Clinical Autonomic Research最新文献

{"title":"Autonomic dysfunction and its association with sexual dysfunction in myasthenia gravis.","authors":"Cagla Tomris, Ayse Caglar Sarilar, Muhammed Ali Tomris, Ayten Ekinci, Metin Unlu","doi":"10.1007/s10286-026-01246-9","DOIUrl":"https://doi.org/10.1007/s10286-026-01246-9","url":null,"abstract":"<p><strong>Purpose: </strong>Autonomic dysfunction has been reported in myasthenia gravis (MG); however, its clinical relevance and relationship with sexual dysfunction (SD) remain unclear. This study aimed to evaluate autonomic dysfunction in MG and to investigate its association with SD using objective autonomic tests.</p><p><strong>Methods: </strong>A total of 44 patients with MG and 50 age- and sex-matched healthy controls (HCs) were included. Autonomic function was assessed with the Composite Autonomic Symptom Score-31 (COMPASS-31), sympathetic skin response (SSR), and R-R interval variability (RRIV). Ocular autonomic involvement was evaluated using the Schirmer test, noninvasive tear break-up time, pupillometry, and corneal confocal microscopy. Sexual function was assessed using the Female Sexual Function Index, International Index of Erectile Function, and Premature Ejaculation Profile. Depression and anxiety were evaluated with the Beck Inventories.</p><p><strong>Results: </strong>Patients with MG showed prolonged SSR latencies, reduced amplitudes, and lower RRIV than HCs (p < 0.05). COMPASS-31 total scores were higher, especially in vasomotor, secretomotor, gastrointestinal, and bladder domains. Corneal nerve fiber density, length, and branching were significantly reduced in patients with MG (p < 0.05). SD scores were significantly worse and correlated with selected autonomic measures. After adjustment for age, depression, and anxiety, reduced corneal nerve fiber parameters were independently associated with SD. In male patients, RRIV during hyperventilation and gastrointestinal autonomic symptom burden were associated with ejaculatory function.</p><p><strong>Conclusions: </strong>Patients with MG exhibit evidence of autonomic dysfunction based on objective autonomic assessments. SD is common in patients with MG and appears to be associated with autonomic dysfunction beyond psychosocial factors alone.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we treating the wrong POTS in RECOVER-AUTONOMIC? A call for phenotype subtyping.","authors":"Carlo Uran","doi":"10.1007/s10286-026-01253-w","DOIUrl":"https://doi.org/10.1007/s10286-026-01253-w","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insular involvement and atrial fibrillation first detected after ischemic stroke: a systematic review and meta-analysis.","authors":"Kailing Guo, Wang Guo, Zhihao Wang, Hongxin Li, Lingfu Ouyang, Jie Pu, Hongyu Li, Qiang Tang","doi":"10.1007/s10286-026-01252-x","DOIUrl":"https://doi.org/10.1007/s10286-026-01252-x","url":null,"abstract":"<p><strong>Purpose: </strong>The association between insular involvement identified on brain imaging and atrial fibrillation first detected after ischemic stroke remains uncertain. We evaluated this association and summarized prespecified neurocardiac outcomes.</p><p><strong>Methods: </strong>Seven databases were searched through April 5, 2026; six were searched from inception, and Wanfang Data was searched from January 2000. Eligible studies enrolled adults with ischemic stroke, assessed insular involvement on brain imaging, and reported atrial fibrillation or another prespecified neurocardiac outcome. Atrial fibrillation first detected after stroke was defined as atrial fibrillation identified after the index stroke in patients without previously known atrial fibrillation. Random-effects meta-analysis was performed when at least three studies were sufficiently comparable.</p><p><strong>Results: </strong>Thirty-one studies were included; only three provided comparable adjusted estimates for the primary meta-analysis, totaling 2164 participants. Insular involvement was associated with higher odds of atrial fibrillation first detected after stroke (odds ratio 3.35, 95% confidence interval 2.30-4.89; P < 0.001). An exploratory analysis of overall atrial fibrillation excluding one atrial flutter event yielded an odds ratio of 1.51 (95% confidence interval 0.99-2.32; P = 0.056). Other outcomes were summarized descriptively.</p><p><strong>Conclusion: </strong>Across three observational studies, insular involvement identified on brain imaging was associated with atrial fibrillation first detected after ischemic stroke. Previously undetected paroxysmal atrial fibrillation may have preceded the stroke, leaving the temporal direction uncertain. These findings are hypothesis-generating and are insufficient to support the use of lesion location to select rhythm monitoring strategies or guide anticoagulation decisions.