Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"Neuromodulation of heart rate variability: A systematic review","authors":"Rodrigo Souza ,&nbsp;Irinaldo Capítulino de Souza ,&nbsp;Suellen Mary Marinho do Santos Andrade ,&nbsp;Marcelo Rodrigo Portela Ferreira","doi":"10.1016/j.autneu.2026.103379","DOIUrl":"10.1016/j.autneu.2026.103379","url":null,"abstract":"<div><h3>Background</h3><div>Autonomic nervous system (ANS) dysfunction contributes to an increased risk of cardiovascular events. Non-invasive neuromodulation methods, such as transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and transcutaneous vagus nerve stimulation (tVNS), have been used to modulate the ANS. However, their comparative efficacy and optimal protocols remain uncertain due to study heterogeneity. This study aimed to verify the level of evidence for the effect of these neuromodulation methods on heart rate variability (HRV) and sympathovagal balance.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. Databases including Cochrane Library, Web of Science, PubMed, and Embase were searched up to October 2024. Randomized controlled trials (RCTs) that compared tDCS, TMS, or tVNS against control or sham conditions in humans, with HRV variables as an outcome, were included.</div></div><div><h3>Results</h3><div>Thirteen RCTs were included: 5 used tDCS, 6 used tVNS, and 2 used TMS. Significant heterogeneity was observed in the neuromodulation protocols. The meta-analysis found no statistically significant effects of tDCS on frequency-domain variables. Similarly, tVNS showed no significant effect on frequency- or time-domain variables. The quality of evidence for the main outcomes was rated as moderate for both tDCS and tVNS.</div></div><div><h3>Conclusion</h3><div>The current evidence on the effects of tDCS, TMS, and tVNS on HRV is limited and heterogeneous. These findings reinforce the need for methodological standardization in stimulation protocols and for studies with larger sample sizes to provide more robust clinical findings.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103379"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of Postural Orthostatic Tachycardia Syndrome (POTS): Findings from a physician chart-audit pre- and post-COVID-19","authors":"Joost J. van Middendorp ,&nbsp;Martina Orlovic ,&nbsp;Femke De Ruyck ,&nbsp;Montserrat Roset ,&nbsp;Mayara Torres ,&nbsp;Daniel Cuadras ,&nbsp;Josep Maria Garcia-Alamino ,&nbsp;Satish R. Raj ,&nbsp;Pam R. Taub ,&nbsp;Artur Fedorowski","doi":"10.1016/j.autneu.2025.103378","DOIUrl":"10.1016/j.autneu.2025.103378","url":null,"abstract":"<div><h3>Introduction</h3><div>Postural orthostatic tachycardia syndrome (POTS) is a complex disorder with challenging diagnosis and management.</div></div><div><h3>Methods</h3><div>This cross-sectional, multi-national, web-based physician chart audit described clinical features and management of POTS, offering insights into disease burden and outcomes before and after the COVID-19 pandemic.</div></div><div><h3>Results</h3><div>Physicians (<em>n</em> = 153), primarily cardiologists (77.1 %), reported data from 599 patients from two cohorts: 1) POTS not triggered by COVID-19 (<em>n</em> = 361) and 2) POTS triggered by COVID-19 (<em>n</em> = 238). Overall, most patients experienced POTS symptoms onset between the ages of 18 and 39 years (33 %), with 13 % presenting symptom onset before 18 years of age. Over 70 % had at least one pre-existing medical condition. Most patients underwent 5–8 tests to define POTS diagnosis. Around 80 % received incorrect diagnoses before POTS confirmation, and 25 % waited over a year for diagnosis. Although some patients showed reduction in symptom severity over time, symptoms were still persistent at last consultation. Non-pharmacological interventions were common in the first treatment line. In subsequent lines, there was an increase in pharmacological treatments, with beta-blockers and ivabradine being the most frequently prescribed medications. Comparative analysis between pre- and post-COVID-19 POTS showed that while POTS patients triggered by COVID-19 were somewhat older and had fewer comorbidities, differences were not clinically meaningful, suggesting similar diagnostic, management and treatment patterns. Regional differences in diagnoses and treatment patterns were observed between US and Europe.</div></div><div><h3>Conclusion</h3><div>This study highlights the challenges faced by POTS patients, while providing insights into the diagnostic and treatment approaches in real-world settings.