Clinical autonomic nervous system laboratories in Europe

Scientific paper - Original scientific paper

• Author: Mario Habek
• Author: Fabian Leys
• Author: Magdalena Krbot Skorić
• Author: Diogo Reis Carneiro
• Author: Giovanna Calandra‐Buonaura
• Author: Jennifer Camaradou
• Author: Giacomo Chiaro
• Author: Pietro Cortelli
• Author: Cristian Falup‐Pecurariu
• Author: Roberta Granata
• Author: Pietro Guaraldi
• Author: Raimund Helbok
• Author: Max J. Hilz
• Author: Valeria Iodice
• Author: Jens Jordan
• Author: Evert C. A. Kaal
• Author: Anita Kamondi
• Author: Anne Pavy Le Traon
• Author: Isabel Rocha
• Author: Johann Sellner
• Author: Jean Michel Senard
• Author: Astrid Terkelsen
• Author: Gregor K. Wenning
• Author: Thomas Berger
• Author: Roland D. Thijs
• Author: Walter Struhal
• Author: Alessandra Fanciulli
• Collaboration: European Network of Clinical ANS laboratories
• Author's institution: University of Zagreb; School of Medicine; (Department of Neurology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract (english)

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.
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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.
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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).
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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.

• Keywords (english): Autonomic Nervous System; Autonomic Nervous System Diseases; Humans; Laboratories; Neurology; Surveys and Questionnaires
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: European Journal of Neurology
• Numbering: vol. 29, no. 12, pp. 3633-3646
• p-ISSN: 1351-5101
• e-ISSN: 1468-1331
• DOI: https://doi.org/10.1111/ene.15538
• URN:NBN: urn:nbn:hr:105:978600
• Publication: 2022-09-20
• Document URL: https://onlinelibrary.wiley.com/doi/10.1111/ene.15538
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-02-20 12:29:02