The composite autonomic symptom scale 31 is a useful screening tool for patients with Parkinsonism

Kim, Younsoo; Seok, Jin Myoung; Park, Jongkyu; Kim, Kun-Hyun; Min, Ju-Hong; Cho, Jin Whan; Park, Suyeon; Kim, Hyun‐Jin; Kim, Byoung Joon; Youn, Jinyoung

doi:10.1371/journal.pone.0180744

Cited by 33 publications

(19 citation statements)

References 20 publications

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“…This autonomic symptom pattern has been reported in other conditions complicated by dysautonomia e.g. small fibre polyneuropathy [10], , Parkinson's disease [31], MSA and POTS [27] and autonomic failure secondary to a range of conditions [32]. The lack of change in vasomotor scores in conditions where patients have clinically recognised vasomotor complaints, such as POTS) has caused some authors to speculate that the items in this domain may not adequately capture vasomotor symptoms [27].…”

Section: Discussionmentioning

confidence: 77%

Chronic cough is associated with increased reporting of autonomic symptoms

et al. 2021

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BackgroundPatients with some neuronal hypersensitivity syndromes experience increased autonomic symptoms. Chronic cough is thought to be a neuronal hypersensitivity disorder and, therefore, may be associated with increased autonomic symptoms.Methods96 chronic cough subjects were recruited from the tertiary cough clinic based at Wythenshawe Hospital, Manchester, UK; 76 healthy controls were also recruited. Subjects were aged >18 years. Those with significant respiratory disease, significant smoking history or taking medication known to affect cough or autonomic function were excluded. Subjects completed the Composite Autonomic Symptom Score (COMPASS) 31 autonomic symptom questionnaire, the Cough Quality of Life Questionnaire (CQLQ) and a cough severity visual analogue scale (VAS).Results96 chronic cough subjects and 76 healthy volunteers were included in the final analysis. Mann–Whitney U-tests comparing COMPASS 31 scores in both groups showed that the total COMPASS 31 score was significantly higher in the patient group (median 18.4, interquartile range (IQR) 7.5–32.0) than the control group (median 3.6, IQR 1.1–9.5; p<0.001). The chronic cough subjects had significantly higher symptom scores than the healthy volunteer groups in all domains (p≤0.001) except vasomotor symptoms (p=0.770). There was a positive association between COMPASS 31 and CQLQ in the patient group (p<0.001, r=0.432) but not COMPASS 31 and VAS (p=0.227).InterpretationChronic cough patients do indeed report more frequent and severe autonomic symptoms than healthy volunteers, indicating that this population may suffer from dysautonomia. At present, it remains unclear whether this occurs as a result of the cough or whether both the cough and dysfunction are part of some wider vagal pathology.

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Section: Discussionmentioning

confidence: 77%

Chronic cough is associated with increased reporting of autonomic symptoms

et al. 2021

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“…Previously, scores on such measures have been shown to predict ANS dysfunction assessed using physiological measures, which are considered a reliable screening tool for several disorders characterised by ANS dysfunction (e.g. Kim et al, 2017; Treister et al, 2015).…”

