Impact of the autonomic dysfunction on the quality of life in people with NMOSD and MS: An international cross-sectional study.

Autor: Andabaka M; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia., Pekmezovic T; Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Crnosija L; Department of Neurology, University Hospital Center of Zagreb, Zagreb, Croatia., Veselinovic N; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Junakovic A; Department of Neurology, University Hospital Center of Zagreb, Zagreb, Croatia., Tamas O; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Stefanovic MB; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Jovicevic V; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia., Momcilovic N; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia., Roganovic M; Clinic of Neurology, University Clinical Center of Montenegro, Podgorica, Montenegro., Maric G; Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Jovanovic A; Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Gabelic T; Department of Neurology, University Hospital Center of Zagreb, Zagreb, Croatia., Skoric MK; Department of Neurology, University Hospital Center of Zagreb, Zagreb, Croatia., Mesaros S; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia., Radulovic L; Clinic of Neurology, University Clinical Center of Montenegro, Podgorica, Montenegro., Habek M; Department of Neurology, University Hospital Center of Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia., Drulovic J; Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia. Electronic address: drulovicjelena@gmail.com.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2023 Nov; Vol. 79, pp. 104953. Date of Electronic Publication: 2023 Aug 21.
DOI: 10.1016/j.msard.2023.104953
Abstrakt: 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).
Conclusion: 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.
Competing Interests: Declaration of Competing Interest Marko Andabaka nothing to declare. Tatjana Pekmezovic has been an advisor or speaker for Sanofi-Genzyme, Medis, Hemofarm, Merck, Teva, and Roche. Luka Crnosija nothing to declare. Nikola Veselinovic has been a speaker for Medis, Merck, Teva, Hemofarm, Novartis and Roche. Anmari Junakovic nothing to declare Olivera Tamas has been a speaker for Medis, Merck, Teva, Hemofarm, Novartis and Roche. Maja Budimkic Stefanovic has been a speaker for Medis, Merck, Hemofarm, Novartis and Roche. Vanja Jovicevic nothing to declare. Nikola Momcilovic nothing to declare. Milovan Roganovic nothing to declare. Gorica Maric nothing to declare. Aleksa Jovanovic nothing to declare. Tereza Gabevic participated as a clinical investigator and/or received consultation and/or speaker fees from: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, TG Pharmaceuticals. Magdalena Krbot Skoric participated as a clinical investigator and/or received consultation and/or speaker fees from: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, TG Pharmaceuticals. Sarlota Mesaros has been an advisor or speaker for Medis, Merck, Teva, Hemofarm, Novartis, and Roche. Ljiljana Radulovic has been an advisor or speaker for Medis, Merck, Novartis, and Roche. Mario Habek participated as a clinical investigator and/or received consultation and/or speaker fees from: Biogen, Sanofi Genzyme, Merck, Bayer, Novartis, Pliva/Teva, Roche, Alvogen, Actelion, Alexion Pharmaceuticals, TG Pharmaceuticals. Jelena Drulovic has been an advisor or speaker for Bayer HealthCare, Sanofi-Genzyme, Medis, Merck, Teva, Novartis, Biogen, Hemofarm, Pharma Swiss, Amicus, and Roche.
(Copyright © 2023. Published by Elsevier B.V.)
Databáze: MEDLINE