Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31

Background: Autonomic nervous system dysfunction is commonly seen in multiple sclerosis patients and should be explored in the routine evaluation. Composite Autonomic Symptom Score questionnaire was validated as a self-assessment instrument of autonomic symptoms. Objectives: Determine the frequency of autonomic symptoms in multiple sclerosis patients through a Portuguese version of Composite Autonomic Symptom Score; compare questionnaire results between patients and a control group; assess the feasibility of this questionnaire application in multiple sclerosis Portuguese patients. Material and Methods: This case-control study used a Portuguese translated version of Composite Autonomic Symptom Score to determine the frequency of autonomic symptoms in multiple sclerosis patients. Results: One-hundred and three relapsing-remitting multiple sclerosis patients – median age 41 years, median disease duration 6 years, median EDSS score 1 - and 80 healthy subjects were included. Alterations in autonomic function were reported in 97.1% of the cases, with statistical significance in orthostatic intolerance and gastrointestinal domain scores. Nevertheless, the difference between multiple sclerosis patients (41.7%) without confounding factors that could interfere with autonomic dysfunction (i.e. comorbidities or medications) and controls showed no statistical significance. Discussion: Our results may be related to the short disease duration, young age and lowdisability status of our patients unaffected by confounding factors. The questionnaire was not designed specifically for multiple sclerosis and it may not be as sensible to early autonomic symptoms as to more severe manifestations. Conclusions: Further studies are needed to achieve more robust results, validate this questionnaire and assess its application in multiple sclerosis patients in Portugal. Keywords: Autonomic Nervous System; Multiple Sclerosis; Portugal; Questionnaires.

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Clinical Assessment of Autonomic Function in Fibromyalgia by the Refined and Abbreviated Composite Autonomic Symptom Score (COMPASS 31): A Case-Controlled Study

Reviews on Recent Clinical Trials ◽

10.2174/1574887116666210612033002 ◽

2021 ◽

Vol 16 ◽

Author(s):

Basant K. Puri ◽

Gary S. Lee

Keyword(s):

Symptom Score ◽

Autonomic Dysfunction ◽

Autonomic Function ◽

Orthostatic Intolerance ◽

Fibromyalgia Impact Questionnaire ◽

Controlled Study ◽

Group Status ◽

Cross Sectional ◽

Autonomic Symptom ◽

Revised Fibromyalgia Impact Questionnaire

Background: It has been shown that autonomic dysfunction in fibromyalgia can be assessed by the Composite Autonomic Symptom Score (COMPASS) questionnaire. More recently, a refined and much abbreviated 31-item version of the questionnaire has been developed, the COMPASS 31. Objectives: The study has the following objectives: First, to determine whether the COMPASS 31 can assess changes in autonomic function in fibromyalgia. Second, to assess whether the COMPASS 31 values in fibromyalgia patients are positively correlated with scores on the Revised Fibromyalgia Impact Questionnaire (FIQR). Method: A cross-sectional, case-controlled study was carried out with 25 fibromyalgia patients and 26 healthy controls. Results: The two groups were matched for age, sex and ethnicity, but not for body mass index (BMI). The total mean (standard error) COMPASS 31 for the fibromyalgia patients, 37.2 (1.8), differentiated the patients from the controls (9.5 (1.4); p < 0.00000001). The scores were greater in the fibromyalgia patients across all COMPASS 31 autonomic domains, namely orthostatic intolerance (p < 0.00000001), and vasomotor (p < 0.0001), secretomotor (p < 0.000001), gastrointestinal (p < 0.000001), bladder (p < 0.00001), and pupillomotor functions (p < 0.00000001). The total COMPASS 31 values were positively correlated with FIQR scores (rs = 0.45, p < 0.05). General linear modelling of the COMPASS 31 scores showed that only group status (fibromyalgia or control) was significant (p = 3.4 × 10-16), with age, sex and BMI being non-significant. Conclusion: This study confirms that non-pain autonomic dysfunction symptoms occur in fibromyalgia and can be assessed with COMPASS 31.

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Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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Evaluation of dysautonomic symptoms in MS patients: use of the Composite Autonomic Symptom Score (COMPASS)-31 questionnaire

10.26226/morressier.59a3edaad462b8028d8945ec ◽

2017 ◽

Author(s):

Luca Mancinelli

Keyword(s):

Symptom Score ◽

Autonomic Symptom

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Multiple Sclerosis: Brain Atrophy and Computerized Cognitive Testing – A Cross-Sectional Pilot Investigation

10.26226/morressier.59a3edabd462b8028d894c9b ◽

2017 ◽

Author(s):

Mark Gudesblatt

Keyword(s):

Multiple Sclerosis ◽

Brain Atrophy ◽

Cognitive Testing ◽

Cross Sectional ◽

Pilot Investigation

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Relationship between urodynamic findings and bowel function in multiple sclerosis patients with lower urinary tract dysfunction: Results from an Italian Cross-Sectional Study

10.26226/morressier.59b63e40d462b802923892e7 ◽

2017 ◽

Author(s):

Raffaele Balsamo

Keyword(s):

