Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"Autonomic dysfunction in polycystic ovary syndrome","authors":"Zoe H. Adams ,&nbsp;Lydia L. Simpson ,&nbsp;Emma C. Hart ,&nbsp;Rachel N. Lord","doi":"10.1016/j.autneu.2025.103357","DOIUrl":"10.1016/j.autneu.2025.103357","url":null,"abstract":"<div><div>Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting premenopausal females. Alongside the endocrine, reproductive and psychological consequences of the condition, PCOS has now been linked to increased risk of cardiovascular and metabolic disease e.g., insulin resistance. The mechanisms behind this excess risk are not fully understood and multiple characteristics of PCOS (e.g., hyperandrogenism, obesity and vascular dysfunction) likely contribute to individual risk. Autonomic dysfunction may also drive cardiovascular risk in PCOS, via its effects on both blood pressure control and the modulation of sex hormone release at the ovaries. Whilst current studies are limited by moderate sample sizes and one-off measurements, evidence broadly suggests that sympathetic activity may be increased, and vagal control of heart rate may be reduced in PCOS. In this review, we examine the potential mechanisms by which autonomic dysfunction may occur in PCOS. Finally, we discuss how PCOS may interact with ageing and ethnicity to modulate cardiovascular risk secondary to autonomic dysfunction.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103357"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350160","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":"Clinical features of paroxysmal sympathetic hyperactivity in brain tumor: a retrospective case series study and literature review","authors":"Ying Zhou,&nbsp;Guangqiang Chen,&nbsp;Guangzhi Shi","doi":"10.1016/j.autneu.2025.103352","DOIUrl":"10.1016/j.autneu.2025.103352","url":null,"abstract":"<div><h3>Background</h3><div>Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of brain tumor, mostly occurred after craniotomy for brain tumor resection. The purpose of this study is to characterize the pathogenesis and clinical features of PSH in brain tumor.</div></div><div><h3>Methods</h3><div>All PSH cases with brain tumor at a single center over a 4-year period were retrospectively identified based on medical records. A systematic literature review of the PSH cases with brain tumor was also conducted. PubMed and Web of Science databases were searched.</div></div><div><h3>Results</h3><div>We identified nine patients at our center and 14 patients in the literature with brain tumor and PSH. There were 10 adult patients and 13 pediatric patients with a median age of 13 years. Most tumors (96 %) were located in deep brain regions. The brainstem and adjacent structures were the most common tumor locations, accounting for 70 %. Glioma (39 %) was the most common pathology type. The onset of PSH occurred after tumor resection or biopsy in 18 patients, during tumor resection in two patients, and during conservative treatment in three patients. The most common PSH symptoms in brain tumor were hypertension (100 %) and tachycardia (96 %).</div></div><div><h3>Conclusions</h3><div>PSH is not only an underlying complication of brain tumor resection, but also a rare clinical manifestation of brain tumor. We speculate that damage to the midbrain or pons, especially close to the midline of the tegmentum, might be one of the lesion patterns underlying PSH.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103352"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423527","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":"Stellate ganglion blockade for the treatment of post-traumatic stress disorder: A systematic review and meta-analysis","authors":"Yihan Yang ,&nbsp;Ruifang Pu ,&nbsp;Diaofeng Zhang ,&nbsp;Jie Wu ,&nbsp;Wei Deng ,&nbsp;Guocan Shen ,&nbsp;Jiao Gao ,&nbsp;Bo Feng ,&nbsp;Liming Cheng ,&nbsp;Jiangang Li","doi":"10.1016/j.autneu.2025.103360","DOIUrl":"10.1016/j.autneu.2025.103360","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic stress disorder (PTSD) is a prevalent psychiatric condition linked to diminished health-related quality of life, physical difficulties, and significant socioeconomic expenses. The stellate ganglion block (SGB) approach is increasingly utilized in patients with PTSD. Due to its efficacy and the variety of treatment alternatives, there is an urgent necessity for consistent and high-quality evidence about the usefulness of this intervention. This study aimed to investigate the effectiveness of SGB in treating PTSD and its related symptoms.</div></div><div><h3>Methods</h3><div>A systematic search of the PubMed, EMBASE, Web of Science, Cochrane Library, Wan Fang, VIP, and China Knowledge Network databases was performed till November 2024. Risks of bias were analyzed, and the methodological quality of the available literature was assessed. Data extraction and meta-analysis of the studies were conducted to determine the validity of SGB.