Clinical Autonomic Research最新文献

{"title":"Peripheral autonomic failure is associated with more severe postprandial hypotension compared to central autonomic failure.","authors":"Pouya E Mehr, Pedro J Ortiz, Kaitlyn R O'Rourke, Tan Ding, Amber J Hackstadt, Surat Kulapatana, André Diedrich, Daniel O Claassen, Italo Biaggioni, Amanda C Peltier, Cyndya A Shibao","doi":"10.1007/s10286-025-01131-x","DOIUrl":"https://doi.org/10.1007/s10286-025-01131-x","url":null,"abstract":"<p><strong>Purpose: </strong>Postprandial hypotension (PPH) defined as a decrease in systolic blood pressure of more than 20 mmHg within 2 h post meal is prevalent in patients with autonomic failure and is associated with negative cardiovascular outcomes. Previous studies reported peripheral autonomic failure with less residual sympathetic tone in Parkinson disease (PD). Therefore, we hypothesized that PPH is more severe in PD than in multiple system atrophy (MSA) with central autonomic failure.</p><p><strong>Methods: </strong>Thirteen patients with PD and 13 patients with MSA were enrolled. Autonomic function testing and neurohormonal measurements were performed to assess autonomic failure and residual sympathetic activity. Subjects were fed a standard breakfast. Systolic and diastolic blood pressure and heart rate were monitored every 5 min from 30 min before to 120 min post meal. Postprandial hemodynamic changes were summarized using area under the curve (AUC). Differences between the groups were assessed with two-sample independent t test and linear regression.</p><p><strong>Results: </strong>Patients with PD (69% male, 72 ± 9 years) had a significantly lower post-meal diastolic blood pressure (P = 0.003) and heart rate AUC (P = 0.007) than patients with MSA (62% male, 62 ± 8 years). After adjusting for age and supine systolic blood pressure, PD as diagnosis still had significant estimate effect for diastolic blood pressure AUC (P = 0.019). No significant difference was found in the mean systolic blood pressure AUC, but at 30 min post meal, systolic blood pressure decrease was significantly lower in PD (P = 0.016).</p><p><strong>Conclusion: </strong>The PD group with peripheral autonomic failure exhibits more severe PPH than the MSA group. This highlights the need for tailored management for PPH in PD.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969646","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":"Excessive sweating associated with cervical canal stenosis confirmed by microneurography recordings.","authors":"Kazumasa Shindo, Tatsuya Saito, Yuto Morishima, Atsuhiko Shindo, Hiroaki Murata, Takanori Hata, Yuji Ueno","doi":"10.1007/s10286-025-01133-9","DOIUrl":"https://doi.org/10.1007/s10286-025-01133-9","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982034","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":"Autonomic neuropathy is associated with an increase in type-1 cytokines in people living with HIV.","authors":"Bridget R Mueller, Mitali Mehta, Maya Campbell, Niyati Neupane, Gabriela Cedillo, Gina Lee, Kaitlyn Coyle, Jinging Qi, Zhihong Chen, Mary Catherine George, Jessica Robinson-Papp","doi":"10.1007/s10286-025-01129-5","DOIUrl":"https://doi.org/10.1007/s10286-025-01129-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-clinical studies have demonstrated direct influences of the autonomic nervous system (ANS) on the immune system. However, it remains unclear if ANS-immune connections delineated in these preclinical studies underlie the relationship between autonomic dysregulation and chronic inflammatory diseases in patients with human immunodeficiency virus (HIV). The aims of this study were: (1) to examine the relationship between interleukin-6 (IL-6) and the parasympathetic/vagal component of baroreflex sensitivity in people with HIV; (2) to determine whether the subtype and severity of HIV-autonomic neuropathy (AN) would predict distinct immunotypes; and (3) to compare the burden of non-acquired immunodeficiency syndrome (AIDS)-related co-morbidities between immunotypes.</p><p><strong>Methods: </strong>A total of 79 adults with well-controlled HIV underwent a standard battery of autonomic function tests summarized as the Composite Autonomic Severity Score (CASS) and vagal and adrenergic baroreflex sensitivity (BRS-V and BRS-A, respectively) (Low: Mayo Clin Proc 68:748-752, 1993). Levels of immune biomarkers were measured in all participants using the Target 96 Inflammation Panel on the Olink proteomics platform, and immunotypes were identified using unbiased, non-negative matrix factorization. Mass cytometry (CyTOF) was completed on a subset of participants with and without autonomic neuropathy (N = 10).