Alcoholism mimicking multiple system atrophy: a case report
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 30, 2020 Category: Research Source Type: research

Somatic and autonomic findings in cancer-related base of the skull syndromes
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 27, 2020 Category: Research Source Type: research

Comments on ‘Recurrent sigmoid volvulus in a patient with Parkinson’s disease’
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 26, 2020 Category: Research Source Type: research

Recording and quantifying sympathetic outflow to muscle and skin in humans: methods, caveats and challenges
AbstractThe development of microneurography, in which the electrical activity of axons can be recorded via an intrafascicular microelectrode inserted through the skin into a peripheral nerve in awake human participants, has contributed a great deal to our understanding of sensorimotor control and the control of sympathetic outflow to muscle and skin. This review summarises the different approaches to recording muscle sympathetic nerve activity (MSNA) and skin sympathetic nerve activity (SSNA), together with discussion on the issues that determine the quality of a recording. Various analytical approaches are also described,...
Source: Clinical Autonomic Research - June 25, 2020 Category: Research Source Type: research

Pandysautonomia and alpha-1 adrenergic receptor autoantibodies: a cause or a consequence? A case report
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 22, 2020 Category: Research Source Type: research

Neural control of blood pressure during pregnancy in humans
ConclusionThese findings provide important insight into the neural mechanisms underlying hypertensive disorders during pregnancy. With this knowledge, early prevention or treatment targeted to the appropriate pathophysiology may be initiated, which may reduce maternal and fetal death or morbidity, as well as cardiovascular risks in women later in life. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 20, 2020 Category: Research Source Type: research

Effects of self-administered cannabidiol in a patient with multiple system atrophy
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 19, 2020 Category: Research Source Type: research

Autonomic function testing in the COVID-19 pandemic: an American Autonomic Society position statement
AbstractCOVID-19 is a global pandemic that is wreaking havoc with the health and economy of much of human civilization. In this document from the American Autonomic Society, we identify the potential risks of exposure to patients, physicians, and allied healthcare staff. We provide guidance for conducting autonomic function testing safely in this environment. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 11, 2020 Category: Research Source Type: research

Retrospective observation of children with the diagnosis of postural tachycardia syndrome while on atomoxetine
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - June 8, 2020 Category: Research Source Type: research

Happy heart syndrome: a case of Takotsubo syndrome with left internal carotid artery occlusion
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 25, 2020 Category: Research Source Type: research

Correction to: The impact of endoscopic thoracic sympathectomy on sudomotor function in patients with palmar hyperhidrosis
Unfortunately, the 3rd coauthor name has been published incorrectly in the original publication. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 25, 2020 Category: Research Source Type: research

Sudor Anglicus: an epidemic targeting the autonomic nervous system
Abstract Renaissance England witnessed a series of brief epidemics of a rapid and often fatal illness, the predominant feature of which was a disturbance of the autonomic nervous system. Profuse sweating was both an emblematic and ominous sign of thisSudor Anglicus. Its story is medically fascinating as well as historically noteworthy. Possible sites of pathological involvement include the hypothalamus, serotonergic neurons in the brainstem or spinal cord, autonomic ganglia, peripheral sympathetic nerves, neuroeffector junctions, or eccrine glands. Of candidate etiologic agents, a virus is most likely, given the seasonal...
Source: Clinical Autonomic Research - May 20, 2020 Category: Research Source Type: research

Risks of adverse events in patients with orthostatic intolerance undergoing surgery with general anesthesia
ConclusionPatients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 17, 2020 Category: Research Source Type: research

Central autonomic dysfunction in multiple system atrophy: can we measure it with MRI?
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 16, 2020 Category: Research Source Type: research

The quest for biomarkers in postural tachycardia syndrome and other updates on recent autonomic research
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 16, 2020 Category: Research Source Type: research

Cardiovascular autonomic function testing in multiple system atrophy and Parkinson ’s disease: an expert-based blinded evaluation
ConclusionCAFT is the gold standard for assessing the presence and severity of cardiovascular autonomic failure, but the results of our pilot study suggest that CAFT might be of limited value in the differential diagnosis between MSA-P and PD once nOH is present. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 15, 2020 Category: Research Source Type: research

Autonomic impairment in REM sleep behavior disorder: a potential biomarker of phenoconversion?
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 14, 2020 Category: Research Source Type: research

Restoration of autonomic cardiovascular regulation in spinal cord injury with epidural stimulation: a case series
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 13, 2020 Category: Research Source Type: research

