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Optimizing measures of HIV‐associated neuropathy
Author(s) -
RobinsonPapp Jessica,
Sharma Sandeep,
Dhadwal Neetu,
Simpson David M.,
Morgello Susan
Publication year - 2015
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.24282
Subject(s) - medicine , human immunodeficiency virus (hiv) , autonomic nervous system , autonomic nerve , polyneuropathy , physical medicine and rehabilitation , immunology , blood pressure , heart rate
: Distal symmetric polyneuropathy (DSP) is common in HIV and is associated with autonomic impairment. However tools to measure HIV‐DSP do not include autonomic indices. We sought to optimize the Total Neuropathy Score (TNS) and the Composite Autonomic Severity Score (CASS) for use in HIV. Methods : HIV‐infected adults ( n = 102) underwent neurologic examination, quantitative sensory testing (QST), nerve conduction studies, and autonomic testing. Modifications of the TNS and CASS were assessed for validity based on correlation with the original measure and internal consistency. Results : The TNS version commonly used in HIV‐DSP is valid, but it is improved by elimination of QST and addition of autonomic indices. A modified version of the CASS (M‐CASS) which was designed for sensitivity to milder impairment was also valid. Conclusions : A modified TNS that excludes QST and includes autonomic indices is optimal for HIV‐DSP. The M‐CASS is a valid measure of autonomic impairment in HIV. Muscle Nerve 51 : 56–64, 2015