Clinical autonomic research : official journal of the Clinical Autonomic Research Society最新文献

{"title":"Norepinephrine reuptake blockade to treat neurogenic orthostatic hypotension.","authors":"Graeme Eisenhofer, David S Goldstein","doi":"10.1007/s10286-021-00808-3","DOIUrl":"https://doi.org/10.1007/s10286-021-00808-3","url":null,"abstract":"","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"351-353"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00808-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38983582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and neuroendocrinological characteristics of delayed orthostatic hypotension in Parkinson's disease.","authors":"Tomotaka Shiraishi,&nbsp;Tadashi Umehara,&nbsp;Hisayoshi Oka,&nbsp;Atsuo Nakahara,&nbsp;Takeo Sato,&nbsp;Hiromasa Matsuno,&nbsp;Teppei Komatsu,&nbsp;Shusaku Omoto,&nbsp;Hidetomo Murakami,&nbsp;Yasuyuki Iguchi","doi":"10.1007/s10286-020-00758-2","DOIUrl":"https://doi.org/10.1007/s10286-020-00758-2","url":null,"abstract":"<p><strong>Purpose: </strong>Delayed orthostatic hypotension (DOH), a fall in blood pressure after a 3-min cutoff, is clinically meaningful. The aim of this study was to elucidate the clinical and neuroendocrinological characteristics of DOH in patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>A total of 132 patients with newly diagnosed PD were enrolled. Baseline clinical characteristics, including olfactory function, and changes in norepinephrine (NE) and vasopressin (ADH) concentrations during the head-up tilt test (HUT), were examined.</p><p><strong>Results: </strong>Fifty-five patients (42%) had classical orthostatic hypotension (COH), and 19 patients (14%) had DOH. Patients with COH and DOH tended to have more severe hyposmia than patients without OH. A multivariate linear regression model showed that hyposmia was associated with DOH and COH. The increase of heart rate against the fall in blood pressure was significantly lower in patients with COH and DOH than those without OH. The NE levels at supine rest and after upright tilting were lower in the COH group than in the PD without OH and DOH groups. The levels of ADH were higher in the DOH group than in the COH group at supine rest and higher than in the PD without OH group after upright tilting. There was no significant difference in the cardiac ¹²³I-MIBG scintigraphy between the COH and DOH groups.</p><p><strong>Conclusion: </strong>Compared with patients without OH, patients with DOH had severe hyposmia. Relatively preserved peripheral sympathetic nervous system function in patients with DOH suggests that DOH might be an early and milder form of OH in PD.</p>","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"425-431"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-020-00758-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38866258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the best method to diagnose a vasovagal syncope?","authors":"Wouter Wieling,&nbsp;Horacio Kaufmann","doi":"10.1007/s10286-021-00809-2","DOIUrl":"https://doi.org/10.1007/s10286-021-00809-2","url":null,"abstract":"","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"347-349"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00809-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38959469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The new frontier in pure autonomic failure: getting a grip on cerebral blood flow.","authors":"Jurgen A H R Claassen","doi":"10.1007/s10286-021-00806-5","DOIUrl":"https://doi.org/10.1007/s10286-021-00806-5","url":null,"abstract":"","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"355-357"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00806-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39031138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-COVID postural tachycardia syndrome: an American Autonomic Society statement.","authors":"Satish R Raj,&nbsp;Amy C Arnold,&nbsp;Alexandru Barboi,&nbsp;Victoria E Claydon,&nbsp;Jacqueline K Limberg,&nbsp;Vera-Ellen M Lucci,&nbsp;Mohammed Numan,&nbsp;Amanda Peltier,&nbsp;Howard Snapper,&nbsp;Steven Vernino","doi":"10.1007/s10286-021-00798-2","DOIUrl":"https://doi.org/10.1007/s10286-021-00798-2","url":null,"abstract":"<p><p>COVID-19 is a global pandemic that has had a devastating effect on the health and economy of much of human civilization. While the acute impacts of COVID-19 were the initial focus of concern, it is becoming clear that in the wake of COVID-19, many patients are developing chronic symptoms that have been called Long-COVID. Some of the symptoms and signs include those of postural tachycardia syndrome (POTS). Understanding and managing long-COVID POTS will require a significant infusion of health care resources and a significant additional research investment. In this document from the American Autonomic Society, we outline the scope of the problem, and the resources and research needed to properly address the impact of Long-COVID POTS.