Autonomic Neuroscience[JOURNAL]
Sun
200 papers
The co-existence of Ehlers-Danlos syndrome and postural orthostatic tachycardia syndrome: A systematic review of the literature.
Kwok CS, Hagger G, Gillespie D … +6 more , Hall M, Nazari B, Chong D, Hinton J, Qureshi AI, Raj SR
Auton Neurosci · 2026 Jun · PMID 42398445 · Publisher ↗
There is a growing body of literature evaluating both postural orthostatic tachycardia syndrome (POTS) and Ehlers-Danlos syndrome (EDS). We conducted a systematic review to evaluate what is currently known about the co-e...
There is a growing body of literature evaluating both postural orthostatic tachycardia syndrome (POTS) and Ehlers-Danlos syndrome (EDS). We conducted a systematic review to evaluate what is currently known about the co-existence of both conditions. A search of MEDLINE and EMBASE was performed in December 2025 and data were collected in tables and pooled to determine the prevalence of POTS in EDS and EDS in POTS. A total of 30 studies were included with 8421 patients with EDS and 12,983 patients with POTS. The average age across 16 studies that reported mean age was 33.3 years. POTS in patients with EDS ranges from 17.5% to 92.7% depending on the population. EDS in patients with POTS ranges from 17.9% to 50.0% depending on the population. One study suggested that patients with EDS and POTS had greater medication use, pain medications and greater number of clinic visits compared to POTS alone while another suggests that these patients have greater gastrointestinal symptoms and the odds were greatest for postprandial distress syndrome, chronic nausea and vomiting syndrome, vomiting and post-prandial fullness. We conclude that EDS and POTS frequently co-occur, and proportions of patients with POTS and EDS depends on the population evaluated. Overall, more research is needed to better understand how to effectively manage patients living with both EDS and POTS.
Urodynamics and what they reveal about autonomic innervation of the lower urinary tract: A narrative review.
Yasmin H, Aleksejeva K, Johnston L … +3 more , Malladi P, Simeoni S, Pakzad M
Auton Neurosci · 2026 Jun · PMID 42385264 · Publisher ↗
Urodynamics remain the gold standard for objectively evaluating bothersome lower urinary tract symptoms (LUTS) and offer indirect insight into the autonomic innervation of the lower urinary tract (LUT). Disruptions to th...
Urodynamics remain the gold standard for objectively evaluating bothersome lower urinary tract symptoms (LUTS) and offer indirect insight into the autonomic innervation of the lower urinary tract (LUT). Disruptions to the autonomic nervous system (ANS), particularly sympathetic and parasympathetic denervation, are frequently encountered in urological and neurological practice due to their common manifestation as LUTS. This narrative review synthesises current evidence on urodynamic features observed during bladder filling and voiding and their relationship to autonomic innervation in health and disease, drawing on established principles of LUT neural physiology. It contrasts normal urodynamic patterns with characteristic findings reported in neurological disorders associated with ANS disruption, such as multiple system atrophy, Parkinson's disease, diabetic and amyloid neuropathies, and spinal cord injury, to infer autonomic pathway integrity. These findings include changes in cystometric capacity, bladder compliance, filling sensations, and bladder neck appearance, the presence of detrusor overactivity or incontinence, and voiding phase abnormalities, including detrusor underactivity and bladder outflow obstruction. Together, these findings may provide insight into autonomic regulation across both health and disease. Urodynamics do not directly measure neural activity, and interpretation may be influenced by overlapping somatic effects, variable diagnostic thresholds, and non-neurogenic or co-existing pathology, but they remain an indispensable clinical tool for understanding LUT function and ANS involvement.
Pelvic venous disorders and orthostatic intolerance: A systematic review of diagnostic associations and treatment outcomes.
Imami MR, Galdino VDS, Harvey P … +3 more , Selke MS, Barr M, Brown AD
Auton Neurosci · 2026 Jun · PMID 42372331 · Publisher ↗
BACKGROUND: Pelvic venous disorders (PeVD) are recognised causes of chronic pelvic pain; emerging evidence suggests that venous outflow obstruction or reflux can also provoke orthostatic intolerance (OI) by infra-diaphra...