Determining whether sympathetic nervous activity influences cerebral blood velocity at rest: a novel approach
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 3, 2020 Category: Research Source Type: research

Dysautonomia in early Parkinson disease: a window into the determinants of functional disability and an opportunity for early intervention
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - May 2, 2020 Category: Research Source Type: research

The impact of endoscopic thoracic sympathectomy on sudomotor function in patients with palmar hyperhidrosis
ConclusionAll of the sweating parameters were increased in palmar hyperhidrosis patients prior to surgery. Immediately after ETS, all these parameters were significantly reduced. At> 1  year after ETS, the BSR had increased to a level similar to that of the healthy volunteers, although PSR did not respond to mental stress. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - April 27, 2020 Category: Research Source Type: research

Dissociation between reduced pain and arterial blood pressure following epidural spinal cord stimulation in patients with chronic pain: A retrospective study
AbstractPurposeAcute pain and resting arterial blood pressure (BP) are positively correlated in patients with chronic pain. However, it remains unclear whether treatment for chronic pain reduces BP. Therefore, in a retrospective study design, we tested the hypothesis that implantation of an epidural spinal cord stimulator (SCS) device to treat chronic pain would significantly reduce clinic pain ratings and BP and that these reductions would be significantly correlated.MethodsPain ratings and BP in medical records were collected before and after surgical implantation of a SCS device at the University of Iowa Hospitals and C...
Source: Clinical Autonomic Research - April 22, 2020 Category: Research Source Type: research

Understanding vasovagal syncope: a role for sex and gender
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - April 16, 2020 Category: Research Source Type: research

Exercise-based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta-analysis
AbstractPurposeThe effects of exercise-based cardiac rehabilitation (CR) on parasympathetic modulation are controversial. This systematic review and meta-analysis aims to (a) determine the effect of exercise-based CR on heart-rate-derived indices associated with cardiac parasympathetic modulation in resting and post-exercise conditions in coronary artery disease (CAD) patients and (b) identify the possible moderator variables of the effect of exercise-based CR on parasympathetic modulation.MethodsWe searched CENTRAL and Web of Science up to November 2018 for the following terms: adult CAD patients, controlled exercise-base...
Source: Clinical Autonomic Research - April 8, 2020 Category: Research Source Type: research

Correction to: Ambulatory blood pressure profiles in familial dysautonomia
Unfortunately, the original version of this article contained (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - April 4, 2020 Category: Research Source Type: research

Impact of depressive symptoms on self-perceived severity of autonomic dysfunction in multiple system atrophy: relevance for patient-reported outcomes in clinical trials
AbstractPurposeTo assess the relationship between depressive symptoms and self-perceived severity of autonomic dysfunction in patients with multiple system atrophy (MSA).MethodsCross-sectional evaluation of patients with MSA who underwent autonomic testing, Unified MSA Rating Scale (UMSARS)-1 and -2, rating of the presence and severity of depressive symptoms (Zung scale), quality of life (SF-36), body vigilance, anxiety (Spielberger ’s anxiety scale), severity of autonomic dysfunction with the Composite Autonomic Symptoms Score (COMPASS-31), and severity of orthostatic hypotension (OH) symptoms with the Orthostatic H...
Source: Clinical Autonomic Research - April 3, 2020 Category: Research Source Type: research

Diagnosing multiple system atrophy at the prodromal stage
AbstractIdentifying individuals at the earliest disease stage becomes crucial as we aim to develop disease-modifying treatments for neurodegenerative disorders. Prodromal diagnostic criteria were recently developed for Parkinson ’s disease (PD) and are forthcoming for dementia with Lewy bodies (DLB). The latest 2008 version of diagnostic criteria for multiple system atrophy (MSA) have improved diagnostic accuracy in early disease stages compared to previous criteria, but we do not yet have formal criteria for prodromal MS A. Building on similar approaches as for PD and DLB, we can identify features on history-taking,...
Source: Clinical Autonomic Research - March 30, 2020 Category: Research Source Type: research

Cardiovascular autonomic effects of electronic cigarette use: a systematic review
ConclusionsElectronic cigarettes are sympathoexcitatory. Cardiac sympathoexcitatory effects are less when vaping using the earlier generation ECs than when smoking TCs. Additional studies of the latest pod-like EC devices, which deliver nicotine similarly to a TC, are necessary. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 26, 2020 Category: Research Source Type: research

