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The subclinic autonomic dysfunction in patients with Behçet disease an electrophysiological study       
Yazarlar
Pınar Borman
Kastamonu Üniversitesi, Türkiye
 Figen TUNCAY Figen TUNCAY
Ahi Evran Üniversitesi, Türkiye
Müyesser Okumuş
Kırıkkale Üniversitesi, Türkiye
Güngör Emel
Ekşioğlu Meral
Özet
Studies that have evaluated autonomic nervous system (ANS) function in Behcet disease (BD) are rare and have indicated conflicting results with different degrees of involvement. The aim of this study was to investigate ANS function by using electrophysiological tests in patients with BD and to determine the relationship between the disease activity parameters and the indicators of autonomic activity. We included 70 BD patients and 50 healthy controls. Demographic characteristics including age, sex, and disease duration were recorded. A detailed neurological examination was performed, and clinical autonomic symptoms were recorded. The Behcet Disease Current Activity Form (BDCAF) was used to determine the disease activity. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were determined for laboratory activity. The electrophysiological assessments of ANS function were performed by sympathetic skin response (SSR) and R-R interval variation (RRIV) tests. The mean values of sympathetic (SSR latency and amplitude) and parasympathetic (RRIV at rest [R%] and deep breathing [D%], D% - R%, and D%/R%) parameters were compared, and any correlations between ANS parameters and clinical disease characteristics were determined. Seventy BD patients (23 males, 47 females) with a mean age of 41.2 +/- 10.01 years and 50 control subjects (18 males, 32 females) with a mean age of 39.5 +/- 8.94 years were included in the study. All the subjects were totally symptom free with respect to ANS involvement, and the subjects in both groups had normal neurological examination findings. The demographic characteristics were similar between the groups. The mean latency of SSR was increased (1.4 +/- 0.4 vs 0.7 +/- 0.8), and R% (0.3 +/- 0.3 vs 0.5 +/- 0.4) and D% (0.3 +/- 0.3 vs 0.6 +/- 0.5) values were decreased in BD patients compared to control subjects. No correlation was found between BDCAF scores and ANS variables. However, there was a significant correlation between SSR latency and ESR and CRP values (p<0.01, r=-0.25, r=-0.31, respectively) in the patient group, indicating a more sympathetic dysautonomia in patients with active laboratory parameters. In conclusion, our study indicates a subclinical sympathetic and parasympathetic autonomic dysfunction in patients with BD, which may be related with disease activity. As the early recognition of abnormalities in ANS may be very important in order to prevent excessive morbidity, simple electrophysiological methods are suggested to identify Behcet patients at high risk for symptomatic dysautonomia.
Anahtar Kelimeler
Autonomic nervous system, Behcet disease, Disease activity
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı Clinical Rheumatology
Dergi ISSN 0770-3198
Dergi Tarandığı Indeksler SCI-Expanded
Makale Dili İngilizce
Basım Tarihi 01-2012
Cilt No 31
Sayı 1
Sayfalar 41 / 47
Doi Numarası 10.1007/s10067-011-1763-9
Makale Linki http://link.springer.com/10.1007/s10067-011-1763-9