Symptoms of autonomic dysfunction impact the quality of life of patients with neuromyelitis optica spectrum disorder (NMOSD) and were found to correlate with certain clinical characteristics in a study published in BMC Neurology.

Scores on the Composite Autonomic Symptom Score 31 (COMPASS-31) were found to be significantly correlated with quality of life for patients with NMOSD as measured by the 36-item short-form health survey (SF-36). The COMPASS-31 scores correlated with all 8 dimensions of the SF-36 (all P >.05) using a multivariable linear regression model.

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The study also found that COMPASS-31 scores were significantly higher for NMOSD patients compared to scores for healthy controls, with a mean value of 17.2 compared to a mean of 11.6 (P =.002). NMOSD patients had significantly higher scores in 5 of the 6 domains of the COMPASS-31, including orthostatic intolerance (P =.003), vasomotor (P =.007), secretomotor (P =.006), bladder (P <.001), and pupillomotor (P =.04) scores.

Among NMOSD patients, higher COMPASS-31 scores were found to correlate with more acute attacks, a longer disease duration, higher scores on the Expanded Disability Status Scale (EDSS), worse sleep quality, more anxiety and depression, and worse fatigue (P <.001 for all factors). Higher COMPASS-31 scores also correlated with more lesions of the thoracic spinal cord (P =.02) and more total spinal cord lesions (P =.005).

“These findings might help us identify patients with a high risk of autonomic dysfunction and suggest that the evaluation and management of autonomic dysfunction are of great significance for improving the quality of life in NMOSD patients,” the authors wrote.

During the study, 63 patients with NMOSD and 63 healthy controls were recruited from a single clinic in China between June 2021 and July 2022. No significant difference in age or gender was observed between the 2 groups. Of the patients with NMOSD, 15 had optic neuritis only, 22 had transverse myelitis only, and the remaining 26 had both.


Yang L, Li W, Xie Y, et al. Impact of dysautonomic symptom burden on the quality of life in Neuromyelitis optica spectrum disorder patients. BMC Neurol. Published online March 20, 2023. doi:10.1186/s12883-023-03162-1