Autonomic dysfunction and phenoconversion in idiopathic REM sleep behavior disorder
AbstractBackgroundREM sleep behavior disorder (RBD) is a common finding among patients with synucleinopathies. We aimed to determine the degree of autonomic dysfunction in patients presenting with idiopathic RBD (iRBD), and the predictive value of autonomic dysfunction for phenoconversion to a defined neurodegenerative disease.MethodsWe searched our electronic medical record for patients diagnosed with iRBD who also underwent standardized autonomic function testing within 6  months of iRBD diagnosis, and who had clinical follow-up of at least 3 years following iRBD diagnosis. The composite autonomic severity scor...
Source: Clinical Autonomic Research - March 19, 2020 Category: Research Source Type: research

Synuclein in red blood cells: a potential biomarker for multiple system atrophy, and other updates on recent autonomic research
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 18, 2020 Category: Research Source Type: research

Mechanisms underlying unawareness of neurogenic orthostatic hypotension
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 13, 2020 Category: Research Source Type: research

The effect of heart rate variability on blood pressure is augmented in spinal cord injury and is unaltered by exercise training
ConclusionAfter SCI, marked frequency-specific differences exist in the relationship between heart rate and blood pressure variabilities. The high-frequency cross-spectral relationship indicates that a feedback mechanism of blood pressure into heart rate may predominate in this range. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 12, 2020 Category: Research Source Type: research

Neurogenic lower urinary tract dysfunction predicts prognosis in patients with multiple system atrophy
ConclusionDetrusor contractility can be a prognostic marker in MSA patients. A high BCI value is a protective factor for survival from baseline and overall survival. The presence of urinary incontinence predicts shortened overall survival. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 12, 2020 Category: Research Source Type: research

Autonomic nervous system: a key player in prodromal multiple sclerosis?
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - March 11, 2020 Category: Research Source Type: research

Relationship between cardiac parasympathetic dysfunction and the anteroposterior diameter of the medulla oblongata in multiple system atrophy
AbstractPurposeNeurodegeneration of the nucleus ambiguus and the dorsal vagal motor nucleus has been implicated in cardiac parasympathetic dysfunction in multiple system atrophy (MSA). The nucleus ambiguus and the dorsal vagal motor nucleus, which are located in the medulla oblongata (MO), control the autonomic —specifically, the parasympathetic—functions of the body. The aim of our study was to investigate the relationship between cardiac parasympathetic dysfunction and the anteroposterior diameter of the MO in MSA by quantitatively analyzing magnetic resonance imaging (MRI) outcome measures.MethodsWe retrospe...
Source: Clinical Autonomic Research - March 7, 2020 Category: Research Source Type: research

Longitudinal change in autonomic symptoms predicts activities of daily living and depression in Parkinson ’s disease
ConclusionsLongitudinal changes in autonomic symptoms impact ADLs function in patients with early signs of PD, both directly and indirectly through their impact on depressive symptoms. Future investigation into the influence of treatment of these symptoms on outcomes in PD is warranted. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - February 20, 2020 Category: Research Source Type: research

Dose-dependent heart rate responses to drinking water: a randomized crossover study in young, non-obese males
AbstractPurposeThe aim of the study was to explore a potential dose effect of water on heart rate responses and markers of vagal tone modulation.MethodsThis was a randomized crossover study involving eight men whose heart rate and heart rate variability parameters were continuously measured following ingestion of different volumes of still mineral water (200, 400, 600, and 800  mL).ResultsA significant volume by time effect for heart rate (p 
Source: Clinical Autonomic Research - February 20, 2020 Category: Research Source Type: research

Baroreflex function and postprandial hypotension in older adults
ConclusionPatients with PPH demonstrated an acute postprandial decrease in baroreflex effectiveness during meal testing as compared with normal subjects, suggesting a potential contributing mechanism for this condition. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - February 15, 2020 Category: Research Source Type: research

Baroreflex activation therapy reduces frequency and duration of hypertension-related hospitalizations in patients with resistant hypertension
AbstractPurposeBaroreflex activation therapy (BAT) has been shown to lower blood pressure in patients with resistant hypertension. The purpose of this study was to analyze whether this translates into a reduction of more relevant clinical endpoints.MethodsPatients with resistant hypertension were treated with the second-generation BAT system. Records on hospitalization (dates of admission and discharge, main diagnosis) were obtained from medical insurance companies.ResultsRecords on hospitalization were available for a period of 1 year before BAT in two patients and 2 years in 22 patients. The total number of hospitalizati...
Source: Clinical Autonomic Research - February 12, 2020 Category: Research Source Type: research

