Abstract
Original language | English |
---|---|
Pages (from-to) | 3633-3646 |
Number of pages | 14 |
Journal | European journal of neurology |
Volume | 29 |
Issue number | 12 |
Early online date | 2022 |
DOIs | |
Publication status | Published - Dec 2022 |
Keywords
- (disorders of) autonomic nervous system
- Composite Autonomic Severity Score
- Survey
- cardiovascular autonomic function tests
- disorders of consciousness (other than epilepsy)
- neurodisparity
- neurological disorders
- orthostatic hypotension
- sweat tests
- syncope
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In: European journal of neurology, Vol. 29, No. 12, 12.2022, p. 3633-3646.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Clinical autonomic nervous system laboratories in Europe
T2 - A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies
AU - Habek, Mario
AU - Leys, Fabian
AU - Krbot Skorić, Magdalena
AU - Reis Carneiro, Diogo
AU - Calandra-Buonaura, Giovanna
AU - Camaradou, Jennifer
AU - Chiaro, Giacomo
AU - Cortelli, Pietro
AU - Falup-Pecurariu, Cristian
AU - Granata, Roberta
AU - Guaraldi, Pietro
AU - Helbok, Raimund
AU - Hilz, Max J.
AU - Iodice, Valeria
AU - Jordan, Jens
AU - Kaal, Evert C. A.
AU - Kamondi, Anita
AU - Pavy le Traon, Anne
AU - Rocha, Isabel
AU - Sellner, Johann
AU - Senard, Jean Michel
AU - Terkelsen, Astrid
AU - Wenning, Gregor K.
AU - Berger, Thomas
AU - Thijs, Roland D.
AU - Struhal, Walter
AU - Fanciulli, Alessandra
AU - the Collaborators of the European Network of Clinical ANS laboratories
AU - Adamec, Ivan
AU - Aerts, Arnaud
AU - Canta, Leo L. R.
AU - Delamont, Robert Shane
AU - de Lange, Frederik
AU - del Sorbo, Francesca
AU - Devigili, Grazia
AU - di Leo, Rita
AU - Dinh, Trang
AU - Fortrat, Jacques-Olivier
AU - Gierthmühlen, Janne
AU - Hemels, Martin
AU - Köhn, Julia
AU - Krøigård, Thomas
AU - Lipp, Axel
AU - Maier, Andrea
AU - Marinelli, Lucio
AU - Mazzeo, Anna
AU - Milenkovic, Ivan
AU - Motyl, Maciej
AU - Natali Sora, Maria Grazia
AU - Navarro-Otano, Judith
AU - Nilsen, Kristian Bernhard
N1 - Funding Information: Academic study without external financial support. We received administrative support from the EAN Head Office. Funding Information: We would like to thank Ms Lucia Pavlakova and Ms Abigail Magno (Scientific Department, European Academy of Neurology) for the excellent administrative support and the following collaborators of the European Network of Clinical ANS laboratories for their thoughtful completion of the survey: Adamec Ivan – Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia; Aerts Arnaud – Department of Cardiology, Zuyderland Medical Centre, Heerlen, Netherlands; Canta LR (Leo) – Department of Neurology, Catharina Ziekenhuis, Eindhoven, Netherlands; Delamont Robert Shane – Department of Neurology and Clinical Neurophysiology, King's College Hospital, London, UK; de Lange Frederik – Syncope Unit, Amsterdam University Medical Center, Amsterdam, Netherlands; Del Sorbo Francesca – Parkinson and Movement Disorders Unit, ASST Gaetano Pini-CTO, Milano, Italy; Devigili Grazia – Parkinson and Movement Disorder Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy; Di Leo Rita – Department of Neurology, Ospedale San Giovanni e Paolo, Venezia, Italy; Dinh Trang – Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands; Fortrat Jacques-Olivier – Explorations Fonctionnelles Vasculaires, Centre Hospitalier Universitaire, Angers, France; Gierthmühlen Janne – Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany; Hemels Martin – Department of Cardiology, Rijnstate Hospital and Radboud University Medical Center, Arnhem - Nijmegen, Netherlands; Köhn Julia – Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Krøigård Thomas – Department of Neurology, Odense University Hospital, Odense, Denmark; Lipp Axel – Department of Neurology, Park-Klinik Weißensee, Berlin, Germany; Maier Andrea – Department of Neurology, Outpatient Service for ANS Disorders, University Clinic RWTH Aachen, Aachen, Germany; Marinelli Lucio – Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genova, Italy; Mazzeo Anna – Department of Clinical and Experimental Medicine, Neurology and Neuromuscular Disease Unit, Messina, Italy; Milenkovic Ivan – Department of Neurology, Medical University of Vienna, Vienna, Austria; Motyl Maciej – Department of Neurology, Jagiellonian University Medical College, Krakow, Poland; Natali Sora Maria Grazia – Department of Neurology, Ospedale San Raffaele, Milano, Italy; Navarro-Otano Judith – Department of Neurology, Hospital Clinic, Barcelona, Spain; Nilsen Kristian Bernhard – Department of Neurology, Oslo University Hospital, Oslo University Hospital, Norway; Oliveira Mario – Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal; Omland Petter Moe – Department of Neurology, Section of Clinical Neurophysiology, St. Olavs University Hospital, Trondheim, Norway; Pelliccioni Giuseppe – Department of Neurology, Istituto Nazionale di Ricovero e Cura per Anziani IRCCS Ancona, Ancona, Italy; Pereon Yann – Reference Centre from Neuromuscular Disorders, Department of Neurology, University Hospital, Nantes, France; Resch Roland Josef – Department of Neurology, Kepler University, Linz, Austria; Rocchi Camilla – Department of Neurology, Policlinico Tor Vergata, University of Rome “Tor Vergata”, Rome, Italy; Roche Frederic – Department of Clinical Physiology, CHU And INSERM U 1059 Sainbiose, Saint Étienne, France; Rutten Joost – Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands; Tijero Merino Beatriz – Movement Disorders and Autonomic Disorders Unit, Cruces Hospital, Barakaldo, Spain; Tutaj Marcin – Department of Neurology, Jagiellonian University Medical College, Krakow, Poland; van der Heijden-Montfroy AMHG – Department of Neurology, VieCuri, Venlo, Netherlands; van Hoeve Bas JA – Department of Neurology, ZorgSaam Hospital, Terneuzen, Netherlands; van Orshoven Narender – Department of Neurology, Zuyderland Medical Centre, Heerlen, Netherlands; Wang Ruihao – Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany; Z'Graggen Werner J – Department of Neurology, University Hospital Bern, Bern, Switzerland. Publisher Copyright: © 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2022/12
