| Autonomic nervous system disorders  

Clinical autonomic nervous system laboratories in Europe

Disorders of the autonomic nervous system (ANS) are common and disabling. A previous survey by the European Federation of Neurological Societies aimed to gain insight into the distribution of ANS laboratories in Europe and their clinical, research and educational activities.

1Last year, a paper published in the European Journal of Neurology presented the results of a new survey of the European Academy of Neurology and the European Federation of Autonomic Societies.2 This joint effort included the contact of all European national ANS, neurological societies and other individual members.
The authors described the diversity of autonomic evaluation across different European countries after identifying 84 different neurology-driven or interdisciplinary laboratories in 22 countries. All laboratories perform cardiovascular autonomic function tests, and most perform sweat tests (83%). Other frequent tests include blood catecholamines (63%), blood autoantibodies (56%) and skin biopsy with epidermal nerve fiber density analysis (63%). The most frequently diagnosed cardiovascular ANS disorders are reflex syncope and neurogenic orthostatic hypotension. Most centers have associated autonomic inpatient care (91%) or outpatient clinic (76%). Forty-one laboratories (89%) are involved in research activities, mainly focused on cardiovascular ANS.
The authors highlight regional disparities in the availability of healthcare services for people with ANS disorders across European countries. In particular, there is a need for improved access to specialized care in South, East and Greater Europe.

Key Points:

• Most centers that have autonomic laboratories also have associated autonomic inpatient care and/or outpatient clinic and are involved in research activities
• Cardiovascular autonomic nervous system is the main focus of laboratorial evaluation and research across autonomic centers in Europe
• There are inequalities in assessing specialized care on autonomic nervous across Europe


Lahrmann H, Magnifico F, Haensch CA, Cortelli P. Autonomic nervous system laboratories: a European survey. Eur J Neurol. May 2005;12(5):375-9. doi:10.1111/j.1468-1331.2004.01114.x
2. Habek M, Leys F, Krbot Skorić M, et al. Clinical Autonomic Nervous System Laboratories in Europe. Eur J Neurol. 2022;doi:10.1111/ene.15538

Publish on behalf of the Scientific Panel on Autonomic nervous system disorders