Clinical Autonomic Research最新文献

{"title":"Relationship between cerebral white matter hyperintensities and autonomic function in older individuals with cerebral small vessel disease.","authors":"Yanna Li, Yajing Wang, Shoufeng Liu, Yilin Ma, Jialing Wu","doi":"10.1007/s10286-026-01221-4","DOIUrl":"10.1007/s10286-026-01221-4","url":null,"abstract":"<p><strong>Purpose: </strong>Heart rate variability (HRV) has been linked to cerebral small vessel disease (CSVD) development. This study aimed to investigate the relationship between white matter hyperintensity (WMH) and HRV in older patients with CSVD.</p><p><strong>Methods: </strong>Patients with CSVD aged ≥ 60 years, diagnosed via magnetic resonance imaging and treated at Tianjin Huanhu Hospital in October 2022-April 2023, were included. WMH burden was defined as periventricular (PV-WMH) or deep WMH (D-WMH), with Fazekas scores of 3 or 2-3, respectively. Modified WMH burden was categorized based on total Fazekas scores (PV-WMH + D-WMH): grade 0 for 0-2, grade 1 for 3-4, and grade 2 for 5-6. Patient demographics were documented, and HRV was analyzed through 10-min short-range electrocardiography recordings. Time-domain indices included standard deviation of N-N intervals, root-mean-squared differences of successive N-N intervals, and the proportion of N-N intervals exceeding 50 ms. Frequency-domain indices included low-frequency power (LF, 0.04-0.15 Hz), high-frequency power (HF, 0.15-0.4 Hz), and LF/HF. Correlations were examined using univariable and multivariable analyses.</p><p><strong>Results: </strong>Among 108 patients with CSVD (age 60-87 years; median 66.0 years [interquartile range 63.0-71.0]), WMH burden was associated with sex, age, stroke, LF, and LF/HF (p < 0.05), with LF/HF independently linked in multivariable analysis. Modified WMH burden showed similar associations and remained independently correlated with LF/HF (p < 0.05).</p><p><strong>Conclusions: </strong>The presence and severity of WMH in CSVD were related to decreased LF/HF. This is possibly due to decreased cardiac sympathetic activity, indicates that decreased LF/HF may be a potential risk factor for WMH, and can be detected via short HRV recordings.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"513-521"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155190","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":"Indications, contraindications, and step-by-step methodology for performing carotid sinus massage in patients presenting with syncope : A scientific statement of an Ad Hoc Syncope Consortium endorsed by: the European Autonomic Society (EFAS), Gruppo Italiano Multidisciplinare Syncope (GIMSI) and European Geriatric Medicine Society (EuGMS).","authors":"Frederik J de Lange, Michele Brignole, David G Benditt, Melani Dani, Jean Claude Deharo, Alessandra Fanciulli, Artur Fedorowski, Antonella Groppelli, Mohamed H Hamdan, Viktor Hamrefors, Jelle S Y de Jong, Rose Anne Kenny, Piotr Kulakowski, Angel Moya, Roberto Maggi, Carlos A Morillo, Brian Olshansky, Satish R Raj, Ciara Rice, Giulia Rivasi, Ineke van Rossum, Vincenzo Russo, Robert Sheldon, Win-Kuan Shen, Richard Sutton, Roland Thijs, Patricia Taraborrelli, Marco Tomaino, Andrea Ungar, Steven van Zanten","doi":"10.1007/s10286-026-01218-z","DOIUrl":"10.1007/s10286-026-01218-z","url":null,"abstract":"<p><p>Carotid sinus massage (CSM) is essential in evaluating recurrent unexplained reflex syncope, as it uniquely identifies cardioinhibitory forms that other tests may miss. CSM is largely underused in clinical practice outside dedicated syncope facilities and, when performed, its execution varies, as does the interpretation of results. Underuse affects the diagnostic yield of CSM in the syncope evaluation, thereby denying patients mechanism-based personalized treatment. There are several barriers to the proper use of CSM in the work-up of patients with unexplained syncope.To address these important limitations, an international panel of experts in the field of syncope provide herein a consensus document with the aim of offering practical guidance for the indications, contraindications, and methodology for performing carotid sinus massage in general and dedicated syncope facilities and in the emergency department.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"485-497"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041517","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":"Vagus nerve stimulation and pulmonary outcomes: a scoping review of preclinical and clinical evidence.","authors":"Miray Başer, Betül Taşpınar, Ferruh Taşpınar","doi":"10.1007/s10286-026-01228-x","DOIUrl":"10.1007/s10286-026-01228-x","url":null,"abstract":"<p><strong>Background: </strong>Vagus nerve stimulation (VNS) is a neuromodulatory intervention with antiinflammatory and autonomic regulatory properties. Although its clinical applications have primarily been explored in neurological disorders, its potential role in pulmonary and respiratory outcomes across preclinical and clinical settings remains incompletely characterized and dispersed across different study domains. This scoping review aimed to map the available evidence on the effects of VNS on the pulmonary and respiratory systems, with particular emphasis on inflammatory and autonomic mechanisms.