Clinical Autonomic Research最新文献

{"title":"The mechanisms and management of fecal incontinence in geriatric neurological diseases.","authors":"Ryuji Sakakibara","doi":"10.1007/s10286-026-01232-1","DOIUrl":"https://doi.org/10.1007/s10286-026-01232-1","url":null,"abstract":"<p><p>Two mechanisms underlie the development of fecal incontinence (FI), which poses a significant autonomic burden among individuals with neurological disease: neurogenic FI, in which neural lesions innervate the bowel/sphincter, and functional FI, without such lesions but occurring secondarily to cognitive decline and/or immobility. Both neurogenic FI and functional FI hinder a person's toiletings. Neurogenic FI is further divided into two mechanisms: overflow FI due to neurogenic constipation, which is common in older individuals, and sphincter FI caused by neurogenic sphincter weakness due to a lesion in the sacral Onuf's nucleus or its periphery, which is rare among older individuals. This paper reviews (i) autonomic (bowel) and somatic (sphincter) innervation and how to assess them, (ii) geriatric brain diseases and cognitive/gait functions relevant to toileting and how to assess them, and (iii) the management of patients with FI. The current treatments for FI not only maximize patients' quality of life but they also help patients avoid gastrointestinal emergencies, as FI is commonly associated with severe constipation. Collaborations between neurologists and gastroenterologists are recommended to achieve the optimal outcomes for individuals with FI.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469398","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 for long COVID-associated autonomic dysfunction: mechanistic rationale and emerging clinical evidence.","authors":"Frédéric Roche, Vincent Pichot, Claire Bory, Noel Bory, David Hupin","doi":"10.1007/s10286-026-01231-2","DOIUrl":"https://doi.org/10.1007/s10286-026-01231-2","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419218","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":"Haemodynamics of (pre)syncope during carotid sinus massage: a beat-to-beat analysis of haemodynamic parameters during carotid sinus massage.","authors":"Frederik J de Lange, Boriana S Gagaouzova, Roland D Thijs, Ineke A van Rossum, J Gert van Dijk, Jelle S Y de Jong","doi":"10.1007/s10286-026-01224-1","DOIUrl":"https://doi.org/10.1007/s10286-026-01224-1","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343551","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":"Co-occurrence of Chiari malformation type 1 and small fiber neuropathy in a family with a novel COL6A5 null variant.","authors":"Francesca Masciarelli, Domenico Dell'Aversana, Floriana Vitale, Giuseppina Ciccarelli, Lucia Micale, Silvia Morlino, Giuseppe Caporaso, Stefano Tozza, Vincenzo Provitera, Marco Castori, Maria Nolano","doi":"10.1007/s10286-026-01225-0","DOIUrl":"https://doi.org/10.1007/s10286-026-01225-0","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249425","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":"Postural tachycardia during active standing: diagnostic criteria in adolescents.","authors":"Imad T Jarjour, Sukru Aras, Laila K Jarjour","doi":"10.1007/s10286-026-01223-2","DOIUrl":"https://doi.org/10.1007/s10286-026-01223-2","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162192","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":"Utilization of machine learning in diagnosis of postural tachycardia syndrome (POTS).","authors":"Seiji Akera, Peter Novak","doi":"10.1007/s10286-026-01193-5","DOIUrl":"10.1007/s10286-026-01193-5","url":null,"abstract":"<p><strong>Purpose: </strong>Postural orthostatic tachycardia syndrome (POTS) is a common autonomic disorder characterized by orthostatic intolerance and excessive tachycardia upon standing. Despite its prevalence, POTS is often underdiagnosed or diagnosed late, largely due to limited access to autonomic specialists and testing. This study aimed to evaluate the performance of machine learning (ML) models in diagnosing POTS using validated symptom surveys and physiological measurements.</p><p><strong>Methods: </strong>We retrospectively analyzed data from patients evaluated at the Autonomic Laboratory at Brigham and Women's Faulkner Hospital (2017-2025), with POTS diagnoses confirmed by autonomic testing. ML models based on a multilayer perceptron were trained using patient-reported surveys (Survey of Autonomic Symptoms [SAS], COMPASS-31) and autonomic testing data. Importantly, no orthostatic heart rate criteria for the POTS diagnosis were provided to the models.