</div></div><div><h3>Results</h3><div>Following the evaluation of 394 records, two randomized controlled trials and one case-control trial were incorporated into this meta-analysis. The methodological rigor of the included randomized controlled trials was elevated. In comparison to the control group, the pooled mean difference (MD) in the post-traumatic stress scale (CAPS) scores was diminished by −6.24 (95 % CI [−10.71, −1.78], <em>P</em> = 0.006) in the random-effects model, indicating that SGB treatment alleviated the symptoms of patients with PTSD.</div></div><div><h3>Conclusion</h3><div>The SGB treatment demonstrates efficacy in alleviating symptoms in people with PTSD. Nonetheless, the limited quantity of randomized controlled trials included necessitates a more extensive collection of high-quality randomized controlled trials to substantiate this result further.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103360"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395283","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":"Vericiguat attenuates the dynamic gain of open-loop baroreflex function in a low-frequency range","authors":"Aimi Yokoi ,&nbsp;Toru Kawada ,&nbsp;Nana Hiraki ,&nbsp;Midori Kakuuchi ,&nbsp;Takuya Nishikawa ,&nbsp;Masafumi Fukumitsu ,&nbsp;Kei Sato ,&nbsp;Joe Alexander Jr ,&nbsp;Ryou Tanaka ,&nbsp;Keita Saku","doi":"10.1016/j.autneu.2025.103354","DOIUrl":"10.1016/j.autneu.2025.103354","url":null,"abstract":"<div><div>Vericiguat, a soluble guanylate cyclase stimulator, enhances the production of cyclic guanosine monophosphate through nitric oxide (NO)-dependent and -independent mechanisms. We examined the effects of vericiguat on the open-loop dynamic characteristics of the carotid sinus baroreflex. In anesthetized Wistar–Kyoto rats (<em>n</em> = 8), sympathetic nerve activity (SNA), arterial pressure (AP), and aortic flow were measured while varying carotid sinus pressure (CSP) according to a Gaussian white noise signal with a mean of 120 mmHg and a standard deviation of 20 mmHg. The neural arc transfer function from CSP to SNA, peripheral arc transfer function from SNA to AP, and total arc transfer function from CSP to AP were compared between the baseline conditions and during intravenous administrations of vericiguat (10 μg·kg⁻¹·min⁻¹). Vericiguat treatment reduced the asymptotic dynamic gain in the peripheral arc but not in the neural arc. It also reduced the asymptotic dynamic gain and increased the corner frequency in the total arc. These findings indicate low-frequency-dominant attenuation of dynamic gain, suggesting that vericiguat enhances the negative feedback regulation of vasoconstriction mediated by endogenous NO.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103354"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309840","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":"Sympathetic innervation of the temporomandibular joint modulates local hyperalgesia and IL-6 levels in zymosan-induced inflammatory pain","authors":"Livia E.C. Corrêa,&nbsp;Tales F.V. Rosin,&nbsp;Fernanda C. Medeiros,&nbsp;Isabela P. Leirão,&nbsp;Eduardo Colombari,&nbsp;Débora S.A. Colombari,&nbsp;Daniel B. Zoccal,&nbsp;Pedro L. Katayama","doi":"10.1016/j.autneu.2025.103351","DOIUrl":"10.1016/j.autneu.2025.103351","url":null,"abstract":"<div><div>The temporomandibular joint (TMJ) is critical for essential orofacial functions including chewing and speaking. Chronic pain and dysfunction of the TMJ and its associated structures are classified as temporomandibular disorders (TMDs) and represent a significant public health burden. However, the precise neurobiological mechanisms driving these conditions are still unclear. The autonomic nervous system, in particular the sympathetic nervous system, plays a modulatory role in joint homeostasis, inflammation, and pain. This study investigated the sympathetic innervation of the rat TMJ and its functional role in inflammatory hyperalgesia. We first mapped the origin of sympathetic innervation to the TMJ using retrograde tracing combined with immunostaining. After confirming that the TMJ receives sympathetic input predominantly from the ipsilateral superior cervical ganglion (SCG), we performed unilateral superior cervical ganglionectomy (SCG-X) to assess the impact of sympathetic denervation on zymosan-induced TMJ inflammatory hyperalgesia and local cytokine production. SCG-X procedure significantly exacerbated zymosan-induced mechanical hyperalgesia in the TMJ and markedly increased intra-articular interleukin-6 (IL-6) levels, while tumor necrosis factor-alpha (TNF-alpha) remained unaffected. These results demonstrate that the sympathetic nervous system exerts anti-hyperalgesic and anti-inflammatory roles in the TMJ by modulating local cytokine responses during acute inflammation. This study reveals a previously unidentified neuroimmune mechanism within the TMJ, providing a foundation for developing novel, targeted therapeutic strategies for TMDs.