Clinical Autonomic Research最新文献

{"title":"Hypoxia disrupts neurovascular regulation of blood pressure in normotensive and untreated hypertensive men.","authors":"Qudus A Ojikutu, Jeann L Sabino-Carvalho, Katherine Latham, Marcos Rocha, Joao D Mattos, Monique O Campos, Daniel E Mansur, Lauro C Vianna, Antonio C L Nóbrega, Igor A Fernandes","doi":"10.1007/s10286-025-01135-7","DOIUrl":"10.1007/s10286-025-01135-7","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia is a common feature of arterial hypertension that does not consistently elevate blood pressure (BP), but triggers exaggerated increases in muscle sympathetic nerve activity (MSNA) and may disturb sympathetic transduction and baroreflex sensitivity in hypertensive individuals. Elevated resting MSNA, enhanced sympathetic transduction, and reduced baroreflex sensitivity are all associated with increased blood pressure variability (BPV), a marker of target organ damage independent of absolute BP levels. We hypothesized that hypoxia would elicit greater BPV in hypertensive individuals compared to normotensive controls METHODS: Nine young- to middle-aged men with untreated stage 1-2 hypertension (HT) and normotensive controls (NT) were exposed to normoxia (21% O₂) and isocapnic hypoxia (IH, 10% O₂). During both conditions, oxygen saturation, beat-to-beat BP, MSNA, and end-tidal CO₂ (PetCO₂) were continuously monitored, with PetCO₂ clamped. BPV was quantified using standard deviation, coefficient of variation, and average real variability for systolic (SBP), diastolic (DBP), and mean BP (MBP). Sympathetic transduction was assessed using a time-domain signal averaging technique. Cardiac baroreflex sensitivity (cBRS) was evaluated using the sequence method, and sympathetic baroreflex sensitivity (sBRS) was calculated via MSNA-DBP regression RESULTS: IH induced comparable oxygen desaturation in both groups (NT: -25.7 ± 3.3% vs. HT: -21.2 ± 4.0%, p > 0.05). Although BP and PetCO₂ remained unchanged, MSNA responses were significantly greater in HT (NT: +8 ± 2 vs. HT: +12 ± 2 bursts/min, p = 0.03). IH increased all indices of BPV and sympathetic transduction, while both cBRS and sBRS were similarly impaired in the two groups.</p><p><strong>Conclusions: </strong>In conclusion, IH similarly exacerbates BPV and disrupts sympathetic transduction and baroreflex function in normotensive and untreated hypertensive men, despite greater MSNA reactivity in the hypertensive group.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"767-777"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12664846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324600","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}

{"title":"Clinical variables do not predict syncope in pacemaker patients with bifascicular block: a SPRITELY substudy.","authors":"Joshua Szaszkiewicz, Robert Sheldon, Satish Raj, Alessandra Rabajoli","doi":"10.1007/s10286-025-01138-4","DOIUrl":"10.1007/s10286-025-01138-4","url":null,"abstract":"<p><strong>Background: </strong>The SPRITELY study showed no differences in the recurrence of syncope in patients with bifascicular block (BFB) and syncope, regardless of whether patients received an empiric pacemaker (PM) or an implantable cardiac monitor (ICM). Whether syncope resistant to pacing can be predicted by baseline clinical variables is unknown.</p><p><strong>Objectives: </strong>To determine whether baseline clinical characteristics predict syncope recurrence in patients with bifascicular block and a permanent pacemaker.</p><p><strong>Methods: </strong>This was a retrospective analysis of the SPIRITELY trial, a randomized clinical trial in which patients with syncope and bifascicular block were assigned randomly to receive either a pacemaker or implantable loop recorder as an initial management strategy. In 60 patients who received a pacemaker, we tested the ability of 38 baseline clinical variables to predict a syncope recurrence. These included demographics, comorbidities, medications, and syncopal history and symptoms. Univariable and multivariate statistics were performed and a p < 0.05 was accepted as significant.</p><p><strong>Results: </strong>In the 60 patients who received a pacemaker, 12 (20%) had recurrent syncope. Only the use of angiotensin receptor blockers (ARB) and a history of a composite of one or more of asystole, supraventricular tachycardia (SVT), or diabetes were univariable significant predictors of recurrent syncope (p = 0.042). In the multivariate analysis only a history of a composite of one or more of asystole, SVT, or diabetes significantly predicted syncope (p = 0.03). Neither SVT nor diabetes alone predicted syncope recurrence.</p><p><strong>Conclusions: </strong>In older patients with syncope and bifascicular heart block, only a history of one or more of asystole, SVT, or diabetes significantly predicted syncope.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"853-858"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215101","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":"Neuronal intranuclear inclusion disease: a dynamic evolution of MRI in 8 years and mimicker of benign paroxysmal positional vertigo.","authors":"Wei-Qin Ning, Yang-Sha Zhuang, Sheng-Peng Diao, Ming-Fan Hong","doi":"10.1007/s10286-025-01143-7","DOIUrl":"10.1007/s10286-025-01143-7","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"863-866"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648649","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":"Harlequin syndrome: using clinical features and autonomic testing to unmask the disorder.","authors":"Hannah Padilla, William P Cheshire, Eduardo E Benarroch, Sarah E Berini, Jeremy K Cutsforth-Gregory, Michelle L Mauermann, Paola Sandroni, Kamal Shouman, Phillip A Low, Wolfgang Singer, Elizabeth A Coon","doi":"10.1007/s10286-025-01151-7","DOIUrl":"10.1007/s10286-025-01151-7","url":null,"abstract":"<p><strong>Purpose: </strong>Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and contralateral anhidrosis. We sought to delineate underlying causes, clinical presentations, and autonomic testing profiles of patients with Harlequin syndrome.