Clinical Autonomic Research最新文献

{"title":"Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management.","authors":"Anush Barkhudaryan, Wolfram Doehner, Nadja Jauert","doi":"10.1007/s10286-025-01120-0","DOIUrl":"10.1007/s10286-025-01120-0","url":null,"abstract":"<p><strong>Purpose: </strong>Central autonomic dysfunction is common in acute stroke and is associated with cardiovascular complications and increased mortality. The aim of this review is to present novel diagnostic and therapeutic approaches to the management of this disorder and the latest data on its impact on the clinical outcome after stroke.</p><p><strong>Methods: </strong>We performed a narrative review of recent literature, with a particular focus on articles related to underlying pathophysiological mechanisms of cardiac autonomic dysregulation, the role of cardiac autonomic dysregulation in the activation of neuroinflammatory response and the development of cardiovascular, respiratory and metabolic complications in patients with ischemic and hemorrhagic stroke.</p><p><strong>Results: </strong>The assessment of central autonomic dysfunction by non-invasive diagnostic techniques, including heart rate variability and baroreflex sensitivity, has gained wide practical application in recent years, and they may have a predictive role for evaluating disease prognosis. The emerging evidence derived from recent trials demonstrates that the presence of autonomic imbalance may lead to increased mortality and have an adverse effect on post-stroke rehabilitation.</p><p><strong>Conclusion: </strong>The early detection and treatment of central autonomic system dysfunction may lead to improved survival of patients with stroke. Among the available therapeutic approaches, neuromodulatory techniques and pharmacological interventions are promising strategies which may be implemented as part of standard acute stroke care to improve patient recovery. Future studies are warranted to address the long-term effects of potential therapeutic agents on the modulation of cardiovascular autonomic function in stroke survivors.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"553-563"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708824","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: Autonomic dysfunction after stroke: an overview of recent clinical evidence and perspectives on therapeutic management.","authors":"Anush Barkhudaryan, Wolfram Doehner, Nadja Jauert","doi":"10.1007/s10286-025-01127-7","DOIUrl":"10.1007/s10286-025-01127-7","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"565-566"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526566","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 nervous system abnormalities in children with inflammatory bowel disease and irritable bowel syndrome: a comparative study.","authors":"Paola Ruška, Antonella Jerković, Sara Sila, Ana Močić Pavić, Magdalena Krbot Skorić, Mario Habek, Iva Hojsak","doi":"10.1007/s10286-025-01134-8","DOIUrl":"10.1007/s10286-025-01134-8","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the subjective and objective autonomic nervous system (ANS) abnormalities in children with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) compared with healthy children (HC).</p><p><strong>Methods: </strong>In total, 69 children were enrolled: 23 in the IBD, 28 in the IBS, and 18 HC group. ANS symptoms were evaluated using the Composite Autonomic Symptom Score (COMPASS-31). The severity and distribution of ANS function were quantitated using adrenergic, cardiovagal, and sudomotor indices of the Composite Autonomic Severity Scale (CASS). Health-related quality of life (HRQoL) was assessed with the Pediatric Quality of Life Inventory (PedsQL).</p><p><strong>Results: </strong>Children with IBS scored highest on the COMPASS-31, followed by patients with IBD and HC (median 11.5, 6.3, and 1.7, respectively; p = 0.001). There was no significant difference between groups in CASS (p = 0.09); however, children with IBD had a higher score on the sudomotor index (p = 0.012). There was a significant difference in symptomatic autonomic dysfunction (defined as COMPASS-31 > 7.913 and CASS > 0) between children with IBS (61.5%) compared with children with IBD (42.1%) and HC (7.1%), p = 0.004. In multivariable logistic regression, the number of squats decreased the probability of special health care needs by 17.2%, and the presence of symptomatic autonomic dysfunction increased the probability by 515.4%.</p><p><strong>Conclusions: </strong>The ANS is frequently affected in children with IBD and IBS; children with IBS show greater autonomic symptom burden, while children with IBD have greater sudomotor dysfunction. HRQoL is significantly influenced by observed ANS changes in both groups.