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103378"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroendocrine, behavioral, cardiovascular and autonomic responses to acute and repeated restraint stress in male rats","authors":"Cristiane Busnardo ,&nbsp;Lucas Barreto-de-Souza ,&nbsp;Luana Omena-Giatti ,&nbsp;Taíz F.S. Brasil ,&nbsp;Heloísa H. Vilela-Costa ,&nbsp;Fernando M.A. Corrêa ,&nbsp;Carlos C. Crestani","doi":"10.1016/j.autneu.2025.103375","DOIUrl":"10.1016/j.autneu.2025.103375","url":null,"abstract":"<div><div>Biological systems seem to be differently affected by stress, resulting in expression of both adaptative and maladaptive responses. The present study aimed to compare the neuroendocrine (plasma corticosterone), behavioral (anxiogenic- and depressive-like effects), cardiovascular (blood pressure and heart rate) and autonomic (tail skin temperature and frequency-domain analysis of blood pressure and pulse interval variabilities) responses observed during an acute (single 2 h session) versus the 21st [2 h/day for 21 consecutive days) restraint stress session. We found that acute restraint stress reduced exploration of elevated plus maze (EPM) open arms, tail skin temperature and cardiac parasympathetic tonus; along with increased plasma corticosterone levels, blood pressure, heart rate and sympathetic modulation of both blood pressure and pulse interval. Repeated exposure to restraint completely inhibited or decreased the pressor, tachycardiac and sympathetic/parasympathetic responses; indicating habituation of autonomic and cardiovascular responses. Chronically stressed animals also had enhanced immobility in the forced swimming test and decreased grooming time in the splash test and exploration of EPM open arms, indicating anxiogenic- and depressive-like effects. Furthermore, chronic restraint stress elevated basal plasma corticosterone and tail skin temperature response. In summary, analysis of extensive set of physiological and behavioral responses to a chronic homotypic stressor indicates expression of adaptative adjustments evidenced mainly as habituation of the autonomic/cardiovascular changes. Nevertheless, maladaptive changes such as anxiogenic- and depressive-like effects and increased basal corticosterone were also observed.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103375"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective sympathetic action on heart rate variability after ultrasound-guided stellate ganglion block","authors":"Ole C. Keim ,&nbsp;Raoul C. Raum ,&nbsp;Robert E. Feldmann Jr ,&nbsp;Dieter Kleinboehl ,&nbsp;Justus Benrath","doi":"10.1016/j.autneu.2025.103367","DOIUrl":"10.1016/j.autneu.2025.103367","url":null,"abstract":"<div><h3>Objective</h3><div>Stellate ganglion block (SGB) blocks the sympathetic branch of the autonomous nervous system, but its specific effects on heart rate variability (HRV) remain widely unidentified in detail. Additionally, under anatomically perspective the vagus nerve is adjacent located to the stellate ganglion. Therefore, the vagus nerve may be affected by a SGB as well. This study aimed at assessing the possibility of selectively blocking efferent sympathetic fibers to the heart and upper extremity via an ultrasound-guided SGB technique.</div></div><div><h3>Methods</h3><div>In a placebo-controlled, double-blind trial based on a within-subject design, twelve healthy male volunteers received a right-sided ultrasound-guided SGB (usSGB) with 3 ml ropivacaine 1 % (verum) or saline 0.9 % solution (placebo), respectively. HRV was assessed during a pre- and post-intervention section.</div></div><div><h3>Results</h3><div>No significant changes were detected in time domain-based HRV indices before and after the usSGB between verum and placebo. However, significant differences between both were found in the low frequency/high frequency ratio (LF/HF ratio) before and after the procedure.</div></div><div><h3>Conclusion</h3><div>The current study demonstrates that usSGB renders HRV changes indicating selective sympathetic inhibition of the heart without affecting vagal tone.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103367"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supportive self-management in postural orthostatic tachycardia syndrome (POTS): A systematic review","authors":"Helen Eftekhari ,&nbsp;Gemma Pearce ,&nbsp;Akansha Singh ,&nbsp;Sophie Staniszewska ,&nbsp;Kate Seers","doi":"10.1016/j.autneu.2025.103342","DOIUrl":"10.1016/j.autneu.2025.103342","url":null,"abstract":"<div><h3>Aim</h3><div>This systematic review aimed to identify components of supportive self-management for postural orthostatic tachycardia syndrome and critically appraise the evidence base.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Data sources</h3><div>EMBASE, MEDLINE, CINHAL and charity databases, trial registries and grey literature were searched until December 14th, 2023.</div></div><div><h3>Review methods</h3><div>The PRISMA guidelines were followed for the search strategy. Data were mapped to the Practical Reviews in Self-management Support taxonomy components and the Middle Range Theory of Self-Care in Chronic Illness. Synthesis and analysis followed guidance on reporting without meta-analysis with summary tables, a logic model, harvest plot, and narrative synthesis.