</p><p><strong>Results: </strong>Reduced BRS-V predicted higher levels of IL-6 (p = 0.002). A pro-inflammatory immunotype defined by elevations in type 1 cytokines (IL-6, IL-17) and increased numbers of CD8+ T-cells was associated with autonomic neuropathy characterized by deficits in sympathetic nervous system activity (adjusted odds ratio 4.7, p = 0.017). This pro-inflammatory immunotype was older with a greater burden of co-morbidities.</p><p><strong>Conclusion: </strong>Deficits in the parasympathetic/cardiovagal and the sympathetic nervous system are associated with inflammation and disease burden in people living with HIV. Future longitudinal research is needed to examine causality.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986606","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":"The clinical characteristics and response to head-up tilt test of patients with micturition syncope: single-center experience in China.","authors":"Jing Li, Xuan Xiao, Shunzhi He, Haitao Sun","doi":"10.1007/s10286-025-01126-8","DOIUrl":"https://doi.org/10.1007/s10286-025-01126-8","url":null,"abstract":"<p><strong>Objective: </strong>This study compared clinical characteristics and response to head-up tilt test (HUTT) between micturition syncope (MS) and typical vasovagal syncope (VVS).</p><p><strong>Methods: </strong>Consecutive patients who underwent nitroglycerin-potentiated HUTT were retrospectively dichotomized into two groups: those with a history of MS and those with a history of VVS. The patients with MS were further subdivided into patients with MS alone and with MS and at least one episode of VVS.</p><p><strong>Results: </strong>A total of 2637 patients were enrolled: 204 had MS (MS alone in 103 and MS+VVS in 101), and 216 had typical VVS. Patients with MS were older (38.6 ± 13.1 vs. 36.3 ± 18.5, p = 0003) and more likely to be male (66.2% vs. 48.1%, p < 0.001). Multivariable analysis revealed that smoking habit (odds ratio [OR] 2.16, p < 0.0001), history of traumatic syncope (OR 2.24, p = 0.0001), and drinking alcohol before syncope (OR 2.63, p < 0.0001) were independently associated with MS. HUTT was positive in 141 (69.1%) patients with MS and in 144 (66.7%) patients with VVS (p = 0.592). Patients with MS showed more mixed (46.1% vs. 28.2%, p < 0.001) and vasodepressor forms (15.2% vs. 7.9%, p = 0.013) and fewer cardioinhibitory responses than others (7.4% vs. 30.6%, p < 0.001).</p><p><strong>Conclusions: </strong>Compared with VVS, patients with MS have different clinical characteristics, and drinking alcohol was an important precipitating factor for MS. The positivity rate of HUTT is high and similar to that of VVS, although patients with MS show a higher prevalence of hypotensive responses.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975167","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":"Morphological and functional assessment of the vagus nerve in multiple sclerosis.","authors":"Ana Abičić, Magdalena Krbot Skorić, Tereza Gabelić, Barbara Barun, Mario Habek, Ivan Adamec","doi":"10.1007/s10286-025-01130-y","DOIUrl":"https://doi.org/10.1007/s10286-025-01130-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this work is to determine the relationship between the cross-sectional area (CSA) of the vagus nerve and cardiovagal function in people with multiple sclerosis (pwMS) and healthy controls (HC).</p><p><strong>Methods: </strong>We enrolled 50 pwMS and 50 HC. All participants underwent an ultrasound of the vagus nerve and autonomic nervous system testing. The Croatian version of the COMPASS-31 questionnaire was used as a measure of autonomic symptom burden. Cardiovagal function was evaluated with the respiratory sinus arrhythmia (RSA), Valsalva ratio (VR), and heart rate variability.</p><p><strong>Results: </strong>The mean vagus CSA in pwMS was 2.03 ± 0.49 mm² on the right side and 1.72 ± 0.38 mm² on the left side. The mean vagus CSA in HC was 2.08 ± 0.50 mm² on the right side and 1.74 ± 0.37 mm² on the left side. There was no statistically significant difference between the two groups in right (p = 0.615) or left (p = 0.866) vagus CSA. In the HC, there was a statistically significant positive correlation between the mean right CSA and both RSA (r_p = 0.331, p = 0.019) and VR (r_p = 0.327, p = 0.020). On univariable linear regression analysis in the HC group, the mean right CSA was a predictor of both RSA (B = 5.599, 95% CI 0.974-10.224, p = 0.019) and VR (B = 0.253, 95% CI 0.041-0.466, p = 0.020). These findings were not present in pwMS.