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"591-600"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092836","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":"A reset on our reclined position-a call to prioritize neurogenic supine hypertension in the synucleinopathies.","authors":"Cameron Miller-Patterson, Abhishek Lenka, Stephen Juraschek, Jeanie Park, Paul A Beach","doi":"10.1007/s10286-025-01140-w","DOIUrl":"10.1007/s10286-025-01140-w","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"545-551"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324599","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":"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":"581-590"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","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":"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":"10.1007/s10286-025-01133-9","url":null,"abstract":"","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":"629-632"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","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":"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":"567-580"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","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":"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":"https://doi.org/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":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-28","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":"Prevalence and impact of orthostatic hypotension in Parkinson's disease: a systematic review and meta-analysis.","authors":"Hui Wang, Chi Zhang, Dongxun Xu","doi":"10.1007/s10286-025-01146-4","DOIUrl":"https://doi.org/10.1007/s10286-025-01146-4","url":null,"abstract":"<p><strong>Objective: </strong>Parkinson's disease (PD) is frequently associated with orthostatic hypotension (OH). Research on the prevalence of OH in PD and its effects on patients has produced inconsistent findings.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted by searching for studies related to PD and OH in the PubMed, Web of Science, Embase, and Cochrane databases. Data were pooled as necessary to calculate the prevalence of OH in patients with PD, along with odds ratios (OR), weighted mean differences (WMD), or standardized mean differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>The prevalence of OH in patients with PD was found to be 33.1% (95% CI 29.3-37%) in a pooled sample of 7748 subjects. Patients with PD and OH were significantly older at the time of examination (WMD 2.92 years) and had a longer disease duration (WMD 0.71 years) compared with those without OH. There was no significant difference in the distribution of sex, or in the scores of the Unified Parkinson's Disease Rating Scale (UPDRS)/the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts I and II, as well as the total scores among patients with Parkinson's disease with or without OH. In addition, patients with PD and OH exhibited significantly higher UPDRS/MDS-UPDRS scores across part III section scores (SMD 0.41, 95% CI 0.23-0.59).</p><p><strong>Conclusions: </strong>The prevalence of OH in PD is 33.1%. Patients with PD and OH are generally older at examination, have a longer disease duration, and display more severe motor symptoms compared with those without OH.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717602","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":"Acetate concentration correlates with MSNA in patients with resistant hypertension.","authors":"Revathy Carnagarin, Gianni Sesa-Ashton, Natalie C Ward, Janis Nolde, Anu Joyson, Justine Chan, Ancy Jose, Markus P Schlaich","doi":"10.1007/s10286-025-01144-6","DOIUrl":"https://doi.org/10.1007/s10286-025-01144-6","url":null,"abstract":"<p><strong>Purpose: </strong>Short-chain fatty acids (SCFAs), metabolites of colonic microflora fermentation of dietary fibre, have been implicated in experimental models and clinical trials to impact blood pressure (BP) regulation. Dietary interventions increasing serum SCFA levels have been associated with reduced 24-h systolic BP in hypertensive patients. However, the underlying mechanisms remain elusive. Given the role of the gut-brain axis and clear evidence for sympathetic nervous system activation as important modulators of blood pressure, we examined the relationship between sympathetic drive and SCFA concentration in patients with resistant hypertension (RH) and healthy control subjects (HC).</p><p><strong>Methods: </strong>A total of 21 patients with RH (68.6 ± 9.7 years, 47% male) and 28 healthy control subjects (HC) (34.6 ± 16.7 years, 75% male) were recruited to undergo microneurography for determination of muscle sympathetic nerve activity (MSNA), automated office BP (AOBP) and blood collection for serum SCFA.</p><p><strong>Results: </strong>Mean systolic AOBP was 156 ± 21 mmHg and 115 ± 10 mmHg for RH and HC, respectively (p < 0.0001). Serum acetate levels were 1340 ± 115.4 umol/L for HC and 724.5 ± 116.9 umol/L for RH (p < 0.0001). Butyrate and propionate concentrations did not significantly differ between groups. MSNA burst frequency was markedly elevated in RH compared with HCs (p < 0.001), with 25.3 ± 7.4 burst/minute in HC compared with 40.24 ± 8.3 burst/minute in RH. An inverse relationship was evident between serum acetate levels and MSNA burst frequency (p = 0.0267, R² = 0.4) along with increased sympathetic vascular transduction (p = 0.0008, R² = 0.82) in RH.</p><p><strong>Conclusions: </strong>Our findings suggest that the beneficial effects of SCFA levels, in particular acetate, on cardiovascular regulation may at least in part be mediated by sympatho-inhibition and altered sympathetic vascular transduction.</p>","PeriodicalId":10168,"journal":{"name":"Clinical Autonomic Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658586","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}