</p><p><strong>Methods: </strong>This scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Three reviewers systematically searched PubMed, Web of Science, and the Cochrane Library for studies published between January 2020 and February 2026. Original preclinical and clinical studies investigating invasive or noninvasive VNS and reporting pulmonary, respiratory physiology, autonomic, or inflammatory outcomes were included.</p><p><strong>Results: </strong>A total of 159 records were identified, of which 12 studies met the inclusion criteria. The evidence base was predominantly preclinical. In animal studies, invasive cervical VNS was frequently associated with reductions in pulmonary inflammation, histopathological lung injury, and proinflammatory cytokine expression. Clinical studies were limited and heterogeneous, but generally indicated variable modulation of autonomic function, including changes in parasympathetic activity, as well as heterogeneous effects on systemic inflammatory markers and limited respiratory outcomes.</p><p><strong>Conclusions: </strong>Current evidence suggests that VNS may modulate pulmonary inflammatory responses in preclinical models. However, clinical evidence remains limited and heterogeneous, particularly regarding autonomic and respiratory outcomes. Well-designed clinical trials using standardized stimulation protocols and predefined respiratory end points are needed to clarify its therapeutic potential in respiratory disorders.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"457-466"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359440","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":"Can a neck lift trigger orthostatic hypertension and tremors?","authors":"Lucy Norcliffe-Kaufmann, Alejandra Gonzalez-Duarte","doi":"10.1007/s10286-026-01207-2","DOIUrl":"10.1007/s10286-026-01207-2","url":null,"abstract":"<p><p>We report a 71-year-old woman who developed disabling orthostatic tremor and severe orthostatic hypertension following cosmetic neck lift surgery. Autonomic testing demonstrated exaggerated pressor responses and excessive orthostatic catecholamine release, consistent with sympathoadrenal overactivation due to impaired carotid baroreflex function. This case highlights a potential autonomic complication of aesthetic neck surgery.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"537-539"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662250","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":"Transcutaneous vagus nerve stimulation and exercise-induced autonomic regulation: a systematic review.","authors":"Laissa Saldanha, Marlene García-Quintana, Juan Francisco Loro-Ferrer, Aníbal Báez-Suárez, Martín Vílchez-Barrera, Raquel Medina-Ramírez","doi":"10.1007/s10286-026-01226-z","DOIUrl":"10.1007/s10286-026-01226-z","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesise current evidence regarding whether transcutaneous vagus nerve stimulation modulates autonomic recovery following exercise-induced physiological stress in healthy individuals, with particular emphasis on vagal reactivation, spontaneous cardiovagal baroreflex sensitivity, sympathetic modulation and inflammatory responses.</p><p><strong>Methods: </strong>This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement and registered in the Open Science Framework. Six electronic databases were searched. Fifteen randomised controlled trials involving 566 participants met inclusion criteria. Methodological quality, risk of bias and certainty of evidence were evaluated using the Physiotherapy Evidence Database scale, the revised Cochrane Risk-of-Bias tool and the Grading of Recommendations Assessment, Development and Evaluation framework.</p><p><strong>Results: </strong>Transcutaneous vagus nerve stimulation was associated with protocol-dependent modulation of autonomic recovery dynamics following exercise-induced physiological stress. Several studies reported changes consistent with enhanced vagal reactivation, reflected by increases in selected vagally mediated heart rate variability indices and improvements in spontaneous cardiovagal baroreflex sensitivity, alongside reductions in sympathetic activity in selected protocols. However, autonomic responses were not uniform across studies, with some investigations demonstrating null or divergent findings depending on stimulation parameters, timing and participant characteristics. Repeated stimulation paradigms demonstrated reductions in selected inflammatory markers, whereas acute stimulation occasionally induced transient cytokine elevations, suggesting context-dependent autonomic-immune interactions. Effects on maximal physical performance remained limited and inconsistent. Certainty of evidence ranged from very low to low, primarily because of methodological heterogeneity, small sample sizes and short follow-up durations.