Abstract
While relapsing–remitting is the most prevalent course of multiple sclerosis, the prognostic/predictive markers of the worsening of symptomatology are still debated. With reference to other diseases, the study of the circadian activity rhythm, according to the theoretical framework of the two-process model of sleep regulation and applying functional linear modeling, proved to be useful to identify a possible marker. The usefulness of the study of circadian activity rhythm in multiple sclerosis is strengthened by recent findings indicating a potential involvement of circadian factors in the multifactorial etiopathology of the disorder. The aim of the present study was to verify whether circadian activity rhythm of early relapsing–remitting multiple sclerosis patients presents specific alterations, through functional linear modeling. Thirty-five relapsing–remitting multiple sclerosis patients (24 females; mean age ± SD = 31.51 ± 7.74) and 35 healthy controls (24 females; mean age ± SD = 31.29 ± 8.02) were enrolled. They wore an actigraph around the non-dominant wrist for one week. Relapsing–remitting multiple sclerosis patients showed a peak in motor activity around 5:00 a.m., higher than that of healthy controls. The timing of the peak in motor activity in the patients could be explained according to the hyperactive hypothalamus-pituitary-adrenal axis and higher cortisol awakening response reported in these patients.
Highlights
Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS)
We examined the following actigraphic wake parameters: diurnal motor activity (DMA), the motor activity counts in 1-min epochs during the assumed wake period; diurnal total sleep time (DTST), the sum in minutes of sleep epochs between get-up time (GUT) and BT; diurnal sleep episodes (NAP), the number of sleep episodes within the interval defined by GUT and BT; duration of the longest sleep episode (NAPD)
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Summary
Multiple sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS). RRMS is the most common form of MS at disease onset (85%–90% of patients) and can progress to SPMS with time. Circadian rhythm disruptive factors, such as daylight saving time, showed an association to a higher prevalence of the disorder [6]. These findings point out a potential involvement of circadian factors in the multifactorial etiopathology of the disease. Najafi and colleagues [9] reported a higher prevalence of self-referred circadian rhythm sleep disorders in a sample of RRMS patients with a history of the disease of at least two years when compared to HCs
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