Validation of the Composite Autonomic Symptom Score 31 in the German language

Hilz, M. J.; Wang, Ruihao; Singer, Wolfgang

doi:10.1007/s10072-021-05764-4

Cited by 11 publications

(12 citation statements)

References 15 publications

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“…The results confirm previous findings 3 , 6 , 7 that patient-reported autonomic symptoms are a poor predictor of objective autonomic dysfunction. Obviously other factors contributing to subjective dysautonomia should be considered such as cerebral hypoperfusion associated with hypocapnic cerebral hypoperfusion 26 and orthostatic cerebral hypoperfusion syndrome 27 as well as comorbidities including depression, anxiety, stress, fatigue, central sensitization 28 – 32 , and mast cell disorders 33 .…”

Section: Discussionsupporting

confidence: 91%

“…The advantage of questionnaires include little to no cost, they are easy to administer, and do not require a specialized autonomic center. Nevertheless, symptoms are a poor predictor of dysautonomia 4 , 5 , and the lack of correlations or poor correlations between autonomic questionnaires and autonomic testing was already noted in previous smaller studies 3 , 6 , 7 . For example, the SAS validation study showed no association between the SAS and Composite Autonomic Severity Score (CASS) 8 , a validated instrument for grading autonomic failure using cardiovascular reflex and sudomotor tests, or CASS subscores 3 .…”

Section: Introductionmentioning

confidence: 76%

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Mismatch between subjective and objective dysautonomia

Novak,

Systrom,

Marciano

et al. 2024

Sci Rep

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Autonomic symptom questionnaires are frequently used to assess dysautonomia. It is unknown whether subjective dysautonomia obtained from autonomic questionnaires correlates with objective dysautonomia measured by quantitative autonomic testing. The objective of our study was to determine correlations between subjective and objective measures of dysautonomia. This was a retrospective cross-sectional study conducted at Brigham and Women’s Faulkner Hospital Autonomic Laboratory between 2017 and 2023 evaluating the patients who completed autonomic testing. Analyses included validated autonomic questionnaires [Survey of Autonomic Symptoms (SAS), Composite Autonomic Symptom Score 31 (Compass-31)] and standardized autonomic tests (Valsalva maneuver, deep breathing, sudomotor, and tilt test). The autonomic testing results were graded by a Quantitative scale for grading of cardiovascular reflexes, sudomotor tests and skin biopsies (QASAT), and Composite Autonomic Severity Score (CASS). Autonomic testing, QASAT, CASS, and SAS were obtained in 2627 patients, and Compass-31 in 564 patients. The correlation was strong between subjective instruments (SAS vs. Compass-31, r = 0.74, p < 0.001) and between objective instruments (QASAT vs. CASS, r = 0.81, p < 0.001). There were no correlations between SAS and QASAT nor between Compass-31 and CASS. There continued to be no correlations between subjective and objective instruments for selected diagnoses (post-acute sequelae of COVID-19, n = 61; postural tachycardia syndrome, 211; peripheral autonomic neuropathy, 463; myalgic encephalomyelitis/chronic fatigue syndrome, 95; preload failure, 120; post-treatment Lyme disease syndrome, 163; hypermobile Ehlers-Danlos syndrome, 213; neurogenic orthostatic hypotension, 86; diabetes type II, 71, mast cell activation syndrome, 172; hereditary alpha tryptasemia, 45). The lack of correlation between subjective and objective instruments highlights the limitations of the commonly used questionnaires with some patients overestimating and some underestimating true autonomic deficit. The diagnosis-independent subjective–objective mismatch further signifies the unmet need for reliable screening surveys. Patients who overestimate the symptom burden may represent a population with idiosyncratic autonomic-like symptomatology, which needs further study. At this time, the use of autonomic questionnaires as a replacement of autonomic testing cannot be recommended.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 76%

Mismatch between subjective and objective dysautonomia

Novak,

Systrom,

Marciano

et al. 2024

Sci Rep

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“…The inclusion of patients with well-defined ME/CFS and obligatory PEM, together with detailed information on clinical and laboratory findings as well as collected biosamples, is expected to significantly enhance clinical and translational research on ME/CFS and thereby improve medical care for affected patients of any age in Germany and beyond. 1 [53] Autonomic symptoms were assessed by COMPASS 31 questionnaire, considering the total score (0-100) and the scores of the six subdomains orthostatic intolerance (0-40), vasomotor (0-5), secretomotor (0-15), gastrointestinal (0-25), bladder (0-10) and pupillomotor (0-5).…”