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103351"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287822","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":"Aging impairs urethral function in male rats: Increased outlet resistance and oxidative stress","authors":"Eduardo Costa Alexandre ,&nbsp;Alline Araujo Curiel ,&nbsp;Jessica Mariana Dias ,&nbsp;Fabio H. da Silva ,&nbsp;Edson Antunes ,&nbsp;Mariana G. de Oliveira","doi":"10.1016/j.autneu.2025.103355","DOIUrl":"10.1016/j.autneu.2025.103355","url":null,"abstract":"<div><div>Epidemiological studies identify age as the primary unmodifiable risk factor for male lower urinary tract symptoms (LUTS). While research has focused on the bladder and prostate, the urethra remains understudied. This study investigates aging-induced changes in rat urethral structure and function and their impact on voiding. Male Wistar rats, young (3.5 months) and middle-aged (10 months), were used. Cystometry assessed voiding in vivo, and isolated urethras were used in vitro. Middle-aged rats showed irregular micturition with increased basal pressure, bladder capacity, compliance, and non-voiding contractions, suggesting elevated outlet resistance. Histology showed no significant differences. Contractions to electrical-field stimulation and the α1-adrenoceptor agonist phenylephrine were enhanced, along with a twofold increase in α1A-adrenoceptor mRNA. Conversely, relaxation to nitric oxide (NO) donors sodium nitroprusside (SNP) and glyceryl trinitrate (GTN) was reduced, while responses to the cGMP analog 8Br-cGMP and the soluble guanylate cyclase (sGC) stimulator BAY 41-2272 were unchanged. Lower NO levels, despite increased endothelial NO synthase (eNOS) mRNA, were observed in middle-aged urethras, with no changes in neuronal NOS (nNOS) or sGC subunit β1. Phosphodiesterase type 5 (PDE5) mRNA was elevated, correlating with reduced basal and SNP-stimulated cGMP. Oxidative stress was evident, with increased superoxide and reduced expression of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT). NADPH oxidase 2 (NOX2) and xanthine dehydrogenase (XDH) mRNA were upregulated, while hypoxia-inducible factor 1-alpha (HIF1α) remained unchanged. In summary, middle-aged rats show urethral hypercontractility, impaired relaxation, and oxidative stress, without tissue remodeling or ischemia.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103355"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314191","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":"Age-related decrease in heat pain tolerance is associated with a simultaneous decline in C-fiber functionality and local cutaneous vasodilation","authors":"Bruno Rojas-Roel ,&nbsp;Julia Devanne ,&nbsp;Olivier Després ,&nbsp;Thierry Pebayle ,&nbsp;André Dufour ,&nbsp;Ségolène Lithfous","doi":"10.1016/j.autneu.2025.103361","DOIUrl":"10.1016/j.autneu.2025.103361","url":null,"abstract":"<div><div>This study aimed to investigate the role of cutaneous vasodilation in heat pain tolerance during aging. We hypothesized that reduced vasodilation in response to heat would lead to a less efficient heat dissipation, and thus be associated with diminished heat pain tolerance. Due to their efferent role in vasomotor function, we hypothesized that C-fiber functionality would be associated to the efficacy of cutaneous vasodilation. Twenty younger and forty older subjects participated in a 15-min heat pain tolerance test, during which pain ratings were continuously measured, along with skin temperature. Participants could terminate the test at any time if the pain became unbearable. A local thermal hyperemia protocol was conducted to assess cutaneous vasodilation using laser Doppler flowmetry. Warm detection and heat pain thresholds were measured to evaluate small fiber functionality. Older subjects were divided into two groups according to their pain tolerance duration. The older MAX group (n = 22; i.e., 55 %) completed the tolerance test, while the older LOW group did not. Older MAX had preserved cutaneous vasodilation compared to young subjects, whereas older LOW had reduced heat-induced vasodilation. In addition, the skin temperature of older LOW subjects reached a higher level during the pain tolerance test, which was associated to higher pain ratings compared to the two other groups. Older LOW also had higher warm detection threshold, pointing to diminished C-fiber functionality. Reduced cutaneous vasodilation, possibly linked to impaired C-fiber functionality in aging, affects heat pain tolerance due to less efficient heat dissipation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103361"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356829","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":"Lower urinary tract dysfunction reported in autonomic disorders","authors":"Ekawat Vichayanrat ,&nbsp;Shiwen Koay ,&nbsp;Claire Hentzen ,&nbsp;Sarah Wright ,&nbsp;Amit Batla ,&nbsp;Sara Simeoni ,&nbsp;Valeria Iodice ,&nbsp;Jalesh N. Panicker","doi":"10.1016/j.autneu.2025.103341","DOIUrl":"10.1016/j.autneu.2025.103341","url":null,"abstract":"","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103341"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103259","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":"Antihypertensive