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To investigate the relationship between DS and disease characteristics (MS subtype, disease duration, Expanded Disability Status Scale (EDSS), clinical and\/or radiological activity, disability progression).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Cross-sectional study includes 324 MS patients (mean age 44.9\u2009\u00b1\u200910.7\u00a0years; 66% female) and 190 HC (mean age 40.60\u2009\u00b1\u200912.83\u00a0years; 63% female). DS were assessed using the Italian validated version of the Composite Autonomic Symptom Score-31 (COMPASS-31). Possible confounding factors were considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      More than 94% of enrolled MS patients reported alterations in \u2265\u20092 domains of the COMPASS-31 scale (score &gt;\u20090) and significantly higher COMPASS-31 total and single domain median scores compared with HC, independently from possible confounding factors (orthostatic intolerance:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001; vasomotor:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017; secretomotor:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040; gastrointestinal:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047; bladder:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; pupillomotor:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; COMPASS-31 total score:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). COMPASS-31 total, secretomotor, gastrointestinal, and bladder domain scores showed weak to moderate correlation with disease duration (Rho\u2009=\u20090.19,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Rho\u2009=\u20090.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01; Rho\u2009=\u20090.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030; Rho\u2009=\u20090.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively). A moderate correlation between EDSS score, COMPASS-31 total, and bladder domain scores (Rho\u2009=\u20090.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 and Rho\u2009=\u20090.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively) was observed. Progressive subtypes showed higher COMPASS-31 total (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025), gastrointestinal (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.07), and bladder (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) domain scores vs relapsing-remitting patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings confirm that MS-related DS are frequent and tend to increase paralleling disease duration and clinical worsening, reaching the highest clinical impact in progressive subtypes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-020-04620-1","type":"journal-article","created":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T10:06:49Z","timestamp":1597054009000},"page":"1395-1403","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Frequency and characteristics of dysautonomic symptoms in multiple sclerosis: a cross-sectional double-center study with the validated Italian version of the Composite Autonomic Symptom Score-31"],"prefix":"10.1007","volume":"42","author":[{"given":"Matteo","family":"Foschi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Giannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Merli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Mancinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Zenesini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Viti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Guaraldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Cortelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2902-5589","authenticated-orcid":false,"given":"Alessandra","family":"Lugaresi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,10]]},"reference":[{"key":"4620_CR1","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1212\/WNL.0000000000000768","volume":"83","author":"P Browne","year":"2014","unstructured":"Browne P, Chandraratna D, Angood C, Tremlett H, Baker C, Taylor BV, Thompson AJ (2014) Atlas of multiple sclerosis 2013: a growing global problem with widespread inequity. 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She received congress and travel\/accommodation expense compensations or speaker honoraria from Biogen, Merck, Mylan, Novartis, Sanofi\/Genzyme, Teva, and Fondazione Italiana Sclerosi Multipla (FISM). Her institutions received research grants from Novartis. Other authors report no disclosures relevant to the manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The research was approved by the local ethics committee (Approval Code: 16151; date of approval: December 15, 2016). Every subject included gave written informed consent to participate and for the publication of data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval, consent to participate and for publication"}}]}}