</div></div><div><h3>Results</h3><div>36 studies were included. Components of supportive self-management were found in 1) lifestyle advice, 2) provision of equipment, and 3) support with adherence. No studies were found on 1) education, 2) psychological well-being, 3) communication needs with health professionals and social support networks, 4) reliable sources of information, 5) training for practical self-management, or clinical action plans, and 5) social support. Studies efficacy’ was hampered by poor research designs, short studies of one day duration, and appropriateness of outcome measures.</div></div><div><h3>Conclusions</h3><div>Significant gaps were identified requiring further research 1) self-care monitoring activities 2) self-care management activities, 3) provision of education, information and resources 4) addressing psychological well-being and 5) addressing social support. A specific gap exists in the POTS evidence base in nurse led interventions.</div></div><div><h3>Impact</h3><div>This review evaluates supportive self-management components and identifies key issues with the current evidence base that require addressing to improve and inform the support needs and services of this often disabling, and predominantly female condition. This review is a novel integration of the taxonomy and theory.</div></div><div><h3>Patient and public contribution</h3><div>Findings were discussed with a postural tachycardia syndrome advisory group, providing important insights into key issues with the studies validity, reliability and generalisability from their perspectives</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103342"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymmetric neuroplasticity in stellate ganglia: Unveiling side-specific adaptations to aerobic exercise","authors":"Fernando Vagner Lobo Ladd ,&nbsp;Aliny Antunes Barbosa ,&nbsp;Renato Albuquerque de Oliveira Cavalcanti ,&nbsp;Larissa Freitas ,&nbsp;Reinaldo Barreto Oriá ,&nbsp;Ricardo Mario Arida ,&nbsp;Mariana Pereira de Melo ,&nbsp;Andrzej Loesch ,&nbsp;A. Augusto Coppi","doi":"10.1016/j.autneu.2025.103338","DOIUrl":"10.1016/j.autneu.2025.103338","url":null,"abstract":"<div><div>The stellate ganglia (SG) are a cluster of sympathetic nerve cells situated in the neck, positioned ventrally to the longus colli muscle and play a vital role in regulating cardiovascular function, especially by modulating cardiac sympathetic nerve activity. While the cardiovascular effects of exercise have been extensively studied, little is known about how physical activity influences the three-dimensional structure of SG neurons. Previous research in Wistar rats demonstrated that aerobic exercise training affects cardiovascular physiology, notably by decreasing heart rate without altering arterial pressures. Remarkably, hypertrophy of SG neurons was observed, suggesting a potential overload-induced adaptation. However, whether these structural changes exhibit side-specific patterns remain unclear. To address this gap, we investigated the effects of moderate-intensity aerobic exercise on SG structure with a focus on body-side asymmetry. Using advanced 3D image analysis and stereological methods, we quantified total neuron count, mean neuronal volume, and overall SG volume in four experimental groups: (1) untrained left SG, (2) trained left SG, (3) untrained right SG, and (4) trained right SG. After 10 weeks of treadmill exercise, trained animals displayed a fourfold increase in neuron count in the right SG compared to the left, an asymmetry absent in untrained animals. Additionally, exercise produced divergent effects on neuronal size: right-side neurons underwent atrophy (1.2-fold decrease), whereas left-side neurons exhibited hypertrophy (1.8-fold increase). In trained animals SG volume was reduced by 1.04- (left SG) or 1.4-fold (right SG) depending on the body side considered. These findings reveal a complex, side-specific neuroplastic response of the autonomic nervous system to physical exercise. The observed asymmetric changes in neuron count, size, and ganglia volume challenge traditional views on exercise-induced neuroplasticity, suggesting a more nuanced and functionally relevant adaptation. This study advances our understanding of autonomic nervous system plasticity in response to exercise and encourages further research into side-specific adaptations, with potential implications for targeted interventions in autonomic disorders, including those impacting cardiovascular function.