VOLUME 29, ISSUE 2 • JUNE 2025. Full issue »
On December 6-7, 2024, we had the pleasure of welcoming more than 100 participants and faculty to Innsbruck for the MDS-European Section course on dysautonomia in movement disorders at the Medical University of Innsbruck. The event fostered a truly international exchange of knowledge and clinical experience, with participants from 29 countries across four continents — made possible in part by the generous support of travel bursaries from the International Parkinson and Movement Disorder Society (MDS) and the Austrian Parkinson Society.
Dysautonomia is a frequent non-motor feature of movement disorders, carrying important diagnostic, therapeutic, and prognostic implications. The course aimed to provide participants with practical tools for bedside screening and first-line therapeutic interventions, while also highlighting clinical red flags and strategies for incorporating second-line diagnostics and sharing care models with allied specialties to improve patient outcomes.
The course was structured to be highly interactive. In addition to expert lectures, we encouraged participant-driven case presentations and provided a half day of small-group clinical rounds where participants could observe and practice autonomic nervous system (ANS) diagnostic procedures in a hands-on setting. A total of 15 faculty members, each with extensive expertise in different domains of autonomic dysfunction, guided these sessions.
Day one began with an overview of ANS anatomy, clinical assessment techniques, and the non-dopaminergic mechanisms underlying dysautonomia in Parkinson’s disease and related disorders. We also explored practical management strategies for cardiovascular autonomic dysfunction and discussed how to address autonomic disturbances affecting the skin, bladder, sexual function, swallowing, and the gastrointestinal tract. In the afternoon, participants presented their own challenging cases, stimulating rich discussion and knowledge exchange among faculty and attendees alike.
After the first day of the course, faculty and participants gathered at one of Innsbruck’s traditional Christmas markets to enjoy a cup of Glühwein — a warm, spiced wine that Innsbruck residents typically drink during the Advent season. It provided a convivial setting to continue discussions while experiencing a cherished local tradition.
On day two, we shifted our focus to disease-specific insights, including isolated autonomic failure as a possible prodrome of α-synucleinopathies, biomarkers in autonomic disorders, and the role of multidisciplinary care in multiple system atrophy. We also reviewed the relevance of autonomic dysfunction in genetic movement disorders. The afternoon session was dedicated to clinical rounds, where participants rotated through eight diagnostic stations at the Neurology Outpatient Clinic, gaining direct exposure to tools such as tilt table testing; sweat testing; ambulatory blood pressure monitoring; baroreflex assessment; and neuro-urological, swallowing, and gastrointestinal evaluations. During the final session, Dr. Andona Milovanovic (Belgrade University Hospital, Serbia) and Dr. Jose Alves (Coimbra University Hospital, Portugal) received the “Best Presentation Award” for their excellent clinical case presentations.
At the Department of Neurology of the Medical University of Innsbruck, we are proud to continue a longstanding tradition of multidisciplinary care for autonomic disorders, established by our late and esteemed colleague and mentor Prof. Gregor Wenning. This course was a reflection of that legacy, and of our shared commitment to advancing the recognition and management of dysautonomia in movement disorders.
We thank all who contributed to the success of the course and look forward to welcoming participants again in future editions.
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