</p>","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"365-368"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00798-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral cortical autonomic connectivity in low-risk term newborns.","authors":"Sarah B Mulkey,&nbsp;Laura Hitchings,&nbsp;Reva Persaud,&nbsp;Srinivas Kota,&nbsp;G Larry Maxwell,&nbsp;Robin Baker,&nbsp;Adre du Plessis,&nbsp;Rathinaswamy Govindan","doi":"10.1007/s10286-021-00793-7","DOIUrl":"https://doi.org/10.1007/s10286-021-00793-7","url":null,"abstract":"<p><strong>Purpose: </strong>The mature central autonomic network includes connectivity between autonomic nervous system brainstem centers and the cerebral cortex. The study objective was to evaluate the regional connectivity between the cerebral cortex and brainstem autonomic centers in term newborns by measuring coherence between high-density electroencephalography and heart rate variability as measured by electrocardiography.</p><p><strong>Methods: </strong>Low-risk term newborns with birth gestational age of 39-40 weeks were prospectively enrolled and studied using time-synced electroencephalography and electrocardiography for up to 60 min before discharge from the birth hospital. The ccortical autonomicc nervous system association was analyzed using coherence between electroencephalography-delta power and heart rate variability. Heart rate variability measured the parasympathetic tone (root mean square of successive differences of heart rate) and sympathetic tone (standard deviation of heart rate).</p><p><strong>Results: </strong>One hundred and twenty-nine low-risk term infants were included. High coherence delta-root mean square of successive differences was found in central, bitemporal, and occipital brain regions, with less robust coherence delta-standard deviation in the central region and bitemporal areas.</p><p><strong>Conclusions: </strong>Our findings describe a topography of ccortical autonomicc connectivity present at term in low-risk newborns, which was more robust to parasympathetic than sympathetic brainstem centers and was independent of newborn state.</p>","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"415-424"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00793-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25477538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of Ross syndrome associated with systemic sclerosis.","authors":"Guillaume Lamotte,&nbsp;Paola Sandroni","doi":"10.1007/s10286-021-00773-x","DOIUrl":"https://doi.org/10.1007/s10286-021-00773-x","url":null,"abstract":"","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"463-465"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00773-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25329473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated cerebral blood flow in patients with pure autonomic failure.","authors":"Paula Trujillo,&nbsp;Olivia C Roman,&nbsp;Kaitlyn R Hay,&nbsp;Meher R Juttukonda,&nbsp;Yan Yan,&nbsp;Hakmook Kang,&nbsp;Sachin Y Paranjape,&nbsp;Emily M Garland,&nbsp;Cyndya A Shibao,&nbsp;Italo Biaggioni,&nbsp;Manus J Donahue,&nbsp;Daniel O Claassen","doi":"10.1007/s10286-021-00792-8","DOIUrl":"https://doi.org/10.1007/s10286-021-00792-8","url":null,"abstract":"<p><strong>Purpose: </strong>Pure autonomic failure (PAF) results from an impaired peripheral autonomic nervous system, and clinical symptoms present with orthostatic hypotension. While the impact on cardiovascular indices of orthostatic intolerance are well-characterized, more limited information is available regarding cerebral hemodynamic dysfunction in PAF. The objective of this study was to test the hypothesis that cerebral blood flow (CBF) is reduced in PAF, and to quantify the relationship between CBF and clinical indicators of disease severity, including peripheral supine arterial blood pressure.