Prevalence of autonomic dysfunction in patients with multiple sclerosis

Area of Science:

• Neurology
• Clinical Medicine
• Autonomic Neuroscience

Background:

• Autonomic nervous system (ANS) dysfunction is prevalent in multiple sclerosis (MS).
• The Composite Autonomic Symptom Score (COMPASS) questionnaire is a validated tool for assessing autonomic symptoms.
• Routine evaluation of ANS dysfunction in MS patients is recommended.

Purpose of the Study:

• To determine the frequency of autonomic symptoms in Portuguese MS patients using a translated COMPASS questionnaire.
• To compare COMPASS results between MS patients and a healthy control group.
• To assess the feasibility of using the COMPASS questionnaire in Portuguese MS patients.

Main Methods:

• A case-control study design was employed.
• A Portuguese version of the Composite Autonomic Symptom Score (COMPASS) questionnaire was utilized.
• 103 relapsing-remitting MS patients and 80 healthy controls were included.

Main Results:

• 97.1% of MS patients reported autonomic dysfunction alterations, with significant findings in orthostatic intolerance and gastrointestinal domains.
• When excluding confounding factors, the difference in autonomic dysfunction between MS patients (41.7%) and controls was not statistically significant.
• The median age of MS patients was 41 years, with a median disease duration of 6 years and a low median EDSS score of 1.

Conclusions:

• The observed high prevalence of symptoms in MS patients may be linked to short disease duration, younger age, and low disability.
• The COMPASS questionnaire, not specifically designed for MS, might be less sensitive to early autonomic symptoms.
• Further research is necessary to validate the questionnaire and confirm its utility in Portuguese MS patients.