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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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Cardiovascular autonomic dysfunction in multiple sclerosis: a meta-analysis
Juan Manuel Racosta1, Luciano A Sposato1, Sarah A Morrow1
1Department of Clinical Neurological Sciences, London Health Sciences Centre. Western, University, London, ON, Canada.
Multiple Sclerosis and Related Disorders
|March 20, 2015
Summary
Defining cardiovascular autonomic dysfunction in multiple sclerosis (MS) is debated. Using one abnormal test diagnosed 42.1% of MS patients, while two abnormal tests diagnosed 18.8%.
Area of Science:
- Neurology
- Cardiology
- Autonomic Nervous System
Background:
- The definition and prevalence of cardiovascular autonomic dysfunction in multiple sclerosis (MS) patients remain unclear.
- Existing diagnostic criteria for cardiovascular dysautonomia in MS lack consensus.
Purpose of the Study:
- To systematically review and compare the proportion of MS patients diagnosed with cardiovascular dysautonomia using two different definitions.
- To evaluate the impact of diagnostic criteria on the estimated prevalence of autonomic dysfunction in MS.
Main Methods:
- A systematic review and meta-analysis of studies published from 1980 to 2013.
- Searched PubMed, Embase, and Scopus for publications on autonomic tests in MS patients.
- Calculated the proportion of patients diagnosed with autonomic dysfunction using definitions of at least one abnormal test versus at least two abnormal tests.
Main Results:
- Included 16 studies with 611 MS patients assessing at least three cardiovascular autonomic tests.
- The proportion of MS patients diagnosed with autonomic dysfunction was significantly higher (42.1%) when using the definition of at least one abnormal test compared to at least two abnormal tests (18.8%).
- A two-fold difference in prevalence was observed based on the diagnostic threshold used (p=0.006).
Conclusions:
- A significant variation exists in diagnosing cardiovascular dysautonomia in MS patients depending on the definition used.
- Consensus is required to establish a standardized definition for autonomic dysfunction in MS.
- Researchers are encouraged to report autonomic dysfunction prevalence using both one and two abnormal test criteria.
