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

IntroduçãoOs ataques de migrânea são caracterizados por sintomas álgicos e não álgicos. Além disso, a migrânea ocorre associada a diversas comorbidades. Tanto os sintomas não álgicos como as comorbidades podem se caracterizar por sintomas autonômicos. Este trabalho tem por objetivo avaliar a disautonomia em migranosos e diferenças relacionadas entre os grupos episódico (ME) e crônico (MC).Material e MétodosEstudo transversal de pacientes atendidos em ambulatório especializado, diagnosticados pela International Classification of Headache Disorders 3 como ME ou MC, convidados de forma consecutiva e utilizando entrevistas semi-estruturadas. O questionário Composite Autonomic Symptom Score (COMPASS) foi utilizado para avaliação de sintomas autonômicos, o Patient Health Questionnaire (PHQ) 9 para avaliação de sintomas depressivos e o Short Form (SF) 36 para avaliação de qualidade de vida. O estudo foi aprovado pelo comitê de ética do HC- UFPR.ResultadosForam incluídos 210 pacientes dos quais 97 (46%) apresentavam ME e 113 (54%) MC. Destes, 78 (69%) consumiam analgésicos excessivamente. A média de idade era de 39,5±12,6 anos e 189 (90%) pacientes eram do sexo feminino. O grupo CM apresentou um escore COMPASS mais alto (34,7±18,3) que o grupo EM (26,4±14,8). A regressão múltipla foi empregada para analisar a associação das variáveis clínicas com o COMPASS. O modelo final ajustado mostra que para cada sintoma não álgico tipicamente vistos na aura de tronco encefálico, há um incremento médio de 2,17-6,3 no COMPASS. Para cada ponto a mais no PHQ9, o COMPASS eleva-se entre 0,78-1,84 em média. Todos os processos de inferência consideraram um valor alpha de 0.05.ConclusãoO processo de cronificação pode cursar com mais sintomas disautonômicos. Estes, por sua vez, estão associados a mais sintomas atribuídos a alterações de tronco e à depressão, indicando esta área como potencialmente envolvida nesta gama de sintomas.

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Validation and cross-cultural adaptation of the Composite Autonomic Symptom Score-31 (COMPASS-31) in Croatian and Serbian multiple sclerosis patients

10.26226/morressier.59a3e8b4d462b8028d894452 ◽

2017 ◽

Author(s):

Jelena Drulovic

Keyword(s):

Multiple Sclerosis ◽

Symptom Score ◽

Cultural Adaptation ◽

Cross Cultural ◽

Autonomic Symptom ◽

Cross Cultural Adaptation ◽

Multiple Sclerosis Patients

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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

Neurological Sciences ◽

10.1007/s10072-020-04620-1 ◽

2020 ◽

Author(s):

Matteo Foschi ◽

Giulia Giannini ◽

Elena Merli ◽

Luca Mancinelli ◽

Corrado Zenesini ◽

...

Keyword(s):

Multiple Sclerosis ◽

Symptom Score ◽

Italian Version ◽

Cross Sectional ◽

Autonomic Symptom ◽

Center Study

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Prevalence of Autonomic Dysfunction in Patients with Multiple Sclerosis

Acta Médica Portuguesa ◽

10.20344/amp.5562 ◽

2015 ◽

Vol 28 (1) ◽

pp. 51 ◽

Cited By ~ 8

Author(s):

Bitia Vieira ◽

Andreia Costa ◽

Gonçalo Videira ◽

Maria José Sá ◽

Pedro Abreu

Keyword(s):

Multiple Sclerosis ◽

Nervous System ◽

Autonomic Nervous System ◽

Symptom Score ◽

Disease Duration ◽

Statistical Significance ◽

Confounding Factors ◽

Autonomic Symptom ◽

Autonomic Symptoms ◽

Multiple Sclerosis Patients

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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A diabeteses autonóm neuropathia vizsgálata a Debreceni Egyetem Diabeteses Neuropathia Centrum betegeinek körében kérdőíves módszer segítségével

Diabetologia Hungarica ◽

10.24121/dh.2021.4 ◽

2021 ◽

Vol 29 (1) ◽

pp. 39-46

Author(s):

Ferenc Sztanek ◽

Zsuzsanna Demeter ◽

Mónika Katkó ◽

Ágnes Molnár ◽

András Áron Jakab ◽

...

Keyword(s):

