Impact of dysautonomic symptom burden on the quality of life in Neuromyelitis optica spectrum disorder patients

Background This study aimed to investigate the clinical risk factors of dysautonomic symptom burden in neuromyelitis optica spectrum disorder (NMOSD) and its impact on patients’ quality of life. Methods A total of 63 NMOSD patients and healthy controls were enrolled. All participants completed the Composite Autonomic Symptom Score 31 (COMPASS-31) to screen for symptoms of autonomic dysfunction. A comprehensive clinical evaluation was performed on NMOSD patients, such as disease characteristics and composite evaluations of life status, including quality of life, anxiety/depression, sleep, and fatigue. Correlated factors of dysautonomic symptoms and quality of life were analyzed. Results The score of COMPASS-31 in the NMOSD group was 17.2 ± 10.3, significantly higher than that in healthy controls ( P = 0.002). In NMOSD patients, the higher COMPASS-31 score was correlated with more attacks ( r = 0.49, P < 0.001), longer disease duration ( r = 0.52, P < 0.001), severer disability ( r = 0.50, P < 0.001), more thoracic cord lesions ( r = 0.29, P = 0.02), more total spinal cord lesions ( r = 0.35, P = 0.005), severer anxiety ( r = 0.55, P < 0.001), severer depression ( r = 0.48, P < 0.001), severer sleep disturbances ( r = 0.59, P < 0.001), and severer fatigue ( r = 0.56, P < 0.001). The disability, total spinal cord lesions, and fatigue were revealed to be independently associated factors. Further analysis revealed that the COMPASS-31 score was independently correlated with scores of all the domains of patients’ quality of life scale ( P < 0.05). Conclusions Dysautonomic symptom burden is correlated with decreased quality of life and certain clinical characteristics such as disability, the burden of spinal cord lesions, and fatigue in NMOSD patients. Investigation and proper management of autonomic dysfunction may help to improve the quality of life in patients with NMOSD.