-
Physical Medicine and Rehabilitation... Aug 2023Persistence of symptoms beyond the initial acute phase of coronavirus disease-2019 (COVID-19) is termed postacute SARS-CoV-2 (PASC) and includes neurologic, autonomic,... (Review)
Review
Persistence of symptoms beyond the initial acute phase of coronavirus disease-2019 (COVID-19) is termed postacute SARS-CoV-2 (PASC) and includes neurologic, autonomic, pulmonary, cardiac, psychiatric, gastrointestinal, and functional impairment. PASC autonomic dysfunction can present with dizziness, tachycardia, sweating, headache, syncope, labile blood pressure, exercise intolerance, and "brain fog." A multidisciplinary team can help manage this complex syndrome with nonpharmacologic and pharmacologic interventions.
Topics: Humans; SARS-CoV-2; COVID-19; Autonomic Nervous System Diseases; Syncope; Syndrome
PubMed: 37419532
DOI: 10.1016/j.pmr.2023.04.003 -
Autonomic Neuroscience : Basic &... Dec 2020Although there is considerably more data showing an association between type 2 diabetes mellitus (T2DM) and autonomic neuropathy, accumulating evidence indicates that... (Review)
Review
Although there is considerably more data showing an association between type 2 diabetes mellitus (T2DM) and autonomic neuropathy, accumulating evidence indicates that cardiovascular autonomic neuropathy (CAN) is common in persons with impaired glucose tolerance (IGT). Furthermore, CAN may occur early after a metabolic insult and obesity, especially among mean, and seems to play an important role in the early pathogenesis of CAN. Autonomic symptoms are common in subjects with IGT. In addition to defects in CAN, in subjects with IGT, there is impaired sudomotor function and abnormalities of endothelial peripheral vasoreactivity. At the present time, the only interventions that may be effective in preventing or reversing IGT associated autonomic neuropathy are lifestyle improvement. These include a tailored diet and exercise program. Other approaches that may be beneficial include modulation of oxidative stress and improvement of metabolic regulation in subjects with IGT. Interventions are most likely to be effective early in the course of disease and therefore it is extremely important to have early diagnosis of IGT and autonomic neuropathy.
Topics: Autonomic Nervous System Diseases; Diabetic Neuropathies; Heart Diseases; Humans; Prediabetic State
PubMed: 33011523
DOI: 10.1016/j.autneu.2020.102722 -
Postgraduate Medical Journal Feb 2006Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical... (Review)
Review
Diabetic neuropathy (DN) refers to symptoms and signs of neuropathy in a patient with diabetes in whom other causes of neuropathy have been excluded. Distal symmetrical neuropathy is the commonest accounting for 75% DN. Asymmetrical neuropathies may involve cranial nerves, thoracic or limb nerves; are of acute onset resulting from ischaemic infarction of vasa nervosa. Asymmetric neuropathies in diabetic patients should be investigated for entrapment neuropathy. Diabetic amyotrophy, initially considered to result from metabolic changes, and later ischaemia, is now attributed to immunological changes. For diagnosis of DN, symptoms, signs, quantitative sensory testing, nerve conduction study, and autonomic testing are used; and two of these five are recommended for clinical diagnosis. Management of DN includes control of hyperglycaemia, other cardiovascular risk factors; alpha lipoic acid and L carnitine. For neuropathic pain, analgesics, non-steroidal anti-inflammatory drugs, antidepressants, and anticonvulsants are recommended. The treatment of autonomic neuropathy is symptomatic.
Topics: Aldehyde Reductase; Antioxidants; Autonomic Nervous System Diseases; Chronic Disease; Diabetic Neuropathies; Humans; Nootropic Agents; Pain; Risk Factors; Thioctic Acid
PubMed: 16461471
DOI: 10.1136/pgmj.2005.036137 -
Clinical Autonomic Research : Official... Jun 2023
Topics: Humans; Autonomic Nervous System Diseases; Obesity; Autonomic Nervous System
PubMed: 37273037
DOI: 10.1007/s10286-023-00957-7 -
Journal of Visualized Experiments : JoVE Jul 2011Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be invaluable tool for...
Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be invaluable tool for evaluation of these disorders, both in clinic and research. There are number of autonomic tests, however, only few were validated clinically or are quantitative. Here, fully quantitative and clinically validated protocol for testing of autonomic functions is presented. As a bare minimum the clinical autonomic laboratory should have a tilt table, ECG monitor, continuous noninvasive blood pressure monitor, respiratory monitor and a mean for evaluation of sudomotor domain. The software for recording and evaluation of autonomic tests is critical for correct evaluation of data. The presented protocol evaluates 3 major autonomic domains: cardiovagal, adrenergic and sudomotor. The tests include deep breathing, Valsalva maneuver, head-up tilt, and quantitative sudomotor axon test (QSART). The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores (CASS). Detailed protocol is provided highlighting essential aspects of testing with emphasis on proper data acquisition, obtaining the relevant parameters and unbiased evaluation of autonomic signals. The normative data and CASS algorithm for interpretation of results are provided as well.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Electrophysiology; Humans; Reflex; Valsalva Maneuver
PubMed: 21788940
DOI: 10.3791/2502 -
Anatolian Journal of Cardiology Jun 2015
Topics: Arthritis, Rheumatoid; Autonomic Nervous System Diseases; Cardiovascular Diseases; Humans; Signal Processing, Computer-Assisted
PubMed: 26258188
DOI: No ID Found -
Arthritis Research & Therapy 2007Autonomic nervous system dysfunction observed in fibromyalgia, characterized without exception by a sympathetic hyperactivity and hyporeactivity, has been reported....
Autonomic nervous system dysfunction observed in fibromyalgia, characterized without exception by a sympathetic hyperactivity and hyporeactivity, has been reported. However, several studies demonstrated reduced levels of norepinephrine and neuropeptide Y at rest and after tilt table in some patients, which was improved by beta-stimulating agents. These findings support heterogeneity in fibromyalgia-associated dysautonomia. Fibromyalgia could be a generalized sympathetic dystrophy since both conditions are activated by trauma and partly linked to sympathetic mechanisms. Yet they differ on several points: hormonal and neurochemical abnormalities are observed in fibromyalgia whereas activation by peripheral trauma and hyperosteolysis are observed in reflex sympathetic dystrophy.
Topics: Autonomic Nervous System Diseases; Fibromyalgia; Humans; Neuropeptide Y; Norepinephrine; Reflex Sympathetic Dystrophy; Tilt-Table Test
PubMed: 17626612
DOI: 10.1186/ar2212 -
Aging Apr 2019
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Diagnostic Techniques, Neurological; Humans; Nervous System Diseases; Primary Dysautonomias
PubMed: 30969941
DOI: 10.18632/aging.101896 -
Autonomic Neuroscience : Basic &... Apr 2013Cardiac and respiratory activities are intricately linked both functionally as well as anatomically through highly overlapping brainstem networks controlling these... (Review)
Review
Cardiac and respiratory activities are intricately linked both functionally as well as anatomically through highly overlapping brainstem networks controlling these autonomic physiologies that are essential for survival. Cardiorespiratory coupling (CRC) has many potential benefits creating synergies that promote healthy physiology. However, when such coupling deteriorates autonomic dysautonomia may ensue. Unfortunately there is still an incomplete mechanistic understanding of both normal and pathophysiological interactions that respectively give rise to CRC and cardiorespiratory dysautonomia. Moreover, there is also a need for better quantitative methods to assess CRC. This review addresses the current understanding of CRC by discussing: (1) the neurobiological basis of respiratory sinus arrhythmia (RSA); (2) various disease states involving cardiorespiratory dysautonomia; and (3) methodologies measuring heart rate variability and RSA.
Topics: Animals; Autonomic Nervous System; Autonomic Nervous System Diseases; Cardiovascular Physiological Phenomena; Humans; Respiratory Physiological Phenomena
PubMed: 23497744
DOI: 10.1016/j.autneu.2013.02.006 -
Clinical Autonomic Research : Official... Jun 2017
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Humans
PubMed: 28315024
DOI: 10.1007/s10286-017-0415-9