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Autonomic effects of simulated periodic breathing in patients with chronic heart failure on contemporary guideline-directed therapy.","authors":"Francesco Gentile, Lars Stumpp, Paolo Sciarrone, Alessandro Navari, Eleonora Degl'Innocenti, Giacomo D'Alesio, Chiara Borrelli, Sabrina Montuoro, John Floras, Vaughan G Macefield, Calogero Maria Oddo, Claudio Passino, Michele Emdin, Alberto Giannoni","doi":"10.1007/s10286-026-01251-y","DOIUrl":"https://doi.org/10.1007/s10286-026-01251-y","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin resistance is potentially associated with 24-h blood pressure variability related to blunted sympathetic reactivity in older adults with hypertension.","authors":"Amane Hori, John D Akins, Yoshiyuki Okada, Takuro Washio, Ayumi Fukazawa, Wanpen Vongpatanasin, Masaki Mizuno, Qi Fu","doi":"10.1007/s10286-026-01241-0","DOIUrl":"https://doi.org/10.1007/s10286-026-01241-0","url":null,"abstract":"<p><strong>Purpose: </strong>Blood pressure variability (BPV) increases with aging and hypertension; however, the underlying mechanisms remain poorly understood. Aging-related insulin resistance is known to contribute to abnormalities in autonomic circulatory regulation. Although hypertension and autonomic dysfunction are closely linked, it remains unclear whether hypertension modifies the effects of insulin resistance on autonomic cardiovascular control and BPV. Since daily life is mostly spent upright, sympathetic responses to postural change may determine BPV. Therefore, we aimed to determine whether insulin resistance is associated with muscle sympathetic nerve activity (MSNA) responses to orthostatic stress in older adults with and without hypertension.</p><p><strong>Methods: </strong>We studied 37 older adults without hypertension (normotension [NTN]) and 30 older patients with hypertension (HTN) without diabetes mellitus. Participants underwent 30° and 60° head-up tilt (HUT), whereby MSNA responses were assessed. In addition to 24-h BPV, fasting glucose, insulin, and homeostasis-model-assessment-estimated insulin resistance (HOMA-IR) were measured.</p><p><strong>Results: </strong>HTN exhibited higher 24-h BPV. There were no significant group differences in MSNA responses to HUT or in fasting glucose, insulin, or HOMA-IR. Importantly, however, only in the HTN group, MSNA responses to HUT were negatively correlated with fasting glucose and HOMA-IR. In multivariable models adjusting for age, sex, and body mass index (BMI), fasting glucose remained an independent predictor of MSNA responsiveness. Furthermore, mediation analysis revealed indirect associations of fasting glucose and HOMA-IR with 24-h BPV in relation to attenuated MSNA responses to HUT.</p><p><strong>Conclusions: </strong>In older adults with hypertension, insulin resistance may be associated with elevated BPV through blunted sympathetic responses to orthostatic stress.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"37th International Symposium on the Autonomic Nervous System.","authors":"","doi":"10.1007/s10286-026-01248-7","DOIUrl":"https://doi.org/10.1007/s10286-026-01248-7","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond haemodynamic monitoring: symptom-based autonomic assessment in falls risk evaluation.","authors":"Deepika Metange, Sudeep Kale, Madhavi Doke","doi":"10.1007/s10286-026-01249-6","DOIUrl":"https://doi.org/10.1007/s10286-026-01249-6","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond blood pressure fall: a mechanistic framework for symptom generation in orthostatic hypotension.","authors":"Güney Sarıoğlu, Abdulmecit Afşin","doi":"10.1007/s10286-026-01250-z","DOIUrl":"https://doi.org/10.1007/s10286-026-01250-z","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two dopaminergic systems, one bladder: recognising a therapy-resistant urinary phenotype in Parkinson's disease.","authors":"Mario Hero, Vladimira Vuletić","doi":"10.1007/s10286-026-01247-8","DOIUrl":"https://doi.org/10.1007/s10286-026-01247-8","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between symptoms of pediatric postural orthostatic tachycardia syndrome and joint hypermobility syndromes.","authors":"Jeffrey R Boris, Thomas Bernadzikowski","doi":"10.1007/s10286-026-01242-z","DOIUrl":"https://doi.org/10.1007/s10286-026-01242-z","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}