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Autonomic Nervous System Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
The most common clinical manifestations of autonomic dysfunction are: Postural (orthostatic) hypotension.Erectile and ejaculatory dysfunction.Bladder dysfunction.Abnormalities of sweating.Vasomotor disturbances.
Neurophysiological Perspectives
Published in Marlysa Sullivan, Laurie C. Hyland Robertson, Understanding Yoga Therapy, 2020
Marlysa Sullivan, Laurie C. Hyland Robertson
Autonomic dysfunction, with its far-reaching physical, psychological, and behavioral effects, is often described as a contributor to, or cause of, many conditions, including cardiovascular, immune, metabolic, musculoskeletal, trauma, and pain disorders. Conversely, promoting regulation and resilience through autonomic control facilitates greater physical, psychological, and behavioral health and well-being in populations with these conditions. By learning to shift autonomic state with yoga therapy practices, we can initiate concurrent effects on physiology (including muscle tone, heart rate, stress-hormone release, and gastrointestinal function), emotional states, and behavior. Unlike a pathology-oriented practice, yoga therapy can be understood as an integrated salutogenic practice that facilitates top-down and bottom-up processes for autonomic regulation and resilience.
Pure Autonomic Failure
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
Although their clinical features may be similar, the time course and natural history of the acute autonomic neuropathies should prevent confusion with PAF. These neuropathies may be post-viral (Yahr and Frontera, 1975), idiopathic (Appenzeller and Kornfeld, 1973; Hopkins, Neville and Bannister, 1974; Young et al., 1975) or associated with diseases such as porphyria (Yeung Laiwah et al., 1985) and botulism (Jenzer et al., 1975). Other causes of autonomic dysfunction without neurological signs include medications, endocrine disease, surgical sympathectomy and possibly normal aging.
Burden and severity of disease of aromatic L-amino acid decarboxylase deficiency: a systematic literature review
Published in Current Medical Research and Opinion, 2022
Katharina Buesch, Rongrong Zhang, Katarzyna Szczepańska, Vladica Veličković, Lucy Turner, Milena Despotović, Branka Đorđević, Alexis Russell
Clinical manifestations of AADCd were heterogenous across the identified studies and formed nine categories, as follows5,32,58: (i) motor function, (ii) autonomic dysfunction, (iii) central nervous system (CNS) and mental status disorders, (iv) behavioural problems, (v) sleep disorders, (vi) respiratory problems, (vii) endocrine problems, (viii) ophthalmological problems, and (ix) gastrointestinal problems. Table 3 presents the categorization of the signs and symptoms and the number of patients that reported with signs and symptoms. Most individuals were non-ambulatory with a broad spectrum of other disease-related disorders. For studies reporting ambulatory status, ambulatory patients had fewer reported disease manifestations compared to studies reporting disease severity in non-ambulatory and mixed populations (Table 4 details all included studies presented in Supplementary Table S7). The three most frequent clinical manifestations identified were dystonia, hypotonia, and oculogyric crises.
Generalised autonomic failure as a prognostic factor in systemic light-chain (AL) amyloidosis
Published in Amyloid, 2022
Soonwook Kwon, Woo Kyo Jeong, Ji-Hyung Park, Juhyun Kim, Eun Bin Cho, Jin Myoung Seok, Seok Jin Kim, Kihyun Kim, Eun-Seok Jeon, Ju-Hong Min, Byoung Joon Kim
In previous studies, autonomic dysfunction was found in 14–28% of AL amyloidosis patients [4,5,15]. In a retrospective study of 112 patients, 23% of AL amyloidosis patients had autonomic neuropathy (AN), defined as orthostatic hypotension or a score >5 points in autonomic testing based on the method by Ewing and Clarke (definite AN) or gastric emptying scans and two non-gastroenterologic symptoms of AN (possible AN) [5,16]. In another retrospective study that included 43 patients, 19% of AL amyloidosis subjects had autonomic dysfunction, which was measured only by coefficients of R–R interval variation [15]. In the present study, most patients (96%) showed abnormality in more than one CASS domain, and 43% had GAF, both of which were higher than in other studies. The differences between previous studies and this study could be attributed to the definition of autonomic dysfunction as well as study design. In a study consisting of 65 patients with AL or familial amyloidosis, autonomic failure, defined as widespread abnormalities of the autonomic nervous system, was found in almost all patients, with CASS score of 7 (median) (adrenergic, 3; cardiovagal, 3; sudomotor, 2), but 22 patients with familial amyloidosis were included [17]. Recently, reduction of intraepidermal nerve fibre density was confirmed in 60% of patients with AL amyloidosis, indicating that skin biopsy also could have prognostic implications in AL amyloidosis [18].
Risk factors for diabetic kidney disease in adults with longstanding type 1 diabetes: results from the Canadian Study of Longevity in Diabetes
Published in Renal Failure, 2019
Nigar Sekercioglu, Leif Erik Lovblom, Petter Bjornstad, Julie A. Lovshin, Yuliya Lytvyn, Geneviève Boulet, Mohammed A. Farooqi, Andrej Orszag, Vesta Lai, Josephine Tse, Leslie Cham, Hillary A. Keenan, Michael H. Brent, Narinder Paul, Vera Bril, Bruce A. Perkins, David Z. I. Cherney
The presence and severity of autonomic dysfunction have been linked with increased cardiovascular risk and also with alterations in heart rate blood pressure through changes in parasympathetic and sympathetic tone [35]. Heart rate variability is considered as an important feature of cardiac autonomic neuropathy in patients with diabetes. A recent systematic review showed a decrease in both parasympathetic and sympathetic activity with lower RMSSD, SDNN, LF, and HF in those with type 2 diabetes as compared to healthy controls [36]. However, in this study population, LF/HF ratios did not differ between the groups implying that among those adults with T1D, there are comparable loses in both components of the autonomic nervous system [36]. Although not statistically significant, SDNN, RMSSD, LF, HF, and LF/HF ratio were lower in the high target group as compared to the low target group in this study cohort. These results also suggest possible sympathetic dominance in those with poor metabolic control. Nevertheless, our logistic regression models showed lower LF/HF increases the likelihood for DKD.