Juan Manuel Racosta1, Luciano A Sposato1, Sarah A Morrow1, Lauren Cipriano2, Kurt Kimpinski1, Kurt Kimpiski1, Marcelo Kremenchutzky3. 1. Department of Clinical Neurological Sciences, London Health Sciences Centre. Western, University, London, ON, Canada. 2. Ivey Business School, Western University, London, ON, Canada. 3. Department of Clinical Neurological Sciences, London Health Sciences Centre. Western, University, London, ON, Canada. Electronic address: marcelo.kremenchutzky@lhsc.on.ca.
Abstract
BACKGROUND AND OBJECTIVE: The definition of cardiovascular autonomic dysfunction in patients with multiple sclerosis is controversial. Thus, its true prevalence is unknown. We performed a systematic review and meta-analysis to compare the proportion of patients with multiple sclerosis that would be diagnosed with cardiovascular dysautonomia using a definition of at least one abnormal cardiac autonomic test vs. at least two abnormal studies. METHODS: We searched PubMed, Embase, and Scopus from 1980 to December 2013 for publications reporting abnormal autonomic tests in patients with multiple sclerosis. We performed random-effects meta-analyses for calculating the proportion of patients diagnosed with autonomic dysfunction with both definitions. RESULTS: We included 16 studies comprising 611 patients with multiple sclerosis, assessing ≥3 cardiovascular autonomic tests. The proportion of patients with autonomic dysfunction was two-fold higher (p=0.006) when using the definition of only one abnormal autonomic test (42.1%) compared to that using at least two abnormal results (18.8%). CONCLUSIONS: We found a wide variation in the proportion of patients with multiple sclerosis diagnosed with cardiovascular dysautonomia by using the two definitions. Consensus is needed to define autonomic dysfunction in patients with multiple sclerosis. In the meantime, we encourage investigators to report results using both thresholds.
BACKGROUND AND OBJECTIVE: The definition of cardiovascular autonomic dysfunction in patients with multiple sclerosis is controversial. Thus, its true prevalence is unknown. We performed a systematic review and meta-analysis to compare the proportion of patients with multiple sclerosis that would be diagnosed with cardiovascular dysautonomia using a definition of at least one abnormal cardiac autonomic test vs. at least two abnormal studies. METHODS: We searched PubMed, Embase, and Scopus from 1980 to December 2013 for publications reporting abnormal autonomic tests in patients with multiple sclerosis. We performed random-effects meta-analyses for calculating the proportion of patients diagnosed with autonomic dysfunction with both definitions. RESULTS: We included 16 studies comprising 611 patients with multiple sclerosis, assessing ≥3 cardiovascular autonomic tests. The proportion of patients with autonomic dysfunction was two-fold higher (p=0.006) when using the definition of only one abnormal autonomic test (42.1%) compared to that using at least two abnormal results (18.8%). CONCLUSIONS: We found a wide variation in the proportion of patients with multiple sclerosis diagnosed with cardiovascular dysautonomia by using the two definitions. Consensus is needed to define autonomic dysfunction in patients with multiple sclerosis. In the meantime, we encourage investigators to report results using both thresholds.
Authors: Mario Habek; Luka Crnošija; Mila Lovrić; Anamari Junaković; Magdalena Krbot Skorić; Ivan Adamec Journal: Clin Auton Res Date: 2016-07-22 Impact factor: 4.435
Authors: Mu Huang; Dustin R Allen; David M Keller; Paul J Fadel; Elliot M Frohman; Scott L Davis Journal: J Neurophysiol Date: 2016-04-13 Impact factor: 2.714