Journal
NEUROLOGY
Volume 76, Issue 12, Pages 1099-1105Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3182120147
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Funding
- NIH [U01AR057967-01, DK064814, NS40458, NS36778, NS38849, U01 RR025764, RR024888, NS42056, 068182, DK076160, AG020591]
- ADA
- JDRF
- AG [109675]
- Office of Research and Development, Medical Service and Rehabilitation Research and Development Service of the Department of Veterans Affairs
- Dorothy and Herman Miller Fund for Mobility Research in Older Adults
- PROMIS [U01AR057967-01]
- NIH/NINDS
- Genentech, Inc.
- Oakland University
- Crohn's and Colitis Foundation of America
- Office of Research Development (Medical Research Service and Rehabilitation Service), Department of Veterans Affairs
- American Diabetes Association
- Juvenile Diabetes Research Foundation
- Diabetes Research Foundation
- NIH/NIA
- Baxter International Inc.
- [1K23 NS056009-01A1]
- [AG08808]
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Objective: Autonomic symptoms may occur frequently in diabetic and other neuropathies. There is a need to develop a simple instrument to measure autonomic symptoms in subjects with neuropathy and to test the validity of the instrument. Methods: The Survey of Autonomic Symptoms (SAS) consists of 11 items in women and 12 in men. Each item is rated by an impact score ranging from 1 (least severe) to 5 (most severe). The SAS was tested in observational studies and compared to a previously validated autonomic scale, the Autonomic Symptom Profile (ASP), and to a series of autonomic tests. Results: The SAS was tested in 30 healthy controls and 62 subjects with neuropathy and impaired glucose tolerance or newly diagnosed diabetes. An increased SAS score was associated with the previously validated ASP (rank order correlation = 0.68; p < 0.0001) and with quantitative measures of autonomic function: a reduced quantitative sudomotor axon reflex test sweat volume (0.31; p < 0.05) and an abnormal 30: 15 ratio (0.53; p < 0.01). The SAS shows a high sensitivity and specificity (area under the receiver operating characteristic curve 0.828) that compares favorably with the ASP. The SAS scale domains had a good internal consistency and reliability (Cronbach alpha = 0.76). The SAS symptom score was increased in neuropathy (95% confidence interval [CI] 2.99-4.14) compared to control (95% CI 0.58-1.69; p < 0.0001) subjects. Conclusions: The SAS is a new, valid, easily administered instrument to measure autonomic symptoms in early diabetic neuropathy and would be of value in assessing neuropathic autonomic symptoms in clinical trials and epidemiologic studies. Neurology (R) 2011;76:1099-1105
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