Neurological Sciences

, Volume 36, Issue 10, pp 1897–1902 | Cite as

Translation and linguistic validation of the Composite Autonomic Symptom Score COMPASS 31

  • Giulia PierangeliEmail author
  • Alessandra Turrini
  • Giulia Giannini
  • Francesca Del Sorbo
  • Giovanna Calandra-Buonaura
  • Pietro Guaraldi
  • Maria Letizia Bacchi Reggiani
  • Pietro Cortelli
Original Article


The aim of our study was to translate and to do a linguistic validation of the Composite Autonomic Symptom Score COMPASS 31. COMPASS 31 is a self-assessment instrument including 31 items assessing six domains of autonomic functions: orthostatic intolerance, vasomotor, secretomotor, gastrointestinal, bladder, and pupillomotor functions. This questionnaire has been created by the Autonomic group of the Mayo Clinic from two previous versions: the Autonomic Symptom Profile (ASP) composed of 169 items and the following COMPASS with 72 items selected from the ASP. We translated the questionnaire by means of a standardized forward and back-translation procedure. Thirty-six subjects, 25 patients with autonomic failure of different aethiologies and 11 healthy controls filled in the COMPASS 31 twice, 4 ± 1 weeks apart, once in Italian and once in English in a randomized order. The test–retest showed a significant correlation between the Italian and the English versions as total score. The evaluation of single domains by means of Pearson correlation when applicable or by means of Spearman test showed a significant correlation between the English and the Italian COMPASS 31 version for all clinical domains except the vasomotor one for the lack of scoring. The comparison between the patients with autonomic failure and healthy control groups showed significantly higher total scores in patients with respect to controls confirming the high sensitivity of COMPASS 31 in revealing autonomic symptoms.


Autonomic failure Questionnaire Score Multiple system atrophy Pure autonomic failure Autonomic neuropathies 



We acknowledge Wolfgang Singer, MD, Department of Neurology, and Mariana Suarez, Data Manager, Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, for their help in the collection and elaboration of data.

Conflict of interest

Giulia Pierangeli has received honoraria for speaking engagements or consulting activities with Allergan, Italia. Alessandra Turrini, Giulia Giannini, Francesca Del Sorbo, Giovanna Calandra-Buonaura, Pietro Guaraldi, Maria Letizia Bacchi Reggiani declare that they have not conflict of interest. Pietro Cortelli has received honoraria for speaking engagements or consulting activities with Allergan Italia, Lundbeck Italy, UCB Pharma S.p.A, AbbVie srl.

Ethical approval

The study was approved by the local Ethic Committee of the local health service of Bologna, Italy. All procedures performed were in accordance with the 1964 Helsinki declaration and its later amendments.

Supplementary material

10072_2015_2278_MOESM1_ESM.doc (37 kb)
Supplementary material 1 (DOC 37 kb)


