Assessing the structural and functional changes in vagus nerve in multiple sclerosis

Multiple sclerosis (MS) is a progressive immune-mediated disease that leads to myelin loss, axonal damage as well as some autonomic nervous system (ANS) in the disease course. Sweat disorders, urinary disorders, orthostatic hypotension, gastrointestinal symptoms and sexual dysfunction are typical ANS disorders that reduce the quality of life of MS patients. The precise etiology of MS is due to the body response to multiple risks and cellular events. However immune dysregulation arising from multifactorial disease processes via an association between genetic predispositions and environmental factors is the possible cause. As we postulated that the vagus nerve (VN) has a vital role in the ANS, we hypothesize that MS can lead to changes in structure and function of VN, resulting in decreased parasympathetic output, causing imbalance between the sympathetic and parasympathetic nervous systems. Conclusion: the vagus nerve can be tested by ultrasonography if autonomic activity are impaired in MS patients. Future directions: further in vivo and experimental trials should be conducted at the future, which will help in non-invasive diagnostic procedure and will open new consideration in pharmaceutical treatments for multiple sclerosis.