</p><p><strong>Conclusion: </strong>Current evidence suggests that transcutaneous vagus nerve stimulation may influence autonomic mechanisms involved in recovery from exercise-induced stress, particularly processes related to vagal regulation, spontaneous cardiovagal baroreflex responsiveness and autonomic recalibration. Nevertheless, substantial heterogeneity in stimulation protocols and outcome assessment limits definitive interpretation. Larger, rigorously controlled and longitudinal investigations using standardised autonomic assessment methodologies are required to clarify the consistency, magnitude and physiological relevance of these effects.</p><p><strong>Trial registration: </strong>The review protocol was registered in the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/H9VRX ).</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"445-455"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410783","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":"The developing relationship between circadian rhythm and heart rate variability in premature infants.","authors":"R B Govindan, Nickie N Andescavage, Sudeepta Basu, Jonathan Murnick, Julius Ngwa, Catherine Limperopoulos, Adre J du Plessis","doi":"10.1007/s10286-026-01216-1","DOIUrl":"10.1007/s10286-026-01216-1","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"533-536"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148027644","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":"A novel autonomic pathway: implications for vagal-sympathetic reflex physiology.","authors":"Massimo Pagani, Giuseppe Baselli, Daniela Lucini","doi":"10.1007/s10286-026-01220-5","DOIUrl":"10.1007/s10286-026-01220-5","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"523-524"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148565","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":"Patient-reported triggers of primary hyperhidrosis.","authors":"Mattias A S Henning, Hajer Ibrahim Al-Rahimi, Claus Zachariae, Ole Pedersen, Gregor B E Jemec","doi":"10.1007/s10286-026-01210-7","DOIUrl":"10.1007/s10286-026-01210-7","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"531-532"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644266","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 new PORT needs the same old evidence-based standards.","authors":"Svetlana Blitshteyn, Jill R Schofield, Katrina Kesterson, Blair P Grubb","doi":"10.1007/s10286-026-01217-0","DOIUrl":"10.1007/s10286-026-01217-0","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"549-550"},"PeriodicalIF":4.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811677","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 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 Macefiled, Calogero Maria Oddo, Claudio Passino, Michele Emdin, Alberto Giannoni","doi":"10.1007/s10286-026-01227-y","DOIUrl":"https://doi.org/10.1007/s10286-026-01227-y","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate sympathetic responses to experimentally induced periodic breathing/Cheyne-Stokes respiration (PB/CSR)-like patterns in optimally treated patients with chronic heart failure (CHF) compared with matched healthy controls.</p><p><strong>Methods: </strong>Muscle sympathetic nerve activity (MSNA) was recorded in 22 patients with systolic CHF (63 ± 9 years; left ventricular ejection fraction 31 ± 8%) and 10 age- and sex-matched healthy controls during spontaneous breathing and during two experimental protocols designed to reproduce PB/CSR-like oscillations: a short-cycle protocol (five cycles of 30-s apnea/30-s recovery breathing) and a long-cycle protocol (five cycles of 30-s apnea/60-s recovery breathing).</p><p><strong>Results: </strong>At baseline, MSNA was comparable between patients with CHF and controls, whereas heart rate variability indices were reduced in CHF. Compared with spontaneous breathing, simulated PB/CSR-averaging apnea and recovery phases-was associated with modest reductions in MSNA, with no significant differences between protocols or groups (p > 0.05). Both maneuvers elicited reproducible oscillatory patterns in MSNA, characterized by increases during apnea and decreases during recovery breathing, consistent with PB/CSR-like entrainment. However, patients with CHF exhibited weaker and more temporally dispersed coupling between MSNA and cardiorespiratory variables compared with controls.</p><p><strong>Conclusions: </strong>In optimally treated CHF, baseline sympathetic activity is comparable to that of healthy controls, and PB/CSR-like breathing primarily induces phase-locked oscillatory modulation of MSNA rather than sustained sympathetic activation. Impaired autonomic-hemodynamic coupling may represent a key mechanism underlying the clinical relevance of abnormal breathing patterns in CHF.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519932","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}