1. Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort.
- Author
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Maillart, Elisabeth, Redolfi, Stefania, Louapre, Céline, Houot, Marion, Chaugne, Emeline, Laveneziana, Pierantonio, Ungureanu, Aurelian, Stankoff, Bruno, Arnulf, Isabelle, Papeix, Caroline, Bodini, Benedetta, Similowski, Thomas, Lubetzki, Catherine, and Morélot-Panzini, Capucine
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MULTIPLE sclerosis , *CRITICALLY ill , *SLEEP apnea syndromes , *NECK muscles , *SYMPTOMS , *VITAL capacity (Respiration) , *CANCER fatigue - Abstract
Background: Respiratory disorders remain incompletely described in multiple sclerosis (MS), even though they are a frequent cause of death. Methods: The objective was to describe respiratory disorders in MS patients with Expanded Disability Status Score (EDSS) ⩾ 6.5. Diaphragm dysfunction was defined by at least two of the seven criteria: clinical signs, inspiratory recruitment of neck muscles during wakefulness, reduced upright vital capacity (VC) < 80%, upright-to-supine VC ⩾ 15% of upright VC, decrease in Maximal Inspiratory Pressure < 60%, phasic activation of inspiratory neck muscles during sleep, and opposition of thoracic and abdominal movements during sleep. Cough weakness was defined by a peak cough flow < 270 L/min and/or need for cough assist. Sleep apnea syndrome was defined by an apnea–hypopnea index ⩾ 15. Results: Notably, 71 MS patients were included: median age 54 [48, 61] years; median disease duration 21.4 [16.0, 31.4] years. Of these, 52 patients had one or more respiratory disorders; diaphragm dysfunction was the most frequent (n = 34). Patients with diaphragm dysfunction and cough weakness were more disabled. The fatigue score and the cognitive evaluations did not differ between the groups. Five patients required non-invasive ventilation. Conclusion: Respiratory disorders are frequent in severe MS, mostly diaphragm dysfunction. Of interest, instrumental interventions are available to address these disorders. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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