Section: Discussionmentioning

confidence: 99%

“…The Composite Autonomic Symptom Score-31 (COMPASS-31) is a concise instrument to assess autonomic nervous system dysfunction. It comprises 31 validated items in six domains: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor function, and a total score ranging from 0 to 100 [53].…”

Section: Patient-reported Outcomes Measuresmentioning

confidence: 99%

The German Multicenter Registry for ME/CFS (MECFS-R)

Hieber,

Pricoco,

Gerrer

et al. 2024

Preprint

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Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multi-systemic disease characterized by a complex, incompletely understood etiology. To facilitate future clinical and translational research, a multicenter German ME/CFS registry was established to collect comprehensive, longitudinal, clinical, epidemiological, and laboratory data from adults, adolescents, and children in a web-based multilayer-secured database. Here, we present the research protocol and first results of a pilot cohort of 174 ME/CFS patients diagnosed at two specialized tertiary fatigue centers, including 130 (74.7%) adults (mean age 38.4; SD 12.6) and 43 (25.3%) pediatric patients (mean age 15.5; SD 4.2). A viral trigger was identified in 160/174 (92.0%) cases, with SARS-CoV-2 in almost half of them. Patients exhibited severe functional and social impairment, as reflected by a median Bell Score of 30.0 (IQR 30.0 to 40.0) and a poor health-related quality of life assessed with the Short form-36 health survey, resulting in a mean score of 40.4 (SD 20.6) for physical function and 59.1 (SD 18.8) for mental health. The MECFS-R provides important clinical information on ME/CFS to research and healthcare institutions and, together with a multicenter ME/CFS biobank, will pave the way for research projects addressing the pathogenesis, diagnostic markers, and treatment options. Trial registration: ClinicalTrials.govNCT05778006.

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“…All participants completed the Croatian, Serbian, Slovenian and German versions of the COMPASS-31 [11,12]. The COMPASS-31 is the most widely used questionnaire for the assessment of autonomic symptoms and consists of 31 questions examining six autonomic domains: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor.…”

Section: Sudomotor System Testingmentioning

confidence: 99%

Sudomotor dysfunction in people with neuromyelitis optica spectrum disorders

Habek

Andabaka

Fanciulli

et al. 2022

Euro J of Neurology

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Background and purpose The aim was to determine the extent of sudomotor dysfunction in people with neuromyelitis optica spectrum disorder (pwNMOSD) and to compare findings with a historical cohort of people with relapsing–remitting multiple sclerosis (pwRRMS). Methods Forty‐eight pwNMOSD were enrolled from four clinical centers. All participants completed the Composite Autonomic Symptom Score 31 to screen for symptoms of sudomotor dysfunction. Sudomotor function was assessed using the quantitative sudomotor axon reflex test. The results were compared with a historical cohort of 35 pwRRMS matched for age, sex and disease duration. Results Symptoms of sudomotor dysfunction, defined by a score in the Composite Autonomic Symptom Score 31 secretomotor domain >0, were present in 26 (54%) of pwNMOSD. The quantitative sudomotor axon reflex test confirmed a sudomotor dysfunction in 25 (52.1%) of pwNMOSD; in 14 of them (29.2%) sudomotor dysfunction was moderate or severe. No difference was observed between pwNMOSD and pwRRMS in any of the studied parameters. However, symptomatic sudomotor dysfunction was more frequent in pwNMOSD (n = 8, 22.9%) compared to pwRRMS (n = 1, 3%; p = 0.028). In a multivariable logistic regression analysis, statistically significant predictors for symptomatic sudomotor failure were age and diagnosis of neuromyelitis optica spectrum disorder. Conclusions Sudomotor dysfunction is common in pwNMOSD and more often symptomatic compared to pwRRMS.

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Validation of the Composite Autonomic Symptom Score 31 in the German language

Cited by 11 publications

References 15 publications

Mismatch between subjective and objective dysautonomia

Mismatch between subjective and objective dysautonomia

The German Multicenter Registry for ME/CFS (MECFS-R)

Sudomotor dysfunction in people with neuromyelitis optica spectrum disorders

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