Symptom Score ◽

Autonomic Symptom

A kardiális autonóm neuropathia (CAN) a cukorbetegség gyakori mikrovaszkuláris szövődménye, amely összefüggést mutat a kardiovaszkuláris betegségekkel. A CAN diagnosztikájára a Ewing-féle kardiovaszkuláris reflextesztek használatosak. A paraszimpatikus beidegzés működését a mélylégzéses vizsgálat, a Valsalva-manőver és a felálláskor bekövetkező szívfrekvencia-változás mérésével értékeljük. Az ortosztatikus hipotenzió és a kézizom-szorító erő (handgrip teszt) vizsgálata a szimpatikus idegrendszer működéséről nyújt tájékoztatást. Azonban a Ewing-tesztek elvégzése időigényes folyamat és a beteg részéről is nagyfokú kooperációt igényel. A CAN legtöbbször tünetszegényen jelentkezik és késői stádiumban kerül felismerésre, ezért felmerült az igény egy egyszerű, kérdőíves szűrőmódszer kidolgozására. A Composite Autonomic Symptom Score 31 (COMPASS-31) kérdőív 6 vegetatív tünetcsoportot ölel fel, és a válaszokra adott pontértékek megfelelő súlyozásával megbízható módszernek bizonyult az autonóm neuropathia korai felimerésében. Célkitűzésünk a COMPASS-31 kérdőív alkalmazhatóságának vizsgálata diabeteses neuropathiás betegeink körében. Betegek és módszerek: A vizsgálatunk során a debreceni Diabeteses Neuropathia Centrumban 36 diabeteses neuropathiás beteg (24 nő/12 férfi) töltötte ki a kérdőívet, amelyek pontértékeit a Ewing-teszteken elért eredményeikkel hasonlítottunk össze, ROC analízist végeztünk, és meghatároztuk azt a pontszámot, amelyet határértékként használva a legkedvezőbb diagnosztikai szenzitivitás és specificitás érhető el. Eredmények: A paraszimpatikus és szimpatikus kardiovaszkuláris reflexteszteket együttesen összehasonlítva a COMPASS-31 teszt eredményeivel, a ROC görbe alatti terület (AUC) 0,83 (95%-os CI: 0,69–0,97, p=0,002), a kérdőív szenzitivitása 88%, specificitása 73%, ha a kérdőíven elért 14 feletti pontszámot tekintettük diagnosztikusnak. Ha a CAN diagnózisát a handgrip teszt megbízhatatlansága miatt a paraszimpatikus reflextesztek és az ortosztatikus hipotenzió fennállása alapján állítottuk fel, akkor a ROC-AUC 0,92 (95%-os CI: 0,81–1,03, p<0,0001), a kérdőív szenzitivitása 88%-nak, specificitása 90%-nak bizonyult, ha a 17 feletti pontszámot tekintettük diagnosztikusnak. Következtetés: A COMPASS-31 kérdőív alkalmas lehet a diabeteses betegek szűrésére és a CAN korai stádiumban való felismerésére.

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COMPASS 31: A Refined and Abbreviated Composite Autonomic Symptom Score

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2012.10.013 ◽

2012 ◽

Vol 87 (12) ◽

pp. 1196-1201 ◽

Cited By ~ 133

Author(s):

David M. Sletten ◽

Guillermo A. Suarez ◽

Phillip A. Low ◽

Jay Mandrekar ◽

Wolfgang Singer

Keyword(s):

Symptom Score ◽

Autonomic Symptom

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Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for the assessment of symptoms of autonomic neuropathy in people with diabetes

Diabetic Medicine ◽

10.1111/dme.13310 ◽

2017 ◽

Vol 34 (6) ◽

pp. 834-838 ◽

Cited By ~ 9

Author(s):

C. Greco ◽

F. Di Gennaro ◽

C. D'Amato ◽

R. Morganti ◽

D. Corradini ◽

...

Keyword(s):

Symptom Score ◽

Autonomic Neuropathy ◽

Autonomic Symptom

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Validation of the Composite Autonomic Symptom Score 31 in the German language

Neurological Sciences ◽

10.1007/s10072-021-05764-4 ◽

2021 ◽

Author(s):

Max-Josef Hilz ◽

Ruihao Wang ◽

Wolfgang Singer

Keyword(s):

Symptom Score ◽

Orthostatic Intolerance ◽

Correlation Coefficients ◽

German Version ◽

Self Assessment ◽

Autonomic Symptom ◽

Autonomic Symptoms ◽

Cronbach Alpha ◽

And Gender ◽

Post Hoc

Abstract Background The Composite Autonomic Symptom Score 31 (COMPASS 31) is a validated, 31-item self-assessment questionnaire assessing autonomic symptoms in six domains, orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor function. So far, there is no validated German COMPASS 31 version. This study aimed at developing and validating a German COMPASS 31. Methods Two autonomic experts with command of German and English independently translated the English COMPASS 31 into German. One agreed-upon German version was translated back into English to assure conformity with the original version. Twenty patients with possible autonomic symptoms and 20 age- and gender-matched healthy persons completed the English and German COMPASS 31 in a randomized order with a 4-week interval. To evaluate reliability of the German COMPASS 31, total scores and sub-scores of the domains assessed with the German version were correlated with corresponding scores of the English version using Pearson’s or Spearman’s test. The Cronbach alpha-coefficient evaluated the internal consistency of the questions. Total- and sub-scores of both COMPASS 31 versions were compared between patients and controls by analysis of variance with post-hoc analysis (significance: p < 0.05). Results Total scores and sub-scores of the German and English COMPASS 31 correlated significantly (p < 0.001) and closely (correlation coefficients: 0.757–0.934). Cronbach alpha-coefficients were above 0.7 in all domains except for the secretomotor domain. In the German and English COMPASS 31, total scores were significantly higher in patients than controls. Conclusions The German COMPASS 31 is reliable, internally consistent, and valid to detect and quantify autonomic symptoms in patients with neurological disorders.

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