  1. 1.
    Sletten BA, Suarez GA, Low PA, Mandrekar J, Singer W (2012) COMPASS31: a refined and abbreviated composite autonomic symptom score. Mayo Clin Proc 87(12):1196–1201PubMedCentralCrossRefPubMedGoogle Scholar
  2. 2.
    Suarez GA, Opfer-Gehrking TL, Offord KP, Atkinson EJ, O’Brien PC, Low PA (1999) The autonomic symptom profile: a new instrument to assess autonomic symptoms. Neurology 52(3):523–528CrossRefPubMedGoogle Scholar
  3. 3.
    Low PA (1993) Composite autonomic scoring scale for laboratory quantification of generalized autonomic failure. Mayo Clin Proc 68(8):748–752CrossRefPubMedGoogle Scholar
  4. 4.
    Low PA (1997) Laboratory evaluation of autonomic function. In: Low PA (ed) Clinical autonomic disorders: evaluation and management, 2nd edn. Lippincott-Raven, Philadelphia, pp 179–208Google Scholar
  5. 5.
    Benrud-Larson LM, Dewar MS, Sandroni P, Rummans TA, Haythornthwaite JA, Low PA (2002) Quality of life in patients with postural tachycardia syndrome. Mayo Clin Proc 77(6):531–537CrossRefPubMedGoogle Scholar
  6. 6.
    Benrud-Larson LM, Sandroni P, Haythornthwaite JA, Rummans TA, Low PA (2003) Correlates of functional disability in patients with postural tachycardia syndrome: preliminary cross-sectional findings. Health Psychol 22(6):643–648CrossRefPubMedGoogle Scholar
  7. 7.
    Benrud-Larson LM, Sandroni P, Schrag A, Low PA (2005) Depressive symptoms and life satisfaction in patients with multiple system atrophy. Mov Disord 20(8):951–957CrossRefPubMedGoogle Scholar
  8. 8.
    Low PA, Benrud-Larson LM, Sletten DM, Opfer-Gehrking TL, Weigand SD, O’Brien PC, Suarez GA, Dyck PJ, European MSA-Study Group (2004) Autonomic symptoms and diabetic neuropathy: a population-based study. Diabetes Care 27(12):2942–2947CrossRefPubMedGoogle Scholar
  9. 9.
    Schrag A, Geser F, Stampfer-Kountchev M, European MSA-Study Group et al (2006) Health related quality of life in multiple system atrophy. Mov Disord 21(6):809–815CrossRefPubMedGoogle Scholar
  10. 10.
    Thaisetthawatkul P, Boeve BF, Benarroch EE, Sandroni P, Ferman TJ, Petersen R, Low PA (2004) Autonomic dysfunction in dementia with Lewy bodies. Neurology 62(10):1804–1809CrossRefPubMedGoogle Scholar
  11. 11.
    Treister R, O’Neil K, Downs HM, Oaklander AL (2015) Validation of the composite autonomic symptom scale 31 (COMPASS-31) in patients with and without small fiber polyneuropathy. Eur J Neurol 0:1–7Google Scholar
  12. 12.
    Baschieri F, Calandra-Buonaura G, Doria A, Mastrolilli F, Palareti A, Barletta G, Solieri L, Guaraldi P, Martinelli P, Cortelli P (2015) Cardiovascular autonomic testing performed with a new integrated instrumental approach is useful in differentiating MSA-P from PD at an early stage. Parkinsonism Relat Disord (Epub ahead of print) Google Scholar
  13. 13.
    Tesfaye S, Boulton AJ, Dyck PJ, Toronto Diabetic Neuropathy Expert Group et al (2010) Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33(10):2285–2293PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Gelb DJ, Oliver E, Gilman S (1999) Diagnostic criteria for Parkinson disease. Arch Neurol 56(1):33–39CrossRefPubMedGoogle Scholar
  15. 15.
    The Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 46(5):1470CrossRefGoogle Scholar
  16. 16.
    Freeman R, Wieling W, Axelrod FB et al (2011) Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome. Clin Auton Res 21:69–72CrossRefPubMedGoogle Scholar
  17. 17.
    Gilman S, Wenning GK, Low PA et al (2008) Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71(9):670–676PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Giulia Pierangeli
    • 1
    • 2
    Email author
  • Alessandra Turrini
    • 1
    • 2
  • Giulia Giannini
    • 1
    • 2
  • Francesca Del Sorbo
    • 3
  • Giovanna Calandra-Buonaura
    • 1
    • 2
  • Pietro Guaraldi
    • 5
  • Maria Letizia Bacchi Reggiani
    • 4
  • Pietro Cortelli
    • 1
    • 2
  1. 1.IRCCS Institute of Neurological Sciences of BolognaBolognaItaly
  2. 2.Department of Biomedical and Neuromotor Sciences (DIBINEM)Alma Mater Studiorum, University of BolognaBolognaItaly
  3. 3.Neurologia I. Istituto Neurologico Carlo BestaMilanItaly
  4. 4.Department of Experimental, Diagnostic and Specialty Medicine (DIMES)Alma Mater Studiorum, University of BolognaBolognaItaly
  5. 5.Neurology outpatient clinicPublic Local Health Authorithy of ModenaModenaItaly

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