Clinical Autonomic Research最新文献

{"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":"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":"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 Macefield, Calogero Maria Oddo, Claudio Passino, Michele Emdin, Alberto Giannoni","doi":"10.1007/s10286-026-01227-y","DOIUrl":"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}

{"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}