</p><p><strong>Methods: </strong>Retrospective chart review was performed of the Mayo Clinic electronic health record for patients with a Harlequin syndrome diagnosis from 1998 to 2024. Clinical, laboratory, imaging, and autonomic function testing results, including autonomic reflex screen (ARS) and thermoregulatory sweat test (TST), were reviewed.</p><p><strong>Results: </strong>Of 51 patients with Harlequin syndrome, 39 (76%) were women. Median age of onset was 52 years (range 8-73 years). Harlequin syndrome was often idiopathic (N = 19; 37%), followed by postsurgical (N = 9; 17%), neoplasm (N = 5; 9.8%), trauma (N = 4; 7.8%), small fiber neuropathy (N = 4; 7.8%), systemic causes (N = 3; 5.9%), autoimmune (N = 3; 5.9%), pure autonomic failure (N = 2; 3.9%), and multiple sclerosis (N = 1; 2%). Pupil abnormalities were found in 13 patients (25.5%) with abnormal muscle stretch reflexes in 17 (33.3%). Headache was a comorbidity in 20 patients (39%). Of those with postsurgical onset, various surgeries preceded Harlequin syndrome onset, including heart, lung, and neck operations. Onset was acute or subacute in the majority of postsurgical patients (57%), while insidious onset was most common in nonsurgical patients (89%; p = 0.001). Median anhidrosis on TST was 9% (range 0.6-63%; N = 27). Median composite autonomic severity score was 1 (interquartile range (IQR) 0-3; N = 31).</p><p><strong>Conclusions: </strong>Harlequin syndrome commonly has an insidious onset and occurs without an identifiable cause, which could be considered primary Harlequin syndrome. Secondary Harlequin syndrome can occur following surgeries in the vicinity of sympathetic pathways, which most commonly leads to an acute or subacute presentation.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"839-845"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728289","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":"Enhanced visual illusions in Parkinson's disease with cardiovascular autonomic failure.","authors":"Tadashi Umehara, Masahiro Mimori, Tatsushi Kokubu, Masakazu Ozawa, Tomotaka Shiraishi, Asako Onda, Hiromasa Matsuno, Shusaku Omoto, Hidetomo Murakami, Yasuyuki Iguchi","doi":"10.1007/s10286-025-01142-8","DOIUrl":"10.1007/s10286-025-01142-8","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have examined the association between cardiovascular autonomic failure and minor hallucinations in patients with Parkinson's disease (PD). The aim of this study was to clarify this association.</p><p><strong>Methods: </strong>The subjects were 133 patients with PD without well-structured visual hallucinations. Visual illusory responses were evaluated using the noise pareidolia test. Cardiac ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG) uptake and neurogenic orthostatic hypotension (nOH) and supine hypertension (nSH) on head-up tilt-table testing were examined in association with the incidence of pareidolia.</p><p><strong>Results: </strong>Fifty-one (38%) patients had pareidolia. nOH (β = 0.220, p = 0.008), cognitive impairment (β = -0.228, p = 0.028), and longer symptom duration (β = 0.273, p = 0.006) were associated with an increased incidence of pareidolia independently of age, sex, motor severity, levodopa-equivalent dose, and anticholinergic and cholinesterase inhibitor use. An increased incidence of pareidolia was also associated with nSH (β = 0.214, p = 0.009), while no such association was found with cardiac ¹²³I-MIBG uptake. Patients with severe nOH or nSH tended to have a higher incidence of pareidolia than those with mild nOH (p = 0.063) or nSH (p < 0.003), respectively.</p><p><strong>Conclusion: </strong>nOH and nSH were associated with the severity of pareidolia in early PD patients without well-structured visual hallucinations. Further studies are required to clarify whether this association is attributable to widespread central pathological changes related to cardiovascular autonomic failure, or to degeneration of the sympathetic nervous system.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"829-837"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567147","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":"36th International Symposium on the Autonomic Nervous System.","authors":"","doi":"10.1007/s10286-025-01165-1","DOIUrl":"10.1007/s10286-025-01165-1","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"643-696"},"PeriodicalIF":3.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299064","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":"10.1007/s10286-025-01128-6","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"623-627"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","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":"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":"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":"617-622"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","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":"Neurological perspectives and gastroenterological motility diseases: ten lessons from clinical practice.","authors":"Michael Camilleri","doi":"10.1007/s10286-025-01137-5","DOIUrl":"10.1007/s10286-025-01137-5","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"601-606"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132134","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":"Characterising Postural Orthostatic Tachycardia Syndrome (POTS) triggered by a viral illness compared to concussion or trauma.","authors":"Gemma Wilson, Marie-Claire Seeley, Pauline Slater, Dennis H Lau, Celine Gallagher","doi":"10.1007/s10286-025-01136-6","DOIUrl":"10.1007/s10286-025-01136-6","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"637-641"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339959","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}