title: Optimizing measures of HIV-associated neuropathy.
abstract: BACKGROUND
  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.
authors.affiliation: Icahn School of Medicine at Mount Sinai, Department of Neurology, Box 1052, One Gustave L. Levy Place, New York, New York, 10029, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Robinson-Papp
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sharma
authors.forename: Neetu
authors.initials: N
authors.lastname: Dhadwal
authors.forename: David M
authors.initials: DM
authors.lastname: Simpson
authors.forename: Susan
authors.initials: S
authors.lastname: Morgello
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D010146:Pain / Q000209:etiology; D010525:Peripheral Nerves / Q000473:pathology* / Q000503:physiopathology*; D012720:Severity of Illness Index
keywords: Composite Autonomic Severity Score; HIV; Total Neuropathy Score; autonomic; neuropathy