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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

2022Journal article Open access
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dc.contributor.authorHabek, Mario
dc.contributor.authorLeys, Fabian
dc.contributor.authorKrbot Skorić, Magdalena
dc.contributor.authorReis Carneiro, Diogo
dc.contributor.authorCalandra‐Buonaura, Giovanna
dc.contributor.authorCamaradou, Jennifer
dc.contributor.authorChiaro, Giacomo
dc.contributor.authorCortelli, Pietro
dc.contributor.authorFalup‐Pecurariu, Cristian
dc.contributor.authorGranata, Roberta
dc.contributor.authorGuaraldi, Pietro
dc.contributor.authorHelbok, Raimund
dc.contributor.authorHilz, Max J.
dc.contributor.authorIodice, Valeria
dc.contributor.authorJordan, Jens
dc.contributor.authorKaal, Evert C. A.
dc.contributor.authorKamondi, Anita
dc.contributor.authorPavy Le Traon, Anne
dc.contributor.authorRocha, Isabel
dc.contributor.authorSellner, Johann
dc.contributor.authorSenard, Jean Michel
dc.contributor.authorTerkelsen, Astrid
dc.contributor.authorWenning, Gregor K.
dc.contributor.authorBerger, Thomas
dc.contributor.authorThijs, Roland D.
dc.contributor.authorStruhal, Walter
dc.contributor.authorFanciulli, Alessandra
dc.contributor.authorAdamec, Ivan
dc.contributor.authorAerts, Arnaud
dc.contributor.authorCanta, Leo L.R.
dc.contributor.authorDelamont, Robert Shane
dc.contributor.authorde Lange, Frederik
dc.contributor.authorDel Sorbo, Francesca
dc.contributor.authorDevigili, Grazia
dc.contributor.authorDi Leo, Rita
dc.contributor.authorDinh, Trang
dc.contributor.authorFortrat, Jacques‐Olivier
dc.contributor.authorGierthmühlen, Janne
dc.contributor.authorHemels, Martin
dc.contributor.authorKöhn, Julia
dc.contributor.authorKrøigård, Thomas
dc.contributor.authorLipp, Axel
dc.contributor.authorMaier, Andrea
dc.contributor.authorMarinelli, Lucio
dc.contributor.authorMazzeo, Anna
dc.contributor.authorMilenkovic, Ivan
dc.contributor.authorMotyl, Maciej
dc.contributor.authorNatali Sora, Maria Grazia
dc.contributor.authorNavarro‐Otano, Judith
dc.contributor.authorNilsen, Kristian Bernhard
dc.contributor.authorOliveira, Mario
dc.contributor.authorOmland, Petter Moe
dc.contributor.authorPelliccioni, Giuseppe
dc.contributor.authorPereon, Yann
dc.contributor.authorResch, Roland Josef
dc.contributor.authorRocchi, Camilla
dc.contributor.authorRoche, Frederic
dc.contributor.authorRutten, Joost
dc.contributor.authorTijero Merino, Beatriz
dc.contributor.authorTutaj, Marcin
dc.contributor.authorvan der Heijden‐Montfroy, A.M.H.G.
dc.contributor.authorvan Hoeve, Bas J.A.
dc.contributor.authorvan Orshoven, Narender
dc.contributor.authorWang, Ruihao
dc.contributor.authorZ’Graggen, Werner J.
dc.date.accessioned2022-11-21T15:42:31Z
dc.date.available2022-11-21T15:42:31Z
dc.date.issued2022
dc.description© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.pt_PT
dc.description.abstractBackground 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.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur J Neurol. 2022 Dec;29(12):3633-3646pt_PT
dc.identifier.doi10.1111/ene.15538pt_PT
dc.identifier.eissn1468-1331pt_PT
dc.identifier.issn1351-5101
dc.identifier.urihttp://hdl.handle.net/10451/55178
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/14681331pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectAutonomic nervous system, disorderspt_PT
dc.subjectComposite Autonomic Severity Scorept_PT
dc.subjectSurveypt_PT
dc.subjectCardiovascular autonomic function testspt_PT
dc.subjectConsciousness, disorderspt_PT
dc.subjectNeurodisparitypt_PT
dc.subjectNeurological disorderspt_PT
dc.subjectOrthostatic hypotensionpt_PT
dc.subjectSweat testspt_PT
dc.subjectSyncopept_PT
dc.titleClinical autonomic nervous system laboratories in Europe: a joint survey of the European Academy of Neurology and the European Federation of Autonomic Societiespt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3646pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage3633pt_PT
oaire.citation.titleEuropean Journal of Neurologypt_PT
oaire.citation.volume29pt_PT
person.familyNamerocha
person.givenNameisabel
person.identifier.orcid0000-0002-7582-0893
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication472714e8-fa6c-4d7b-9c4d-d6f5b55e39f4
relation.isAuthorOfPublication.latestForDiscovery472714e8-fa6c-4d7b-9c4d-d6f5b55e39f4

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