</p><p><strong>Conclusions: </strong>The loss of correlation between vagus nerve CSA and parameters of parasympathetic nervous system function in pwMS corroborates the presence of cardiovagal dysfunction in multiple sclerosis.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954893","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: Chronic autonomic symptom burden in long‑COVID: a follow‑up cohort study.","authors":"Ella F Eastin, Jannika V Machnik, Lauren E Stiles, Nicholas W Larsen, Jordan Seliger, Linda N Geng, Hector Bonilla, Phillip C Yang, Mitchell G Miglis","doi":"10.1007/s10286-025-01123-x","DOIUrl":"https://doi.org/10.1007/s10286-025-01123-x","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966687","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":"\"Body-first\" dementia with Lewy bodies.","authors":"David S Goldstein, Courtney Holmes, Patti Sullivan, Risa Isonaka, Dragan Maric, Parvez Alam, Christine Cliatt-Brown, Janna Gelsomino, Sarah Moore, Byron Caughey, Guillaume Lamotte","doi":"10.1007/s10286-025-01128-6","DOIUrl":"https://doi.org/10.1007/s10286-025-01128-6","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978393","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":"Amplitude of low-frequency fluctuation (ALFF) alterations in heart transplant patients with cognitive impairment: a resting-state fMRI study.","authors":"Qian Qin, Jia Liu, Wenliang Fan, Xinli Zhang, Jue Lu, Xiaotong Guo, Ziqiao Lei, Jing Wang","doi":"10.1007/s10286-025-01124-w","DOIUrl":"https://doi.org/10.1007/s10286-025-01124-w","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to investigate the changes in brain functional activity in heart transplant patients and to explore the relationship between abnormal spontaneous brain activity and cognitive function through amplitude of low-frequency fluctuations (ALFF).</p><p><strong>Methods: </strong>Sixty-eight heart transplant patients and 56 healthy controls were assessed by the Montreal Cognitive Assessment (MoCA) scale and the Mini-Mental Status Examination (MMSE) scale, and resting-state functional magnetic resonance scans were performed. Cortical analysis was applied to calculate the ALFF, and two-sample t test was used to detect differences of mean ALFF in the brain region between the two groups. In addition, the correlations between abnormal functional activity brain regions, cognitive functions, and clinical indicators were analyzed.</p><p><strong>Results: </strong>Heart transplant patients had significantly lower MoCA scores and MMSE scores compared to healthy subjects. ALFF were found to be decreased in the right cerebellum anterior lobe, left parahippocampal gyrus, left temporal lobe, left parietal lobe, and right postcentral gyrus, and increased in the right superior frontal gyrus and left middle frontal gyrus. In addition, ALFF in right superior frontal gyrus was positively correlated with MoCA score (r = 0.397, P < 0.05), MMSE score (r = 0.356, P < 0.05), stroke volume (SV, r = 0.412, P < 0.05), and left ventricular ejection fraction (LVEF, r = 0.614, P < 0.05) in heart transplant patients.</p><p><strong>Conclusions: </strong>Cognitive function is impaired in heart transplant patients. The brain activity was altered in heart transplant recipients compared to healthy controls. ALFF changes in these brain regions may be associated with altered hemodynamics after transplantation, leading to impaired cognitive function. These findings help us to understand the neural mechanisms of cognitive changes in heart transplant recipients and provide a basis for developing interventions and rehabilitation strategies.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986451","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":"Acute effects of bolus water intake on post-exercise orthostatic hypotension and cardiovascular hemodynamics.","authors":"Yuki Tajima, Mayu Komiyama, Naoya Mimura, Maika Yamamoto, Marina Fukuie, Rina Suzuki, Shinya Matsushima, Ai Hirasawa, Shigeki Shibata","doi":"10.1007/s10286-024-01077-6","DOIUrl":"10.1007/s10286-024-01077-6","url":null,"abstract":"<p><strong>Introduction: </strong>Water intake is known to be effective in preventing orthostatic hypotension (OH). However, it is unknown whether water intake would be effective in acutely preventing exercise-induced OH.