Imperial College London
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Dr Lucia M. Li

Faculty of Medicine, Department of Brain Sciences

Clinical Lecturer (Neurology)
 
 
 
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Contact

 

lucia.li

 
 
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Location

 

Burlington DanesHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Li:2022:10.1136/bmjno-2022-000308,
author = {Li, L and Vichayanrat, E and Del, Giovane M and Lai, H and Iodice, V},
doi = {10.1136/bmjno-2022-000308},
journal = {BMJ Open Neurology},
title = {Autonomic dysfunction after moderate-to-severe traumatic brain injury: symptom spectrum and clinical testing outcomes},
url = {http://dx.doi.org/10.1136/bmjno-2022-000308},
volume = {4},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Survivors of moderate-to-severe traumatic brain injury (msTBI) frequently experience troublesome unexplained somatic symptoms. Autonomic dysfunction may contribute to these symptoms. However, there is no previous study of clinical subjective and objective autonomic dysfunction in msTBI.Methods: We present results from two groups of patients with msTBI. The first, a case–control comparative study, comprises prospectively recruited msTBI outpatients, in whom we measured burden of autonomic symptoms using the Composite Autonomic Symptom Score (COMPASS31) questionnaire. The second, a descriptive case series, comprises retrospectively identified msTBI outpatients who had formal clinical autonomic function testing at a national referral autonomics unit.Results: Group 1 comprises 39 patients with msTBI (10F:20M, median age 40 years, range 19–76), median time from injury 19 months (range 6–299) and 44 controls (22F:22M, median age 45, range 25–71). Patients had significantly higher mean weighted total COMPASS-31 score than controls (p<0.001), and higher gastrointestinal, orthostatic and secretomotor subscores (corrected p<0.05). Total COMPASS31 score inversely correlated with subjective rating of general health (p<0.001, rs=−0.84). Group 2 comprises 18 patients with msTBI (7F:11M, median age 44 years, range 21–64), median time from injury 57.5 months (range 2–416). Clinical autonomic function testing revealed a broad spectrum of autonomic dysfunction in 13/18 patients.Conclusions: There is clinically relevant autonomic dysfunction after msTBI, even at the chronic stage. We advocate for routine enquiry about potential autonomic symptoms, and demonstrate the utility of formal autonomic testing in providing diagnoses. Larger prospective studies are warranted, which should explore the causes and clinical correlates of post-TBI autonomic dysfunction.
AU  - Li,L
AU  - Vichayanrat,E
AU  - Del,Giovane M
AU  - Lai,H
AU  - Iodice,V
DO  - 10.1136/bmjno-2022-000308
PY  - 2022///
SN  - 2632-6140
TI  - Autonomic dysfunction after moderate-to-severe traumatic brain injury: symptom spectrum and clinical testing outcomes
T2  - BMJ Open Neurology
UR  - http://dx.doi.org/10.1136/bmjno-2022-000308
UR  - http://hdl.handle.net/10044/1/96923
VL  - 4
ER  -
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