Preradiotherapy Calcium Scores of the Coronary Arteries in a Cohort of Women With Early-Stage Breast Cancer: A Comparison With a Cohort of Healthy Women Mirjam E. Mast, M.Sc.,* Mark W. Heijenbrok, M.D.,y Anna L. Petoukhova, Ph.D.,* Astrid N. Scholten, M.D., Ph.D.,z Joop H.M. Schreur, M.D., Ph.D.,x and Henk Struikmans, M.D., Ph.D.*,z *Radiotherapy Centre West, The Hague, The Netherlands; yDepartment of Radiology, Medical Center Haaglanden, The Hague, The Netherlands; zDepartment of Clinical Oncology, Leiden University Medical Centre, Leiden, The Netherlands; and Department of Cardiology, xMedical Center Haaglanden, The Hague, The Netherlands

In this study the vibratory perception threshold (VPT) and the thermal discrimination threshold (TDT) were measured in 33 patients with clinically definite multiple sclerosis (MS). VPT values were abnormal in a majority of MS patients (68%). There was no relation between VPT and the severity of the disease. TDT values were elevated less frequently (30%); abnormal TDTs were found only in patients with severe disease. It is suggested that this can be explained by MS-plaques having predilection sites within the central nervous system and by differences in functional and morphological properties of sensory pathways. Quantitative measurements of VPT and TDT seem to be suitable techniques for the detection of minor sensory signs of central origin.

In this study blood pressure (BP) and heart rate (HR) responses to standing and HR responses to deep breathing were assessed in 34 patients with clinically definite multiple sclerosis (MS) and 63 healthy subjects. Normal ranges, which were clearly age related for both HR responses, were obtained. The BP response to standing was abnormal in 13% of the MS patients, these patients demonstrating significant postural hypotension. The HR response to standing was abnormal in 28% of the MS patients, with a normal initial increase in heart rate and a significantly reduced reflex bradycardia. On deep breathing 36% of MS patients showed abnormal HR changes. The resting HR did not differ between both groups. Abnormalities of one or more tests were found in 53% of the MS patients. No relationship was found between abnormal cardiovascular autonomic responses and the symptoms, duration, severity and progression of the disease. Based on clinical and magnetic resonance imaging findings no indications were found for localisation of the autonomic disturbances in the brainstem. It is suggested that at least a part of the cardiovascular autonomic lesions in MS is located outside the brainstem, i.e. in supramedullary reflex pathways or in the spinal cord.