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103338"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of taVNS in attenuating blood-brain barrier damage, promoting angiogenesis and improving impaired cognitive function in a rat model of vascular cognitive impairment and dementia by activating the Wnt7/β-catenin signaling pathway","authors":"Rongshan Sun ,&nbsp;Hong Li ,&nbsp;Meng Wang ,&nbsp;Long Yan ,&nbsp;Jinglei Jiang ,&nbsp;Qidi Liu ,&nbsp;Shijun Li ,&nbsp;Ying Liang ,&nbsp;Yulin Qian ,&nbsp;Tao Yu","doi":"10.1016/j.autneu.2025.103353","DOIUrl":"10.1016/j.autneu.2025.103353","url":null,"abstract":"<div><h3>Background</h3><div>Studies consistently demonstrate that vascular cognitive impairment and dementia (VCID) onset and progression are associated with diminished activity in the Wnt/β-catenin signaling pathway, crucial for maintaining blood-brain barrier (BBB) integrity and promoting angiogenesis in the central nervous system. Transcutaneous auricular vagal nerve stimulation (taVNS) has shown potential to enhance cognitive function by reducing BBB permeability and stimulating angiogenesis, yet its direct linkage to the Wnt7/β-catenin pathway activation remains uncertain and requires mechanistic validation.</div></div><div><h3>Methods</h3><div>A rat model of VCID was established by inducing temporary bilateral common carotid artery occlusion (tBCCAO) in rats. Following surgery, rats received daily taVNS treatments for 14 consecutive days (Days 13–26). Cognitive function was assessed on postoperative day 26. Additionally, the hippocampal region was analyzed to detect changes in the Wnt7/β-catenin signaling pathway-related proteins, neuronal injury and apoptosis, angiogenesis, BBB tight junction integrity, and astrocyte activation.</div></div><div><h3>Results</h3><div>TaVNS treatment resulted in significant cognitive improvements, alongside marked reductions in neuronal damage and apoptosis within the hippocampal CA1 region. It effectively decreased BBB permeability and enhanced angiogenesis. Mechanistically, taVNS suppressed astrocyte activation, promoted a shift from pro-inflammatory (A1) to anti-inflammatory (A2) phenotypes, and consequently upregulated the Wnt7/β-catenin signaling pathway, boosting expression of its downstream targets to foster neuroprotection and vascular repair.</div></div><div><h3>Conclusions</h3><div>This study confirms that taVNS effectively alleviates neurological damage in VCID by upregulating the Wnt7/β-catenin pathway, potentially through astrocyte phenotypic modulation. These findings underscore taVNS as a promising non-invasive intervention for cognitive deficits in vascular disorders, warranting further clinical investigation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103353"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial profiles of autonomic dysfunction","authors":"William S. Frye ,&nbsp;Sydney Ward ,&nbsp;Daniel Mauriello ,&nbsp;Brooke Mitchell ,&nbsp;Jamie Decker","doi":"10.1016/j.autneu.2025.103365","DOIUrl":"10.1016/j.autneu.2025.103365","url":null,"abstract":"<div><div>Forms of dysautonomia, including Postural Orthostatic Tachycardia Syndrome (POTS), significantly impacts youth, yet psychosocial aspects remain under-researched, particularly outside of patients diagnosed with POTS. This study examines the clinical and psychosocial profiles of youth with autonomic dysfunction and compares findings between groups with different heart rate (HR) responses to orthostatic testing.</div><div>This retrospective review analyzed demographics, symptoms, quality of life (QoL), and mental health variables (e.g., anxiety, depression, ADHD) in youth with autonomic dysfunction. Differences between higher and lower HR response groups were compared. QoL was assessed using the PedsQL™ and symptom severity was measured with the Malmö POTS Symptom Score (MAPS). Medical history and psychosocial concerns were extracted from electronic medical records.</div><div>Symptom severity scores exceeded clinical cutoffs for the full sample (65.8) and across HR groups. Independent <em>t</em>-tests showed no differences between groups for any variable. Pain (92.5 %) and impaired eating (42.5 %) were prevalent across the sample. QoL was clinically impaired in all domains, and mental health concerns, such as anxiety (83.3 %) and depression (54.3 %), were common.</div><div>Findings describe the pervasive symptom and psychosocial burden in youth with autonomic dysfunction, which was consistent across higher and lower HR response groups. The study emphasizes the importance of addressing medical, mental health, and daily life challenges in all patients seen for autonomic dysfunction. Additionally, it highlights the importance of expanding research and clinical focus to include all youth with autonomic dysfunction, regardless of HR response to ensure youth who are experiencing impairment obtain the comprehensive care they need.