</p><p><strong>Methods: </strong>Fourteen adults (men/women: 7/7, age: 20 ± 8 years) were recruited. Each subject underwent two protocols with and without 500 ml water intake using a randomized crossover design (Water vs. Control). Participants underwent 30 min of cycle ergometry at the 60-70% predicted VO₂ max. OH and hemodynamics were assessed before and after exercise, and immediately (Water 1) and 20 min (Water 2) after the water intake. OH was evaluated with a 1-min standing test as the criteria for systolic blood pressure (SBP) < 90 mmHg. A cross-spectral analysis for RR and SBP variability was used to evaluate the cardiac autonomic activity and baroreflex sensitivity.</p><p><strong>Results: </strong>In both protocols, the incidence of OH increased after the exercise. The incidence of OH was lower in Water than in Control at Water 1 (OR: 0.093, 95% CI: 0.015-0.591). Heart rate was lower and SBP was higher in Water than in Control at Water 1 and 2 (P < 0.05). High-frequency power of RR variability and transfer function gains in Water were normalized and higher than in Control at Water 1 and 2 (P < 0.05). The ratio of low- to high-frequency power of RR variability in Water was normalized and lower in Water than in Control at Water 1 (P < 0.05).</p><p><strong>Conclusion: </strong>Our findings indicate that water intake may prevent acute exercise-induced OH, accompanied by normalized cardiac autonomic activity and baroreflex sensitivity.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"231-241"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544071","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":"Blood volume deficit in postural orthostatic tachycardia syndrome assessed by semiautomated carbon monoxide rebreathing.","authors":"Surat Kulapatana, Vasile Urechie, Stefano Rigo, Abigail Mohr, Yuliya A Vance, Luis E Okamoto, Alfredo Gamboa, Cyndya Shibao, Italo Biaggioni, Raffaello Furlan, André Diedrich","doi":"10.1007/s10286-024-01091-8","DOIUrl":"10.1007/s10286-024-01091-8","url":null,"abstract":"<p><strong>Purpose: </strong>The semiautomated carbon monoxide (CO) rebreathing method has been introduced as a noninvasive and radiation-free blood volume estimation method. We tested whether the semiautomated CO rebreathing method can detect the blood volume deficit in postural orthostatic tachycardia syndrome (POTS). In addition, we explored the relationship between blood volume estimated from CO rebreathing and body impedance.</p><p><strong>Patients and methods: </strong>We recruited 53 subjects (21 female patients with POTS, 19 healthy female participants, and 13 healthy male participants) to record blood volumes and hemodynamic data. Blood volumes were measured by CO rebreathing and segmental body impedance. Linear regression models to predict normal values of red blood cell volume (RBCV), plasma volume (PV), and total blood volume (BV) were developed. Percentage deviations from the predicted normal volumes were calculated.</p><p><strong>Results: </strong>Patients with POTS had lower RBCV (25.18 ± 3.95 versus 28.57 ± 3.68 mL/kg, p = 0.008, patients with POTS versus healthy female participants), BV (64.53 ± 10.02 versus 76.78 ± 10.00 mL/kg, p < 0.001), and BV deviation (-13.92 ± 10.38% versus -0.02 ± 10.18%, p < 0.001). Patients with POTS had higher supine heart rate (HR) (84 ± 14 versus 69 ± 11 bpm, p < 0.001) and upright HR (123 ± 23 versus 89 ± 22 bpm, p < 0.001). We found a correlation between BV deviation and upright HR in patients with POTS (r = -0.608, p = 0.003), but not in healthy participants. Volumes from the CO rebreathing and body impedance were well correlated (r = 0.629, p < 0.001).</p><p><strong>Conclusions: </strong>The CO rebreathing method can detect BV deficit, as well as the RBCV deficit in patients with POTS. The negative correlation between BV deviation and upright HR indicates that hypovolemia is one of the pathophysiological causes of POTS. Correlations between body impedance and CO rebreathing volume suggest its usefulness for measurements of volume changes.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"267-276"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}