학술논문
Clinical autonomic nervous system laboratories in Europe: 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.
Document Type
Academic Journal
Author
Habek M; Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.; Department of Neurology, University of Zagreb, School of Medicine, Zagreb, Croatia.; Leys F; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; Krbot Skorić M; Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.; Faculty of Electrical Engineering and Computing, University of Zagreb, Zagreb, Croatia.; Reis Carneiro D; Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.; Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Calandra-Buonaura G; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.; Camaradou J; Patient Partner of the EAN Scientific Panel for Autonomic Nervous System Disorders, London, UK.; UCL Social Research Institute, University College London, London, UK.; Chiaro G; Autonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.; UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.; Cortelli P; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.; Falup-Pecurariu C; Department of Neurology, Faculty of Medicine, Transilvania University, Brasov, Romania.; Granata R; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; Guaraldi P; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.; Helbok R; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; Hilz MJ; Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Department of Neurology, University Erlangen-Nuremberg, Erlangen-Nuremberg, Germany.; Iodice V; Autonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.; UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.; Jordan J; Institute of Aerospace Medicine, German Aerospace Center (DLR) and Medical Faculty, University of Cologne, Cologne, Germany.; Kaal ECA; Department of Neurology, Maasstad Ziekenhuis, Rotterdam, The Netherlands.; Kamondi A; Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.; Pavy Le Traon A; Department of Neurology, Centre Hospitalier Universitaire de Toulouse and INSERM U 1297, Toulouse, France.; Rocha I; Institute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.; Sellner J; Department of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.; Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.; Senard JM; Department of Cardiolog, Toulouse University Hospital, Institute des Maladies Métaboliques et Cardiovasculaires, INSERM U 1297, Toulouse, France.; Terkelsen A; Department of Neurology, Aarhus University Hospital and Danish Pain Research Center, Aarhus University, Aarhus, Denmark.; Wenning GK; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.; Berger T; Department of Neurology, Medical University of Vienna, Vienna, Austria.; Thijs RD; Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.; Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.; Struhal W; Department of Neurology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.; Fanciulli A; Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Source
Publisher: Wiley Country of Publication: England NLM ID: 9506311 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-1331 (Electronic) Linking ISSN: 13515101 NLM ISO Abbreviation: Eur J Neurol Subsets: MEDLINE
Subject
Language
English
Abstract
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.
(© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
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.
(© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)