TY - JOUR
T1 - Clinical autonomic nervous system laboratories in Europe
T2 - 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
AU - Habek, Mario
AU - Leys, Fabian
AU - Krbot Skorić, Magdalena
AU - Reis Carneiro, Diogo
AU - Calandra-Buonaura, Giovanna
AU - Camaradou, Jennifer
AU - Chiaro, Giacomo
AU - Cortelli, Pietro
AU - Falup-Pecurariu, Cristian
AU - Granata, Roberta
AU - Guaraldi, Pietro
AU - Helbok, Raimund
AU - Hilz, Max J.
AU - Iodice, Valeria
AU - Jordan, Jens
AU - Kaal, Evert C.A.
AU - Kamondi, Anita
AU - Pavy Le Traon, Anne
AU - Rocha, Isabel
AU - Sellner, Johann
AU - Senard, Jean Michel
AU - Terkelsen, Astrid
AU - Wenning, Gregor K.
AU - Berger, Thomas
AU - Thijs, Roland D.
AU - Struhal, Walter
AU - Fanciulli, Alessandra
AU - the Collaborators of the European Network of Clinical ANS laboratories
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
KW - (disorders of) autonomic nervous system
KW - cardiovascular autonomic function tests
KW - Composite Autonomic Severity Score
KW - disorders of consciousness (other than epilepsy)
KW - neurodisparity
KW - neurological disorders
KW - orthostatic hypotension
KW - Survey
KW - sweat tests
KW - syncope
KW - Laboratories
KW - Humans
KW - Neurology
KW - Autonomic Nervous System
KW - Surveys and Questionnaires
KW - Autonomic Nervous System Diseases
UR - http://www.scopus.com/inward/record.url?scp=85138408564&partnerID=8YFLogxK
U2 - 10.1111/ene.15538
DO - 10.1111/ene.15538
M3 - Journal article
C2 - 36056590
AN - SCOPUS:85138408564
SN - 1351-5101
VL - 29
SP - 3633
EP - 3646
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 12
ER -