University of Oulu

Mikkola A, Ojanen A, Hartikainen JEK, Remes AM, Simula S. The impact of multiple sclerosis onset symptom on cardiac repolarization. Brain Behav. 2017;7:e00742.

The impact of multiple sclerosis onset symptom on cardiac repolarization

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Author: Mikkola, Alma1,2; Ojanen, Aku3; Hartikainen, Juha E. K.4,5;
Organizations: 1Department of Neurology, Kuopio University Hospital
2Institute of Clinical Medicine – Neurology, University of Eastern Finland
3Department of Clinical Physiology and Nuclear Medicine, Mikkeli Central Hospital
4Heart Center, Kuopio University Hospital
5Institute of Clinical Medicine – Medicine, University of Eastern Finland
6Medical Research Center, Oulu University Hospital
7Research Unit of Clinical Neuroscience, Neurology, University of Oulu
8Department of Neurology, Mikkeli Central Hospital
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: John Wiley & Sons, 2017
Publish Date: 2017-08-25


Introduction: Multiple sclerosis is associated with prolonged cardiac repolarization but the underlying physiology has remained unknown. In this study, we compared cardiac repolarization during the relapsing- remitting multiple sclerosis (RRMS) disease course in patients with motor and sensory onset symptom.

Methods: Twenty- five RRMS patients with motor and 33 RRMS patients with sensory onset symptom having 12- lead electrocardiogram (ECG) recorded at the time of the first demyelinating event (ECG1) as well as at the later disease course (ECG2) were identified from the patient records. The average time interval between ECG1 and ECG2 was 8.6 ± 5.9 y. Heart rate-corrected QT intervals reflecting cardiac repolarization were calculated by Bazett (QTcBaz), Fridericia (QTcFri), and Karjalainen (QTcKar) formulas.

Results: Heart rate-corrected QT intervals as well as heart rate were similar in patients with motor and sensory onset symptom in ECG1. However, QTcBaz (p = .002), QTcFri (p = .019), and QTcKar (p = .026) were longer and heart rate was higher (p = .035) in patients with motor than sensory onset symptom in ECG2. Correspondingly, QTcBaz (p = .002), QTcFri (p = .033), and QTcKar (p = .043) prolonged and heart rate tended to increase (p = .060) during the disease course only in the patients with motor onset symptom.

Conclusions: Cardiac repolarization prolonged and heart rate increased during the disease course in RRMS patients with motor but not with sensory onset symptom. This suggests different traits in RRMS according to its initial manifestation and also association of motor onset symptom with more unfavorable cardiovascular prognostic determinants.

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Series: Brain and behavior
ISSN: 2162-3279
ISSN-E: 2162-3279
ISSN-L: 2162-3279
Volume: 7
Issue: 7
Article number: e00742
DOI: 10.1002/brb3.742
Type of Publication: A1 Journal article – refereed
Field of Science: 3112 Neurosciences
Funding: This work was supported by the government [grant number 5772804] and the Finnish MS Foundation. The data are available for researchers with appropriate permissions upon request. This observational research was not preregistered in an independent, institutional registry.
Copyright information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2017 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.