Y1 - 2022/12
N2 - Background and purpose: Disorders of the autonomic nervous system (ANS) are common conditions, but it is unclear whether access to ANS healthcare provision is homogeneous across European countries. The aim of this study was to identify neurology-driven or interdisciplinary clinical ANS laboratories in Europe, describe their characteristics and explore regional differences. Methods: We contacted the European national ANS and neurological societies, as well as members of our professional network, to identify clinical ANS laboratories in each country and invite them to answer a web-based survey. Results: We identified 84 laboratories in 22 countries and 46 (55%) answered the survey. All laboratories perform cardiovascular autonomic function tests, and 83% also perform sweat tests. Testing for catecholamines and autoantibodies are performed in 63% and 56% of laboratories, and epidermal nerve fiber density analysis in 63%. Each laboratory is staffed by a median of two consultants, one resident, one technician and one nurse. The median (interquartile range [IQR]) number of head-up tilt tests/laboratory/year is 105 (49–251). Reflex syncope and neurogenic orthostatic hypotension are the most frequently diagnosed cardiovascular ANS disorders. Thirty-five centers (76%) have an ANS outpatient clinic, with a median (IQR) of 200 (100–360) outpatient visits/year; 42 centers (91%) also offer inpatient care (median 20 [IQR 4–110] inpatient stays/year). Forty-one laboratories (89%) are involved in research activities. We observed a significant difference in the geographical distribution of ANS services among European regions: 11 out of 12 countries from North/West Europe have at least one ANS laboratory versus 11 out of 21 from South/East/Greater Europe (p = 0.021). Conclusions: This survey highlights disparities in the availability of healthcare services for people with ANS disorders across European countries, stressing the need for improved access to specialized care in South, East and Greater Europe.
AB - Background and purpose: Disorders of the autonomic nervous system (ANS) are common conditions, but it is unclear whether access to ANS healthcare provision is homogeneous across European countries. The aim of this study was to identify neurology-driven or interdisciplinary clinical ANS laboratories in Europe, describe their characteristics and explore regional differences. Methods: We contacted the European national ANS and neurological societies, as well as members of our professional network, to identify clinical ANS laboratories in each country and invite them to answer a web-based survey. Results: We identified 84 laboratories in 22 countries and 46 (55%) answered the survey. All laboratories perform cardiovascular autonomic function tests, and 83% also perform sweat tests. Testing for catecholamines and autoantibodies are performed in 63% and 56% of laboratories, and epidermal nerve fiber density analysis in 63%. Each laboratory is staffed by a median of two consultants, one resident, one technician and one nurse. The median (interquartile range [IQR]) number of head-up tilt tests/laboratory/year is 105 (49–251). Reflex syncope and neurogenic orthostatic hypotension are the most frequently diagnosed cardiovascular ANS disorders. Thirty-five centers (76%) have an ANS outpatient clinic, with a median (IQR) of 200 (100–360) outpatient visits/year; 42 centers (91%) also offer inpatient care (median 20 [IQR 4–110] inpatient stays/year). Forty-one laboratories (89%) are involved in research activities. We observed a significant difference in the geographical distribution of ANS services among European regions: 11 out of 12 countries from North/West Europe have at least one ANS laboratory versus 11 out of 21 from South/East/Greater Europe (p = 0.021). Conclusions: This survey highlights disparities in the availability of healthcare services for people with ANS disorders across European countries, stressing the need for improved access to specialized care in South, East and Greater Europe.
KW - (disorders of) autonomic nervous system
KW - Composite Autonomic Severity Score
KW - Survey
KW - cardiovascular autonomic function tests
KW - disorders of consciousness (other than epilepsy)
KW - neurodisparity
KW - neurological disorders
KW - orthostatic hypotension
KW - sweat tests
KW - syncope
UR - http://www.scopus.com/inward/record.url?scp=85138408564&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/ene.15538
DO - https://doi.org/10.1111/ene.15538
M3 - Article
C2 - 36056590
SN - 1351-5101
VL - 29
SP - 3633
EP - 3646
JO - European journal of neurology
JF - European journal of neurology
IS - 12
ER -