Clinical correlates of respiratory disorders in patients with severe multiple sclerosis: A cross-sectional cohort

Maillart, Elisabeth

;Redolfi, Stefania

Secondo

Conceptualization

;Louapre, Céline;Houot, Marion;Chaugne, Emeline;Laveneziana, Pierantonio;Ungureanu, Aurelian;Stankoff, Bruno;Arnulf, Isabelle;Papeix, Caroline;Bodini, Benedetta;Similowski, Thomas;Lubetzki, Catherine;Morélot-Panzini, Capucine

2024-01-01

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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.