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103365"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic symptom burden, comorbidities and quality of life in women with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos syndrome","authors":"Meagan L. Collins Hutchinson ,&nbsp;Emily Liang ,&nbsp;Emily Fuster ,&nbsp;Svetlana Blitshteyn","doi":"10.1016/j.autneu.2025.103356","DOIUrl":"10.1016/j.autneu.2025.103356","url":null,"abstract":"<div><h3>Background</h3><div>Hypermobility Spectrum Disorders (HSD) and hypermobile Ehlers-Danlos syndrome (h-EDS) are multisystemic connective tissue disorders involving joint hypermobility and numerous other manifestations. Autonomic dysfunction, chronic pain, and chronic fatigue are known comorbidities of HSD and h-EDS that can affect patient quality of life (QoL), but there are limited data on the severity of autonomic symptoms, prevalence of comorbid conditions and QoL in patients with HSD/h-EDS.</div></div><div><h3>Methods</h3><div>We utilized the Composite Autonomic Symptom Scale (COMPASS-31) to assess autonomic symptom severity, Short-Form 36 (SF-36) to assess QoL, and the Beck Depression Inventory Second Edition (BDI-II) in a cohort of women with physician-diagnosed HSD or h-EDS, who completed these questionnaires anonymously.</div></div><div><h3>Results</h3><div>84 women (mean age of 37.1 ± 8.4 years) completed the study. 58.3 % reported having physician-diagnosed postural orthostatic tachycardia syndrome (POTS), 32.1 % had mast cell activation syndrome (MCAS), 54.8 % had migraine, 26.2 % had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and 98.8 % reported experiencing chronic pain. Importantly, 25 % of patients reported having all three diagnoses: HSD/h-EDS, POTS and MCAS. Mean COMPASS-31 score was 54.45 (range 18.79–80.93), indicating severe autonomic dysfunction, which was significantly higher than in patients with multiple sclerosis, diabetic neuropathy, scleroderma, and psoriatic arthritis as shown in prior studies. Mean SF-36 score was 32.38 (SD = 22.91) indicating poor QoL, which was worse than in patients with POTS, multiple sclerosis, rheumatoid arthritis, and lupus as determined by prior studies.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that women with HSD/h-EDS experience severe autonomic dysfunction, chronic pain, chronic comorbid conditions and reduced QoL. More than half of participants in this cohort had POTS and migraine, with one in four having a clinical triad of HSD/h-EDS, POTS and MCAS.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103356"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study","authors":"Smriti Badhwar ,&nbsp;Tania J. Pereira ,&nbsp;Kathleen Kerr ,&nbsp;Riina Bray ,&nbsp;Farah Tabassum ,&nbsp;Lauren Sergio ,&nbsp;Heather Edgell","doi":"10.1016/j.autneu.2025.103358","DOIUrl":"10.1016/j.autneu.2025.103358","url":null,"abstract":"<div><div>Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the prolonged sequelae after COVID-19 (&gt;3 months; Long COVID) have similar symptomology, are both associated with autonomic dysfunction, and a growing proportion of Long COVID patients are developing ME/CFS. We aimed to determine an autonomic phenotype of patients with ME/CFS vs Long COVID. We hypothesized that the groups would differ from controls yet be similar to one another. We recruited sedentary controls (<em>n</em> = 10), mild/moderate ME/CFS patients (<em>n</em> = 12), and Long COVID patients (<em>n</em> = 9) to undergo 1) breathing 5 % CO₂, 2) breathing 10 % O₂, and 3) 5-minutes of 70° head-up tilt. Respiratory, hemodynamic, and cerebrovascular variables were measured throughout the 3 trials. Resting vascular function and cognitive-motor-integration were also assessed. ME/CFS and Long COVID were similar to the healthy controls and each other with regard to resting vascular function and the hemodynamic responses to hypoxia, hypercapnia, and head-up tilt (<em>p</em> &gt; 0.05). However, in ME/CFS we observed a greater reduction of cerebrovascular resistance (<em>p</em> = 0.041) and impaired autoregulation (<em>p</em> = 0.042) during hypercapnia alongside impaired cognitive-motor integration (<em>p</em> &lt; 0.02), and in Long COVID we observed reduced peripheral and end-tidal oxygen (<em>p</em> &lt; 0.04) and less vagal withdrawal during tilt (<em>p</em> = 0.028). Our findings suggest unique phenotypes when comparing ME/CFS and Long COVID whereby we have shown that Long COVID patients experience hypoxia while upright contributing to less vagal withdrawal, and ME/CFS patients experience impaired cerebrovascular control during hypercapnia potentially leading to reduced cognitive-motor integration. These differences could stem from disease severity/duration or some unique aspect of the COVID-19 virus.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103358"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}