Evidence map›Paper›PMID 36056590›Full record

ArticleEuropean journal of neurology2022

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.

Mario Habek, Fabian Leys, Magdalena Krbot Skorić, Diogo Reis Carneiro, Giovanna Calandra-Buonaura, Jennifer Camaradou, Giacomo Chiaro, Pietro Cortelli, Cristian Falup-Pecurariu, Roberta Granata and 18 more

Open access · hybridAbstract read
In one paragraph

Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Guideline
  2. Guideline
  3. Review
  4. Article
  5. Rome was not built in a day, nor is a resilient clinical autonomic care unit.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  6. Setting up an autonomic unit within the neurological department: a position statement of the European Federation of Autonomic Societies.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  7. Article
  8. Article
  9. Sudoscan® and QSART in the composite autonomic severity scale: complementary approaches to sudomotor assessment in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  10. How to treat cardiovascular autonomic failure in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. A cross-sectional nationwide survey of guideline based syncope units in the Netherlands: the SU-19 score-a novel validation for best practices.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
    Article
  17. EFAS/EAN survey on the influence of the COVID-19 pandemic on European clinical autonomic education and research.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023
    Article
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 18 institutions in 12 countries.

Mario HabekDepartment of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.ORCID 0000-0002-3360-1748
Fabian LeysDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0003-1714-5305
Magdalena Krbot SkorićDepartment of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.
Diogo Reis CarneiroNeurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Giovanna Calandra-BuonauraIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Jennifer CamaradouPatient Partner of the EAN Scientific Panel for Autonomic Nervous System Disorders, London, UK.ORCID 0000-0002-5742-2840
Giacomo ChiaroAutonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Pietro CortelliIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.ORCID 0000-0002-3633-8818
Cristian Falup-PecurariuDepartment of Neurology, Faculty of Medicine, Transilvania University, Brasov, Romania.
Roberta GranataDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Pietro GuaraldiIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Raimund HelbokDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Max J HilzIcahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0002-6802-1751
Valeria IodiceAutonomic Unit, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Jens JordanInstitute of Aerospace Medicine, German Aerospace Center (DLR) and Medical Faculty, University of Cologne, Cologne, Germany.
Evert C A KaalDepartment of Neurology, Maasstad Ziekenhuis, Rotterdam, The Netherlands.
Anita KamondiDepartment of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
Anne Pavy Le TraonDepartment of Neurology, Centre Hospitalier Universitaire de Toulouse and INSERM U 1297, Toulouse, France.ORCID 0000-0002-9375-1553
Isabel RochaInstitute of Physiology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
Johann SellnerDepartment of Neurology, Landesklinikum Mistelbach-Gänserndorf, Mistelbach, Austria.
Jean Michel SenardDepartment of Cardiolog, Toulouse University Hospital, Institute des Maladies Métaboliques et Cardiovasculaires, INSERM U 1297, Toulouse, France.
Astrid TerkelsenDepartment of Neurology, Aarhus University Hospital and Danish Pain Research Center, Aarhus University, Aarhus, Denmark.
Gregor K WenningDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Thomas BergerDepartment of Neurology, Medical University of Vienna, Vienna, Austria.
Roland D ThijsDepartment of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.ORCID 0000-0003-1435-8970
Walter StruhalDepartment of Neurology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.ORCID 0000-0001-7360-7784
Alessandra FanciulliDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0002-2854-4179
Collaborators of the European Network of Clinical ANS laboratories
Innsbruck Medical University · ATIstituto delle Scienze Neurologiche di Bologna · ITInserm · FRNational Hospital for Neurology and Neurosurgery · GBUniversity Hospital Centre Zagreb · HRAarhus University Hospital · DKFriedrich-Alexander-Universität Erlangen-Nürnberg · DEGerman Sport University Cologne · DEHospitais da Universidade de Coimbra · PTHungarian Institute of Occupational Health · HULeiden University Medical Center · NLMaasstad Ziekenhuis · NLMedical University of Vienna · ATTransylvania University of Brașov · ROTUM Klinikum · DEUK Dementia Research Institute · GBUniversitätsklinikum Tulln · ATUniversity of Lisbon · PT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeDisorders 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.

methodsWe 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.

resultsWe 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).

conclusionsThis 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.

Indexed as

Autonomic Nervous System DiseasesNeurologyAutonomic Nervous SystemHumansLaboratoriesSurveys and Questionnairescardiovascular autonomic function testsComposite Autonomic Severity Score(disorders of) autonomic nervous systemdisorders of consciousness (other than epilepsy)neurodisparityneurological disordersorthostatic hypotensionSurveysweat testssyncope

Identifiers

PMID36056590
PMCPMC9826284
OpenAlexW4294368575

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.