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Clinical autonomic nervous system laboratories in Europe: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies

Habek, M. and Leys, F. and Krbot Skorić, M. and Carneiro, D. and Calandra- Buonaura, G. and Camaradou, J. and Chiaro, G. and Cortelli, P. and Falup-Pecurariu, C. and Granata, R. and Guaraldi, P. and Helbok, R. and Hilz, M.J. and Iodice, V. and Jordan, J. and Kaal, E.C.A. and Kamondi, A. and Le Traon, A. and Rocha, I. and Sellner, J. and Senard, J.M. and Terkelsen, A. and Wenning, G.K. and Berger, T. and Thijs, R.D. and Struhal, W. and Fanciulli, A. (2022) Clinical autonomic nervous system laboratories in Europe: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies. European Journal of Neurology, 29 (12), pp. 3633-3646. Wiley. doi: 10.1111/ene.15538. ISSN 1351-5101.

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Official URL: https://doi.org/10.1111/ene.15538

Abstract

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.

Item URL in elib:https://elib.dlr.de/190285/
Document Type:Article
Title:Clinical autonomic nervous system laboratories in Europe: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies
Authors:
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
Habek, M.Department of Neurology, University Hospital Centre Zagreb, Zagreb, CroatiaUNSPECIFIEDUNSPECIFIED
Leys, F.Department of Neurology, Medical University of Innsbruck, Innsbruck, AustriaUNSPECIFIEDUNSPECIFIED
Krbot Skorić, M.Department of Neurology, University Hospital Centre Zagreb, Zagreb, CroatiaUNSPECIFIEDUNSPECIFIED
Carneiro, D.Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalUNSPECIFIEDUNSPECIFIED
Calandra- Buonaura, G.IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, ItalyUNSPECIFIEDUNSPECIFIED
Camaradou, J.Patient Partner of the EAN Scientific Panel for Autonomic Nervous System Disorders, London, UKUNSPECIFIEDUNSPECIFIED
Chiaro, G.Autonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UKUNSPECIFIEDUNSPECIFIED
Cortelli, P.Department of Biomedical and Neuromotor Sciences and IRCCS, Institute of Neurological Sciences of BolognaUNSPECIFIEDUNSPECIFIED
Falup-Pecurariu, C.Department of Neurology, County Emergency Clinic Hospital, Transilvania University, Brasov, RomaniaUNSPECIFIEDUNSPECIFIED
Granata, R.Department of Neurology, Medical University of Innsbruck, Innsbruck, AustriaUNSPECIFIEDUNSPECIFIED
Guaraldi, P.IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, ItalyUNSPECIFIEDUNSPECIFIED
Helbok, R.Department of Neurology, Medical University of Innsbruck, Innsbruck, AustriaUNSPECIFIEDUNSPECIFIED
Hilz, M.J.Department of Neurology, Universitätsklinikum Erlangen and Department of Neurology, Icahn School of MedicineUNSPECIFIEDUNSPECIFIED
Iodice, V.Autonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UKUNSPECIFIEDUNSPECIFIED
Jordan, J.UNSPECIFIEDhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Kaal, E.C.A.Department of Neurology, Maasstad Ziekenhuis, Rotterdam, The NetherlandsUNSPECIFIEDUNSPECIFIED
Kamondi, A.Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, HungaryUNSPECIFIEDUNSPECIFIED
Le Traon, A.Department of Neurology, Centre Hospitalier Universitaire de Toulouse and INSERM U 1297, Toulouse, FranceUNSPECIFIEDUNSPECIFIED
Rocha, I.Institute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, PortugalUNSPECIFIEDUNSPECIFIED
Sellner, J.Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, AustriaUNSPECIFIEDUNSPECIFIED
Senard, J.M.Department of Cardiolog, Toulouse University Hospital, Institute des Maladies Métaboliques et Cardiovasculaires, INSERM U 1297, Toulouse, FranceUNSPECIFIEDUNSPECIFIED
Terkelsen, A.Department of Neurology, Aarhus University Hospital and Danish Pain Research Center, Aarhus University, Aarhus, DenmarkUNSPECIFIEDUNSPECIFIED
Wenning, G.K.Department of Neurology, Medical University of Innsbruck, Innsbruck, AustriaUNSPECIFIEDUNSPECIFIED
Berger, T.Department of Neurology, Medical University of Vienna, Vienna, AustriaUNSPECIFIEDUNSPECIFIED
Thijs, R.D.Department of Neurology, Leiden University Medical Centre, Leiden, The NetherlandsUNSPECIFIEDUNSPECIFIED
Struhal, W.Department of Neurology, Karl Landsteiner UniversityUNSPECIFIEDUNSPECIFIED
Fanciulli, A.Department of Neurology, Innsbruck Medical UniversityUNSPECIFIEDUNSPECIFIED
Date:2 September 2022
Journal or Publication Title:European Journal of Neurology
Refereed publication:Yes
Open Access:Yes
Gold Open Access:No
In SCOPUS:Yes
In ISI Web of Science:Yes
Volume:29
DOI:10.1111/ene.15538
Page Range:pp. 3633-3646
Publisher:Wiley
ISSN:1351-5101
Status:Published
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
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:22 Nov 2022 10:49
Last Modified:22 Nov 2022 10:49

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