Heart rate variability and falls in Huntington ’s disease
ConclusionsThe observed HRV pattern is consistent with a higher sympathetic prevalence associated with a higher RoF. Reduced parasympathetic HRV values in this patient population predict being a recurrent faller at 6 months of follow-up, independently of orthostatic phenomena. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - February 6, 2020 Category: Research Source Type: research

Delayed recovery from initial orthostatic hypotension: an expression of frailty in the elderly
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 28, 2020 Category: Research Source Type: research

Sympathetic nervous activity and hemoglobin levels in de novo Parkinson ’s disease
ConclusionHemoglobin levels in PD seem to be closely related to noradrenergic nervous activity and nigrostriatal dopaminergic degeneration. In contrast to expectations, decreased hemoglobin levels were associated with increased whole-body sympathetic nervous activity in PD. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 25, 2020 Category: Research Source Type: research

Sequential analysis of heart rate variability, blood pressure variability and baroreflex sensitivity in healthy pregnancy
AbstractObjectiveThe aim of this study was to demonstrate the temporal profile of changes in heart rate variability (HRV), blood pressure variability (BPV), and cardiac baroreflex sensitivity (BRS) during the course of a healthy pregnancy.Materials and methodsThis was a longitudinal study during which autonomic variability parameters (HRV, BPV, BRS) were assessed in 66 pregnant women at 11 –13, 20–22 and 30–32 weeks of gestation. A lead II electrocardiogram tracing and beat-to-beat blood pressure were recorded with the subject breathing spontaneously in the supine position. Changes in the parameters ...
Source: Clinical Autonomic Research - January 24, 2020 Category: Research Source Type: research

Testing individual baroreflex responses to hypoxia-induced peripheral chemoreflex stimulation
AbstractIntroductionBaroreflexes and peripheral chemoreflexes control efferent autonomic activity making these reflexes treatment targets for arterial hypertension. The literature on their interaction is controversial, with suggestions that their individual and collective influence on blood pressure and heart rate regulation is variable. Therefore, we applied a study design that allows the elucidation of individual baroreflex –chemoreflex interactions.MethodsWe studied nine healthy young men who breathed either normal air (normoxia) or an air –nitrogen–carbon dioxide mixture with decreased oxygen content ...
Source: Clinical Autonomic Research - January 23, 2020 Category: Research Source Type: research

ST-segment changes during tilt-table testing in postural tachycardia syndrome: are they relevant?
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 21, 2020 Category: Research Source Type: research

A higher proportion of men than of women fainted in the phase without nitroglycerin in tilt-induced vasovagal syncope
ConclusionMen were more susceptible to induction of VVS without nitroglycerin and women after it. The unexpected findings may be due to sex-specific pathophysiological differences. (Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 18, 2020 Category: Research Source Type: research

Autonomic medical practice viewed through the lens of physician-rating websites
ConclusionA quality patient experience, accurate diagnosis, and appropriate treatment are goals shared by patients and autonomic specialists. In this study, patient reviews of autonomic physicians were comparable to those of physicians across specialties. Metrics of greater autonomic expertise were associated with equal or lower patient satisfaction scores. In conclusion, compiled subjective reviews are a useful but incomplete indicator of autonomic physician quality and expertise. An ideal profile would combine clinical and nonclinical indicators of professional competence. Reliable information is needed to empower autono...
Source: Clinical Autonomic Research - January 17, 2020 Category: Research Source Type: research

Complexity analysis of heart rate variability in chronic obstructive pulmonary disease: relationship with severity and symptoms
AbstractPurposeChronic obstructive pulmonary disease (COPD) negatively impacts autonomic control of the heart rate, as assessed by time and frequency domains of heart rate variability (HRV) analysis. However, it is unknown whether symbolic dynamic analysis may identify cardiac autonomic impairment, and whether such nonlinear indices may be associated with disease severity, prognostic markers, perceived dyspnea and functional capacity in patients with COPD. The current study assessed cardiac autonomic modulation by symbolic analysis of HRV in patients with COPD compared with healthy controls.MethodsWe recruited 54 COPD pati...
Source: Clinical Autonomic Research - January 14, 2020 Category: Research Source Type: research

A 20-year evolution of cardiac performance in microgravity in a male astronaut
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 14, 2020 Category: Research Source Type: research

Is postural tachycardia syndrome an autoimmune disorder? And other updates on recent autonomic research
(Source: Clinical Autonomic Research)
Source: Clinical Autonomic Research - January 14, 2020 Category: Research Source Type: research