title: Growth hormone response to clonidine administration for evaluation of autonomic dysfunction in multiple sclerosis patients.
abstract: OBJECTIVE
  Our objective was to assess the dynamic serum growth hormone (GH) response to clonidine administration in multiple sclerosis patients, looking for a possible biomarker of degenerative process and to correlative with disability.
  
  
  METHODS
  21 patients with relapsing remitting multiple sclerosis, who were evaluated clinically by expanded disability status scale (EDSS) score and multiple sclerosis functional composite (MSFC) score and for whom we measured the GH before and one hour after oral clonidine administration.Different cut-off values of EDSS score were chosen for observation of GH serum dynamics after clonidine administration. All patients had normal IGF1 values.
  
  
  RESULTS
  There was a significant positive correlation between EDSS and time to walk 25 feet (r = 0.5, p = 0.002) and EDSS and nine holes peg tests for dominant and non dominant hands (r = 0.37, p = 0.024 and r = 0.53, p = 0.001, respectively).There was a moderate negative correlation, significant statistically, between EDSS and paced auditory serial additional test (PASAT) (r= -0.36, p= 0.046).4 out of 7 patients with EDSS score over 3.0 failed to increase serum GH levels after clonidine administration, as compared to 4 out of 14 patients with EDSS < 3 (r = 1.6; p=0.02), revealed by means of the Pearson chi square test.
  
  
  CONCLUSIONS
  Despite the small number of subjects enrolled in this pilot study, there is a tendency of blunted GH response in patients with more severe physical disability (stated by an increased value of EDSS), suggesting that GH response to clonidine could assess central autonomic dysfunction in MS patients.
authors.affiliation: Elias Emergency University Hospital, Department of Neurology, Bucharest, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Petrescu
authors.forename: Raluca
authors.initials: R
authors.lastname: Trifanescu
authors.forename: Petru
authors.initials: P
authors.lastname: Ionescu
authors.forename: Gina Doinita
authors.initials: GD
authors.lastname: Vanghelie
authors.forename: Radu
authors.initials: R
authors.lastname: Tanasescu
authors.forename: Mircea
authors.initials: M
authors.lastname: Moldovan
authors.forename: Nicolae
authors.initials: N
authors.lastname: Munjev
authors.forename: Ovidiu
authors.initials: O
authors.lastname: Bajenaru
authors.forename: Cristina
authors.initials: C
authors.lastname: Panea
keywords: autonomic dysfunction; multiple sclerosis; physical disability
references.citation: Physiother Res Int. 2009 Mar;14(1):42-55
references.pmid: 19107708
references.citation: J Neurol. 2007 May;254 Suppl 2:II96-101
references.pmid: 17503142
references.citation: Eur Neurol. 2002;48(1):1-5
references.pmid: 12138302
references.citation: Acta Neurol Scand. 2008 Oct;118(4):226-31
references.pmid: 18355393
references.citation: Acta Neurol Scand. 2005 Dec;112(6):403-8
references.pmid: 16281924
references.citation: Acta Neurol Scand. 2000 Feb;101(2):85-8
references.pmid: 10685853
references.citation: J Neurol Neurosurg Psychiatry. 2003 Sep;74 Suppl 3:iii31-41
references.pmid: 12933912
references.citation: Physiol Rev. 1999 Apr;79(2):511-607
references.pmid: 10221989
references.citation: J Neurol. 2006 Feb;253 Suppl 1:I21-5
references.pmid: 16477481
references.citation: Curr Opin Neurol. 2006 Jun;19(3):242-7
references.pmid: 16702829
references.citation: Int J Med Sci. 2010 Mar 11;7:62-7
references.pmid: 20309394
references.citation: Clin Med Res. 2006 Dec;4(4):322-5
references.pmid: 17210980
references.citation: Mov Disord. 2002 Nov;17(6):1242-7
references.pmid: 12465063
references.citation: Clin Neurophysiol. 2004 Jun;115(6):1473-8
references.pmid: 15134718
references.citation: J Neurol. 2006 Feb;253 Suppl 1:I3-9
references.pmid: 16477484
references.citation: J Neurol. 2001 Apr;248(4):297-303
references.pmid: 11374094