</p><p><strong>Results: </strong>A total of 3210 patients were included, of whom 810 had confirmed POTS. All patients completed SAS; 1337 also completed COMPASS-31 (334 with POTS). Models incorporating heart rate data achieved the highest diagnostic accuracy (PyTorch/LightGBM: AUC 0.98/0.99; precision 0.94/0.93; F1 score 0.88/0.93; sensitivity 83%/92%; specificity 98%/98%). In contrast, models trained solely on SAS (AUC 0.68/0.63) or COMPASS-31 (AUC 0.66/0.62) performed poorly.</p><p><strong>Conclusion: </strong>ML models accurately diagnosed POTS when incorporating heart rate data alongside survey responses, with heart rate data being the strongest predictor. These findings suggest ML could assist in POTS diagnosis. The study also highlights the importance of heart rate measures in POTS diagnosis.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"367-372"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343444","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":"Vagal modulation in pediatric disorders of gut-brain interaction: the role of 24 h heart rate variability.","authors":"Gisela Chelimsky, Julian F Thayer, DeWayne P Williams, Le Kang, Thomas Chelimsky","doi":"10.1007/s10286-026-01186-4","DOIUrl":"10.1007/s10286-026-01186-4","url":null,"abstract":"<p><strong>Background: </strong>Disorders of gut-brain interaction (DGBI) are common in pediatrics. Though the name clearly implies a neural contribution, the role of the autonomic nervous system remains unclear. Heart rate in healthy subjects (HC) follows a circadian pattern with dipping during the night with increased high frequency (hf) heart rate variability (HRV) and root mean square of successive differences (RMSSD). Our hypothesis was that reduced vagal modulation in adolescents with DGBI is associated with blunted rise in nocturnal vagal modulation.</p><p><strong>Methods: </strong>An institutional review board (IRB) approved this study, which included children aged 12-18 years with a DGBI and carefully screened HC. All subjects underwent 24 h HRV recording. The following questionnaires/tools were included: Pain Catastrophizing Scale for Children (PCS-C), Pain Catastrophizing Scale for Parents (PCS-P), Revised Child Anxiety and Depression Scale (RCADS), Trauma Symptom Checklist for Children (TSCC), and Functional Disability Inventory (FDI).</p><p><strong>Results: </strong>In total, 12 HC and 15 participants with DGBI participated (female individuals with DGBI versus HC: 93% versus 58%, p = 0.08). There was no age difference (median [range] HC 16.6 years [13.4, 18.2]; DGBI 16.8 years [13.8, 18.7], p = 0.92). The 24 h, daytime and nighttime HRV demonstrated that RMSSD, low-frequency (lf) HRV, and high-frequency (hf) HRV were lower in the DGBI group (p < 0.001). A nocturnal rise in RMSSD was present in the DGBI group, but less so in the HC group (p = 0.021). Higher catastrophizing correlated with lower nocturnal RMSSD (PCS-C correlation coefficient [CC]: -0.46), depression (RCADS depression CC: -0.51), and post-traumatic stress disorder (PTSD; TSCC PTSD CC: -0.58).</p><p><strong>Conclusions: </strong>HRV is reduced in patients with DGBI with a blunted rise in nocturnal RMSSD at night. As expected, vagal modulation is inversely correlated with catastrophizing, depression, PTDS, and FDI, with nocturnal HRV showing generally better correlations than daytime HRV.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"341-346"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123925","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":"Peripheral neuron phenotypes of familial dysautonomia are rescued by AAV-mediated gene therapy.","authors":"Hsueh-Fu Wu, Tripti Saini, Jennifer Art, William Delaney, Frances Lefcort, Nadja Zeltner","doi":"10.1007/s10286-026-01206-3","DOIUrl":"10.1007/s10286-026-01206-3","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"417-421"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644249","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":"Autonomic debate: symptoms are an optimal target for orthostatic hypotension screening and management. An argument in opposition.","authors":"Paul A Beach","doi":"10.1007/s10286-026-01198-0","DOIUrl":"10.1007/s10286-026-01198-0","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"405-408"},"PeriodicalIF":4.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321393","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":"Correction: Heart rate variability provides prognostic value in multiple system atrophy.","authors":"Paulo Bastos, Marc Kermorgant, Margherita Fabbri, Frederic Roche, Vincent Pichot, Fabienne Ory-Magne, Clémence Leung, Olivier Rascol, Wassilios G Meissner, Alexandra Foubert-Samier, David Bendetowicz, Cécile Proust Lima, Anne Pavy-le-Traon","doi":"10.1007/s10286-026-01214-3","DOIUrl":"10.1007/s10286-026-01214-3","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"425"},"PeriodicalIF":3.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764113","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}