title: Autonomic dysfunction, immune regulation, and multiple sclerosis.
abstract: OBJECTIVE
  To review existing evidence regarding interactions between the autonomic nervous system and the immune system functions in multiple sclerosis.
  
  
  METHODS
  We reviewed the literature regarding new insights linking autonomic dysfunction to immune deregulation in multiple sclerosis, with particular focus on the specific influence of sympathetic and parasympathetic dysfunction on inflammatory and neurodegenerative processes.
  
  
  RESULTS
  Autonomic dysfunction is common in multiple sclerosis, representing a significant cause of disability. Several connections between pathologic immune pathways and the autonomic nervous system function were found.
  
  
  CONCLUSIONS
  Autonomic dysfunction may enhance inflammatory and neurodegenerative pathways that are of major importance in multiple sclerosis. Autonomic dysfunction can present with highly variable manifestations. Sympathetic and parasympathetic dysfunction displays different patterns in multiple sclerosis, with specific impact on inflammation and neurodegeneration.
authors.affiliation: Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada. juanracosta@hotmail.com.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Racosta
authors.affiliation: Department of Clinical Neurological Sciences, London Health Sciences Centre, Western University, London, ON, Canada.
authors.forename: Kurt
authors.initials: K
authors.lastname: Kimpinski
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications / Q000276:immunology / Q000503:physiopathology*
keywords: Autonomic dysfunction; Clinical manifestations; Immune regulation; Inflammation; Multiple sclerosis; Neurodegeneration