoms through the administration of clinical scales such as: COMPASS 31 autonomic symptoms scale; Small Fiber Neuropathy Symptom Inventory Questionnaire (SFN-SIQ), the Pain Detect Questionnaire and the Total neuropathy score
ICS Maugeri - IRCCS of Telese Terme
Telese Terme, Benevento, Italy
RECRUITINGDepartment of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II
Naples, Italy
RECRUITINGCardiovascular reflex test
Assessment of Cardiovascular reflex responses to physical challenges.
Time frame: At the recruitment
Sudomotor function test
Assessment of postganglionic sudomotor function through dynamic sweat test
Time frame: At the recruitment
Quantification of peripheral autonomic nerve fibers
Quantification of sweat gland innervation (fiber length /um3) and arrector pili muscle (ff/mm).
Time frame: At the recruitment
Quantification of peripheral sensory nerve fibers
Quantification of sensory nerve fibers (Intraepidermal nerve fibers (ff/mm)).
Time frame: At the recruitment
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