</p><p><strong>Methods: </strong>Participants with PAF (n = 17) and age- and sex-matched normotensive healthy controls (n = 17) were examined using established clinical rating scales, cardiovascular autonomic function tests, and 3T MRI measurements of CBF. CBF-weighted images were also used to determine the prevalence of venous hyperintensities from the major dural sinuses as evidence of abnormal capillary flow. Nonparametric tests and general linear models were used to evaluate differences and correlations between study variables.</p><p><strong>Results: </strong>Gray matter CBF was higher in PAF (51.1 ± 13.4 mL/100 g/min) compared to controls (42.9 ± 6.5 mL/100 g/min, p = 0.007). Venous hyperintensities were more prevalent in PAF relative to controls, and the presence and degree of venous hyperintensities was associated with higher mean CBF (p = 0.027). In PAF participants, CBF and supine systolic blood pressure were inversely related (Spearman's rho = -0.545, p = 0.024).</p><p><strong>Conclusions: </strong>Findings suggest that PAF patients may exhibit elevated CBF and provide evidence that this condition exerts a hemodynamic impact in the central nervous system.</p>","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"405-414"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00792-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25444398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and pharmacodynamics of ampreloxetine, a novel, selective norepinephrine reuptake inhibitor, in symptomatic neurogenic orthostatic hypotension.","authors":"Arthur Lo,&nbsp;Lucy Norcliffe-Kaufmann,&nbsp;Ross Vickery,&nbsp;David Bourdet,&nbsp;Jitendra Kanodia","doi":"10.1007/s10286-021-00800-x","DOIUrl":"https://doi.org/10.1007/s10286-021-00800-x","url":null,"abstract":"<p><strong>Purpose: </strong>Ampreloxetine is a novel, selective, long-acting norepinephrine reuptake (NET) inhibitor being investigated as a once-daily oral treatment for symptomatic neurogenic orthostatic hypotension (nOH) in patients with autonomic synucleinopathies. The purpose of this study was to characterize the pharmacokinetic and pharmacodynamic profiles of ampreloxetine in this target population.</p><p><strong>Methods: </strong>Patients with nOH were enrolled in a multicenter, phase II clinical trial of ampreloxetine (NCT02705755). They received escalating doses over 5 days in the clinical research unit, followed by 20 weeks of open-label treatment and then a 4-week withdrawal. As neurochemical biomarkers of NET inhibition, we assayed plasma concentrations of norepinephrine (NE) and its main intraneuronal metabolite 3,4-dihydroxyphenylglycol (DHPG) pre- and post-ampreloxetine.</p><p><strong>Results: </strong>Thirty-four patients with nOH were enrolled. Plasma ampreloxetine concentrations increased with repeated escalating doses, with peak concentrations observed 6-9 h post-drug administration. The median ampreloxetine dose in the 20-week treatment phase was 10 mg once daily. Plasma ampreloxetine concentrations reached steady state by 2 weeks, with stable plasma levels over 24 h. No influence of age or renal function on ampreloxetine plasma concentrations was observed. On treatment, compared to baseline, plasma NE significantly increased by 71% (p < 0.005), plasma DHPG significantly declined by 22% (p < 0.05), and the NE:DHPG ratio significantly increased (p < 0.001).</p><p><strong>Conclusions: </strong>Persistent elevation of plasma NE levels accompanied by reduced DHPG levels after ampreloxetine suggests reduced neuronal reuptake and metabolism of NE in postganglionic efferent sympathetic neurons. The findings are consistent with long-lasting NET inhibition, which may increase vasoconstrictor tone, supporting once-daily ampreloxetine dosing in patients with nOH.</p>","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"395-403"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00800-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do not sweat it: we test while you rest and other updates on recent autonomic research.","authors":"Mitchell G Miglis,&nbsp;Nicholas Larsen,&nbsp;Srikanth Muppidi","doi":"10.1007/s10286-021-00811-8","DOIUrl":"https://doi.org/10.1007/s10286-021-00811-8","url":null,"abstract":"","PeriodicalId":354493,"journal":{"name":"Clinical autonomic research : official journal of the Clinical Autonomic Research Society","volume":" ","pages":"361-363"},"PeriodicalIF":5.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s10286-021-00811-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38984987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}