Abstract：
BACKGROUND: A substantial autonomic nervous system (ANS) dysfunction has been described in multiple sclerosis (MS) and recently, also in neuromyelitis optica spectrum disorder (NMOSD). The prevalence of ANS symptoms contributes to the chronic symptom burden in both diseases. The aim of our study was to assess ANS dysfunction in people with (pw) NMOSD and MS, using the Composite Autonomic Symptom Score-31 (COMPASS-31), and additionally, to evaluate if ANS dysfunction have impact on the quality of life of these patients.
METHODS: We conducted cross-sectional study at three national referral neurological clinics in Serbia, Croatia, and Montenegro. A total of 180 consecutive subjects, 80 pwNMOSD and 100 pwMS, followed-up at these clinics, were enrolled in the study. Subjects included in the study completed: the validated versions of the COMPASS-31 and the Multiple Sclerosis Quality of Life-54 (MSQoL-54), and the Beck Depression Inventory (BDI).
RESULTS: This study demonstrated that the total COMPASS-31 score > 0.0, implicating the presence of ANS dysfunction, was detected in almost all NMOSD and MS study participants tested (80/80, and 97/100, respectively). Our findings showed that autonomic symptom burden was statistically significantly correlated with decreased quality of life, in both NMOSD and MS cohorts. The independent predictors of the better quality of life in pwNMOSD were lower autonomic burden, particularly the absence of the orthostatic intolerance (p = 0.005), along with lower EDSS and BDI score (p ≤ 0.001). Similarly, in pwMS, independent predictors were EDSS, BDI, orthostatic intolerance, and the total COMPASS-31 (p ≤ 0.001).
CONCLUSIONS: Our study demonstrated that a significant proportion of persons with both NMOSD and MS have considerable dysautonomic symptom burden which is correlated with the decreased quality of life. Further investigations are warranted in order to optimize treatment interventions in MS and NMOSD.
METHODS: We conducted cross-sectional study at three national referral neurological clinics in Serbia, Croatia, and Montenegro. A total of 180 consecutive subjects, 80 pwNMOSD and 100 pwMS, followed-up at these clinics, were enrolled in the study. Subjects included in the study completed: the validated versions of the COMPASS-31 and the Multiple Sclerosis Quality of Life-54 (MSQoL-54), and the Beck Depression Inventory (BDI).
RESULTS: This study demonstrated that the total COMPASS-31 score > 0.0, implicating the presence of ANS dysfunction, was detected in almost all NMOSD and MS study participants tested (80/80, and 97/100, respectively). Our findings showed that autonomic symptom burden was statistically significantly correlated with decreased quality of life, in both NMOSD and MS cohorts. The independent predictors of the better quality of life in pwNMOSD were lower autonomic burden, particularly the absence of the orthostatic intolerance (p = 0.005), along with lower EDSS and BDI score (p ≤ 0.001). Similarly, in pwMS, independent predictors were EDSS, BDI, orthostatic intolerance, and the total COMPASS-31 (p ≤ 0.001).
CONCLUSIONS: Our study demonstrated that a significant proportion of persons with both NMOSD and MS have considerable dysautonomic symptom burden which is correlated with the decreased quality of life. Further investigations are warranted in order to optimize treatment interventions in MS and NMOSD.
摘要：
背景：已经在多发性硬化症（MS）中描述了一种实质性的自主神经系统（ANS）功能障碍，最近，视神经脊髓炎谱系障碍（NMOSD）。ANS症状的患病率有助于这两种疾病的慢性症状负担。我们研究的目的是评估（pw）NMOSD和MS患者的ANS功能障碍，使用复合自主症状评分-31(COMPASS-31)，此外，评估ANS功能障碍是否对这些患者的生活质量有影响。
方法：我们在塞尔维亚的三个国家转诊神经诊所进行了横断面研究，克罗地亚,黑山。总共180个连续的科目，80pwNMOSD和100pwMS，在这些诊所跟进，参加了这项研究。纳入研究的受试者完成：验证版本的COMPASS-31和多发性硬化症生活质量-54（MSQoL-54），和贝克抑郁量表(BDI)。
结果：这项研究表明，COMPASS-31总评分>0.0，暗示存在ANS功能障碍，在几乎所有测试的NMOSD和MS研究参与者中都检测到(分别为80/80和97/100)。我们的研究结果表明，自主神经症状负担与生活质量下降有统计学显著相关，在NMOSD和MS队列中。pwNMOSD患者生活质量较好的独立预测因素是较低的自主神经负担，特别是没有直立不耐受(p=0.005)，EDSS和BDI评分较低（p≤0.001）。同样，在pwMS中，独立预测因子是EDSS，BDI,直立不耐受，和总COMPASS-31（p≤0.001）。
结论：我们的研究表明，患有NMOSD和MS的人中有相当大比例的自主神经失调症状负担，这与生活质量下降有关。为了优化MS和NMOSD的治疗干预措施，需要进一步的研究。
方法：我们在塞尔维亚的三个国家转诊神经诊所进行了横断面研究，克罗地亚,黑山。总共180个连续的科目，80pwNMOSD和100pwMS，在这些诊所跟进，参加了这项研究。纳入研究的受试者完成：验证版本的COMPASS-31和多发性硬化症生活质量-54（MSQoL-54），和贝克抑郁量表(BDI)。
结果：这项研究表明，COMPASS-31总评分>0.0，暗示存在ANS功能障碍，在几乎所有测试的NMOSD和MS研究参与者中都检测到(分别为80/80和97/100)。我们的研究结果表明，自主神经症状负担与生活质量下降有统计学显著相关，在NMOSD和MS队列中。pwNMOSD患者生活质量较好的独立预测因素是较低的自主神经负担，特别是没有直立不耐受(p=0.005)，EDSS和BDI评分较低（p≤0.001）。同样，在pwMS中，独立预测因子是EDSS，BDI,直立不耐受，和总COMPASS-31（p≤0.001）。
结论：我们的研究表明，患有NMOSD和MS的人中有相当大比例的自主神经失调症状负担，这与生活质量下降有关。为了优化MS和NMOSD的治疗干预措施，需要进一步的研究。