Multiple Sclerosis ◽

Urinary Tract ◽

Lower Urinary Tract ◽

Bowel Function ◽

Cross Sectional Study ◽

Lower Urinary Tract Dysfunction ◽

Sectional Study ◽

Cross Sectional ◽

Multiple Sclerosis Patients ◽

Lower Urinary

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Multiple Sclerosis: Treadmill Versus Cycle Ergometry Maximal Exercise Test Responses

Journal of Clinical Exercise Physiology ◽

10.31189/2165-6193-9.3.113 ◽

2020 ◽

Vol 9 (3) ◽

pp. 113-117

Author(s):

Garett Griffith ◽

Badeia Saed ◽

Tracy Baynard

Keyword(s):

Multiple Sclerosis ◽

Aerobic Capacity ◽

Work Capacity ◽

Cross Sectional Study ◽

Cycle Ergometer ◽

Cycle Ergometry ◽

Cross Sectional ◽

Complete Test ◽

Peak Aerobic Capacity ◽

Predicted Values

ABSTRACT Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system. MS generally results in decreased mobility and work capacity. Our objective was to determine exercise testing responses on both a treadmill and cycle ergometer among individuals with MS who were able to ambulate freely. Methods: Twenty-six individuals with MS participated in a cross-sectional study (44 ± 11 years; body mass index 26.8 ± 6.2 kg·m−2; expanded disability scale score 3.1 ± 0.9), with 24 individuals with complete test data for both treadmill and cycle ergometry tests. Peak aerobic capacity (VO2peak) for both treadmill and cycle ergometry tests were measured with indirect calorimetry. Results: Participants safely completed both treadmill and cycle ergometry tests, and treadmill testing yielded higher values (26.7 ± 6.4 mL·kg−1·min−1) compared with cycle ergometry (23.7 ± 5.7 mL·kg−1·min−1), with values ~12% greater for treadmill. When comparing tests to their respected predicted values within modality, treadmill tests were 8% lower and cycle ergometry tests were 10% lower than predicted. Conclusions: While peak aerobic capacity was very low for this population, treadmill tests were still higher than cycle ergometry data, with this difference between modes being similar to that observed in healthy adult populations. Additional research is required to determine if these findings are impacted by participation in physical activity or regular exercise.

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Decrease in Secondary Neck Vessels in Multiple Sclerosis: A 5-year Longitudinal Magnetic Resonance Angiography Study

Current Neurovascular Research ◽

10.2174/1567202616666190612111127 ◽

2019 ◽

Vol 16 (3) ◽

pp. 215-223 ◽

Cited By ~ 2

Author(s):

Dejan Jakimovski ◽

Matthew Topolski ◽

Kana Kimura ◽

Virja Pandya ◽

Bianca Weinstock-Guttman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Longitudinal Change ◽

Repeated Measure ◽

Cross Sectional ◽

False Discovery ◽

The Common ◽

Neck Vessels

Background: Studies have previously shown greater arterial and venous extracranial vascular changes in persons with multiple sclerosis (PwMS) when compared to healthy controls (HCs). Objectives: To determine the change in the number and size of secondary neck vessels in PwMS and HCs over a 5-year follow-up period. Methods: Both at baseline and follow-up, 83 PwMS and 25 HCs underwent magnetic resonance angiography (MRA) imaging and analysis. The number and cross-sectional area (CSA) of all secondary neck vessels (excluding the common/internal carotid, vertebral artery, and internal jugular vein) measured at levels from C2-T1 were determined by semi-automated edge detection/ contouring software. The longitudinal change in the number and CSA of the secondary neck vessels from the PwMS and HCs were analyzed by non-parametric Wilcoxon repeated measure. Benjamini-Hochberg procedure adjusted for false discovery rate (FDR). Results: For over 5 years, PwMS demonstrated a consistent longitudinal decrease in both the number of secondary neck vessels (Z-change between -3.3 and -5.4, q=0.001) and their CSA (Zchange between -2.9 and -5.2, q=0.004). On the contrary, the HCs did not demonstrate a significant longitudinal change in secondary neck vessels over the follow-up period. Due to the longitudinal decrease, the PwMS showed a lower number of secondary neck vessels when compared to HCs measured at follow-up (p<0.029, except for C4 with trending p=0.071). The PwMS changes were also corroborated within each MS phenotype. Conclusion: PwMS demonstrate a significant mid-term decrease in the number and the size of the secondary neck vessels. The clinical relevance of these findings and the effect on intracranial blood flow are currently unknown.

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Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽

10.3390/sym13040598 ◽

2021 ◽

Vol 13 (4) ◽

pp. 598

Author(s):

Massimiliano Pau ◽

Bruno Leban ◽

Michela Deidda ◽

Federica Putzolu ◽

Micaela Porta ◽

...

Keyword(s):

Multiple Sclerosis ◽

Lower Limb ◽

Sagittal Plane ◽

Cross Sectional Study ◽

Camera Motion ◽

Cross Sectional ◽

Temporal Parameters ◽

Wide Range ◽

Edss Score ◽

Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

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