effects of the treatment with ATZ and losartan in L-NAME hypertensive rats","authors":"Roberto Braz Pontes,&nbsp;Paulo Ricardo Lopes,&nbsp;Débora S.A. Colombari,&nbsp;Patrícia M. De Paula,&nbsp;Eduardo Colombari,&nbsp;Carina A.F. Andrade,&nbsp;Laurival A. De Luca Jr,&nbsp;José V. Menani","doi":"10.1016/j.autneu.2025.103359","DOIUrl":"10.1016/j.autneu.2025.103359","url":null,"abstract":"<div><div>Previous works suggest that hydrogen peroxide (H₂O₂), a reactive oxygen species, attenuates brain angiotensin II-mediated hypertension in rats. Moreover, the subcutaneous (s.c.) administration of 3-amino-1,2,4-triazole (ATZ), a catalase inhibitor that increases H₂O₂ availability, reduces hypertension and sympathetic activity simultaneously with an increase in angiotensinergic activity in spontaneously hypertensive rats (SHRs). It is not clear how much the increase in angiotensinergic activity affects the sympatho-inhibition and the antihypertensive effect of ATZ, and if this is specific for SHRs. The present study evaluated the effects of s.c. ATZ and losartan (angiotensin II AT1 antagonist), alone or combined for 7 days, on mean arterial pressure (MAP) in nitric oxide synthase-inhibited hypertensive rats (L-NAME model). In addition, angiotensinergic and sympathetic activities were also investigated using acute intravenous losartan and hexamethonium (ganglionic blocker) in the same rats. The treatment with ATZ + losartan s.c. reduced MAP slightly below to normotensive levels in L-NAME hypertensive rats (88 ± 8, vs. L-NAME + saline: 162 ± 7 mmHg), whereas s.c. losartan alone partially reduced MAP (133 ± 7 mmHg). The hypotensive responses produced by hexamethonium were reduced in rats treated with ATZ + losartan s.c. (−44 ± 12, vs. L-NAME + saline: −71 ± 6 mmHg), suggesting that the treatment with ATZ + losartan s.c. significantly reduced sympathetic activation in L-NAME-treated rats. These findings suggest that the combination of ATZ and losartan efficiently blocks sympathetic and angiotensinergic activation in L-NAME hypertensive rats, abolishing hypertension. Further research is necessary on the mechanisms of H₂O₂ and ATZ antihypertensive action.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103359"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363495","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 responses in children and adolescents with orthostatic syncope and presyncope: children are not small adults","authors":"V.-E.M. Lucci ,&nbsp;C.L. Protheroe ,&nbsp;C.A. Albaro ,&nbsp;M.G. Lloyd ,&nbsp;K. Armstrong ,&nbsp;S. Franciosi ,&nbsp;S. Sanatani ,&nbsp;V.E. Claydon","doi":"10.1016/j.autneu.2025.103340","DOIUrl":"10.1016/j.autneu.2025.103340","url":null,"abstract":"<div><div>Children and adolescents commonly experience orthostatic intolerance associated with impaired participation and quality of life. We aimed to characterize autonomic responses to provoked presyncope in children with recurrent presyncope/syncope and healthy adolescents.</div><div>We determined orthostatic tolerance (OT, time to presyncope [mins]) in 36 pediatric patients (age 15 ± 3 yrs., 26 female) with recurrent presyncope/syncope, and 17 asymptomatic controls (age 13 ± 3 yrs., 8 female), using a tilt test with graded lower body negative pressure. Cardiovascular parameters, forearm vascular resistance (FVR), mean middle cerebral artery velocity (MCAv_mean), and breath-by-breath end tidal gases were continuously monitored. Responses to the Valsalva maneuver (VM), cerebral autoregulation, and cerebral reactivity to carbon dioxide were also determined.</div><div>OT was similar in pediatric patients (21 ± 1.5 min) and controls (20 ± 2.0 min, <em>p</em> = 0.74), but smaller than adult reference values (33.8 ± 0.8 min, <em>p</em> &lt; 0.01). Tilting decreased systolic arterial pressure in pediatric patients (<em>p</em> = 0.009), but not pediatric controls (<em>p</em> = 0.12). Tilting decreased MCAv_mean (<em>p</em> = 0.002) in pediatric patients, with impairments in cerebral autoregulation (<em>p</em> = 0.02) that were negatively correlated with OT (<em>r</em> = −0.322; <em>p</em> = 0.024). Both pediatric patients (+48.9 ± 8.0 %) and controls (+36.7 ± 14.7 %) had small FVR responses compared to adult reference data (+100 ± 12 %, <em>p</em> &lt; 0.01). Blood pressure responses to the VM were abnormal in pediatric patients, with a lower nadir in mean arterial pressure (81.7 ± 2.0 mmHg) compared to pediatric controls (94.0 ± 2.8 mmHg, <em>p</em> = 0.001).</div><div>Pediatric patients with recurrent presyncope/syncope had impaired orthostatic cardiovascular and autoregulatory responses compared to pediatric controls. Sympathetically-mediated responses were small in children, underscoring the need for pediatric-specific standards for orthostatic cardiovascular control, and treatments targeting enhancement of vascular resistance in children with syncope.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103340"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093218","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}