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confidence: 99%

Autonomic dysfunction in autism: The roles of anxiety, depression, and stress

Taylor

Livingston

Callan

et al. 2021

Autism

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Autism spectrum disorder (ASD) is associated with atypical autonomic nervous system (ANS) function. However, little is known about this relationship, while accounting for co-occurring mental health conditions (e.g. anxiety) that are also associated with ANS dysfunction. In addition, research on the ANS has typically involved physiological measurements, without using more clinically meaningful measures of ANS dysfunction, such as the self-reported frequency of ANS-related physical health symptoms. Furthermore, very little is known about ANS function in autistic adults, given that previous research has focused on ANS dysfunction in children with ASD. Addressing these gaps in the literature, we compared ANS function in adults with(out) ASD (Study 1). Although autistic adults reported greater ANS dysfunction than matched neurotypical controls, this difference was not significant after controlling for anxiety and depression. Similarly, in a large nonclinical sample (Study 2), we found that anxiety and stress mediated the relationship between autistic traits and ANS dysfunction. Together, we conclude that ANS dysfunction is not a feature of ASD per se, but instead attributable to the high levels of anxiety and stress in autistic adults. We discuss the clinical relevance of these findings for managing ANS dysfunction and other physical and mental health concerns in autistic adulthood. Lay abstract The autonomic nervous system (ANS) is responsible for the functioning of the heart, bladder, pupils and several other bodily functions. Therefore, when the ANS functions abnormally, individuals can experience a number of physical symptoms, including dizziness, abnormal sweating and digestive difficulties. Currently, it is unclear if autistic adults experience ANS dysfunction. Therefore, in this study, we investigated whether autistic adults report more ANS-related physical symptoms, indicating greater ANS dysfunction, and whether this may be related to autism, or rather anxiety, depression, or stress. The findings suggest that ANS dysfunction, where found in autism, is due to co-occurring stress and anxiety. We therefore propose that treating stress and anxiety may be an effective way to ameliorate ANS-related health problems in autistic adults.

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“…More specifically, the pupillomotor weighted COMPASS 31 sub-score inversely correlated with the duration of pupil contraction and the latency of pupil dilation, indicating a relationship between pupillary parasympathetic dysfunction and the severity of pupillomotor symptoms. Previous studies have validated COMPASS 31 as an effective screening tool for the evaluation of autonomic neuropathy in Parkinson’s disease and diabetic autonomic neuropathy 28 – 30 . A recent study has shown abnormalities in thermal thresholds and reduced intraepidermal nerve fiber density, but no relationship with autonomic symptoms in patients with Fabry disease 31 .…”

Section: Discussionmentioning

confidence: 99%

Altered pupillary light responses are associated with the severity of autonomic symptoms in patients with Fabry disease

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Türkmen

Zengin

et al. 2021

Sci Rep

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Symptoms of autonomic dysfunction are common in Fabry disease. In this study we aimed to evaluate alterations in the pupillary response to white light stimulation in patients with Fabry disease and their association with the severity of autonomic symptoms. Fourteen consecutive patients with Fabry disease and 14 healthy control participants were enrolled in this cross-sectional study. The Mainz Severity Score Index (MSSI) was used to measure the severity of Fabry disease and the Composite Autonomic Symptom Scale 31 (COMPASS 31) questionnaire was used to evaluate the severity of autonomic symptoms. The pupil light responses were assessed with an infrared dynamic pupillometry unit. There were significant reductions in the amplitude (P = 0.048) and duration (P = 0.048) of pupil contraction, and the latency of pupil dilation (P = 0.048) in patients with Fabry disease compared to control subjects. The total weighted COMPASS 31 score correlated with MSSI (r = 0.592; P = 0.026) and the duration of pupil dilation (ρ = 0.561; P = 0.037). The pupillomotor weighted sub-score of the COMPASS 31 correlated inversely with the duration of pupil contraction (r = − 0.600; P = 0.023) and latency of pupil dilation (ρ = − 0.541; P = 0.046), and directly with the duration of pupil dilation (ρ = 0.877; P < 0.001) and MSSI (r = 0.533; P = 0.049). In conclusion, abnormal pupillary function is demonstrated in patients with Fabry disease, which is associated with the severity of autonomic symptoms.

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The composite autonomic symptom scale 31 is a useful screening tool for patients with Parkinsonism

Cited by 33 publications

References 20 publications

Chronic cough is associated with increased reporting of autonomic symptoms

Chronic cough is associated with increased reporting of autonomic symptoms

Autonomic dysfunction in autism: The roles of anxiety, depression, and stress

Altered pupillary light responses are associated with the severity of autonomic symptoms in patients with Fabry disease

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