Abstract Details

Title Autonomic Dysfunction in People with Neuromyelitis Optica Spectrum Disorders

Topic Autoimmune Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-006

Objective To determine the difference in a pattern of autonomic symptom burden measured with the Composite Autonomic System Score-31 (COMPASS-31) and presence of objective dysautonomia in people with neuromyelitis optica spectrum disorders (pwNMOSD) compared to people with multiple sclerosis (pwMS).

Background

It has been shown that people with pwMS have a substantial involvement of the autonomic nervous system, and that this is mainly the consequence of brainstem and spinal cord involvement. In light of this, it is surprising that only few case reports exist describing autonomic dysfunction in patients with pwNMOSD, a disease that primarily involves area of the CNS responsible for autonomic dysfunction.

Design/Methods 20 pwNMOSD and 20 pwMS, matched for age, sex and disease duration were enrolled. All patients completed the COMPASS-31. The quantification of cardiovascular autonomic dysfunction (CAD) was made using the two indices of the Composite Autonomic Scoring Scale (CASS): adrenergic index (AI) and cardiovagal index (CI).

Results In all pwNMOSD, COMPASS-31 was >0. AI >0, indicating sympathetic dysfunction, was present in 8 (40%) and CI>0, indicating parasympathetic dysfunction, was present in 10 (50%) pwNMOSD. Orthostatic hypotension on tilt-table test (TTT) was present in 6 (30%) of pwNMOSD. pwNMOSD had higher frequency and level on the pupilomotor domain of the COMAPSS-31 compared to pwMS (p=0.048 and p=0.006, respectively). There was no difference in AI and CI between groups (all p>0.05). pwNMOSD had significantly greater drop in diastolic blood pressure (dBP) during TTT compared to pwMS, p=0.044. Binary logistic regression model showed that drop in dBP during TTT and normal function of autonomic nervous system, defined as AI=0 and CI = 0, are independent predictors of pwNMOSD (p=0.042 and p=0.029, respectively). If CAD was present, it was significantly worse in pwNMOSD compared to pwMS (p=0.008)

Conclusions Significant proportion of pwNMOSD experience dysautonomia, which seems to be different from dysautonomia observed in pwMS.

Authors/Disclosures
PRESENTER	No disclosure on file
Magdalena Krbot Skoric	Magdalena Krbot Skoric has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Sarlota Mesaros	Sarlota Mesaros has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Sarlota Mesaros has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Hemofarm. Sarlota Mesaros has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.
Tatjana Pekmezovic	No disclosure on file
Jelena Drulovic	Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck . Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hemofarm. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PharmaSwiss. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck . Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Actavis TEVA. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Hemofarm. Jelena Drulovic has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medis. Jelena Drulovic has received research support from Ministry of Science, Technological Development and Innovations of the Republic of Serbia.
Mario Habek, MD (University of Zagreb, School of Medicine)	Dr. Habek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck . Dr. Habek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Habek has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.

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