P63-T Longitudinal assessment of autonomic nervous system in patients with first demyelinating event suggestive of MS

Abstract

Background The aim of this study was to investigate the evolution of autonomic nervous system (ANS) abnormalities in people with clinically isolated syndrome (pwCIS) over a two-year follow-up. Material and methods This was a prospective cohort study in which 121 pwCIS were enrolled and followed for two years. After two-year follow-up, data were available for 84 pwCIS. ANS symptoms were evaluated with the Composite Autonomic System Score-31 (COMPASS-31) and results of the ANS tests were expressed using the Composite Autonomic Scoring Scale (CASS) at baseline and month 24 visits. Symptomatic dysautonomia was defined if the patient had COMPASS-31 value above the median of the whole cohort at baseline evaluation (COMPASS-31 > 6.79) and CASS score greater than 0. Results Complete CASS at baseline and M24 was available for 62 patients, in 24 (38.7%) patients there was worsening, in 16 (25.8%) improvement and in 22 (35.5%) there was no change in CASS. A multivariable regression model identified total number of T2 lesions as independent predictor for worsening of symptomatic dysautonomia. Although not reaching significance there was a trend of cervical spinal cord lesions as independent predictor for CASS worsening and age for CASS improvement (p = 0.058 and p = 0.051, respectively). Conclusion Substantial proportion of pwCIS experience worsening of ANS abnormalities during the two-year follow-up and MRI parameters seems to predict these abnormalities.