BACKGROUND: Pelvic venous disorders (PeVD) are recognised causes of chronic pelvic pain; emerging evidence suggests that venous outflow obstruction or reflux can also provoke orthostatic intolerance (OI) by infra-diaphragmatic pooling and reduced preload. Diagnostic and therapeutic frameworks for this overlap remain poorly defined. MATERIALS AND METHODS: We systematically searched PubMed, Ovid MEDLINE, Scopus, and Cochrane to 20 May 2025. Two reviewers extracted data; risk of bias used design-specific validated tools. RESULTS: Sixteen studies met criteria (4 case reports, 7 case series, 2 single-arm cohorts, 2 case-control, 1 cross-sectional), comprising 964 participants (93% female; age 7-67 years). Case-control data suggested left common iliac or left renal-vein compression is more prevalent in patients with postural tachycardia syndrome than in controls. Paediatric series linked left renal-vein entrapment with orthostatic symptoms and proteinuria. Imaging confirmation used duplex ultrasound, CT, CT-venography, intravascular ultrasound, and dynamic MRA with 4D-flow. Eleven studies reported interventions (iliac stenting, ovarian/internal-iliac embolization, superficial venous ablation, renal-vein transposition or robotic auto-transplantation). Orthostatic symptoms generally improved; cohorts using the Orthostatic Hypotension Questionnaire showed ∼50% mean reduction, and several stented patients no longer met POTS criteria. Follow-up was typically ≤12 months. Overall risk of bias was high for single-arm cohorts and moderate for case-control studies. CONCLUSIONS: Available evidence supports a biologically plausible link between pelvic venous obstruction and OI suggests PeVD-directed procedures can ameliorate OI in selected patients. Prospective, multicentre studies with standardized imaging thresholds, objective autonomic endpoints, and longer follow-up are needed to define patient selection and comparative effectiveness.
Application of heart rate variability in clinical practice and research: A systematic review of recent years.
Maldonado-Veas C, León P, Lerma C … +1 more , Echeverría JC
Auton Neurosci · 2026 Jun · PMID 42341657 · Publisher ↗
This systematic review aims to assess the current use of heart rate variability (HRV) analysis in clinical research, focusing on the diseases studied, the common indices used, and the physiological insights gained. A sea...
This systematic review aims to assess the current use of heart rate variability (HRV) analysis in clinical research, focusing on the diseases studied, the common indices used, and the physiological insights gained. A search was conducted in PubMed, articles published in recent years (2019-2025) in English or Spanish involving humans and pathophysiological interpretations were reviewed. After screening and verifying quality criteria, 99 articles were included in the review. HRV was most frequently applied in mental, behavioral, or neurodevelopmental disorders; diseases of the nervous system, and diseases of the circulatory system. Across studies, interpretations clustered around Treatment/Stimulus effects and Etiology/Mechanisms, with comparatively fewer works focused on Diagnostic/Screening or Severity/Staging. Approximately 58% of articles justified a targeted selection of HRV indices aligned with their clinical hypotheses, whereas the rest relied on batteries of indices. This review highlights the diverse use and interpretation of HRV across clinical contexts, pointing to a lack of standardized protocols. The heterogeneity of recording durations, maneuver use, and spectral units provided, together with under-reporting of nonlinear prerequisites, all limit cross-study comparability and clinical translation. We outline a tentative roadmap for clinically oriented HRV work that emphasizes, where appropriate, measurement standardization, analytic rigor and transparency, and clinical translation, ideally supported by preregistration, harmonized reporting, and open, validated resources. Future research should focus on developing standardized and updated guidelines for HRV analysis to improve its clinical utility and to encourage interdisciplinary collaboration in selecting and interpreting HRV indices based on research objectives and clinical hypotheses.
Spinal afferent endings in the gastrointestinal tract.
Spencer NJ, Zagorodnyuk VP, Sharrad DF … +1 more , Hibberd TJ
Auton Neurosci · 2026 Jun · PMID 42302325 · Publisher ↗
Communication between the gastrointestinal tract and the central nervous system, known as the gut-brain axis, is fundamental to physiology and is implicated in a range of pathological conditions. A critical component of...
Communication between the gastrointestinal tract and the central nervous system, known as the gut-brain axis, is fundamental to physiology and is implicated in a range of pathological conditions. A critical component of this axis is the sensory information conveyed from the gut to the brain through spinal afferent pathways. Understanding the location and types of spinal afferents present in the GI tract and their mechanisms of activation is essential to advance our knowledge of gut-brain communication in health and disease. Though generally trailing knowledge of gut vagal afferents, major advances have been made in understanding spinal sensory pathways through recent critical adaptations of neuroanatomical tracing, neurogenetics and molecular profiling techniques, revealing an unforeseen diversity in the morphology of their endings in the gut wall and novel classifications based on molecular identity. Moreover, spinal afferents have been implicated in multiple physiological functions besides their well-known role in nociception, including potential roles in nutrient sensing and regulating gut motility. Among spinal afferent endings in the gut mucosal layer, much has been learnt about how enterochromaffin (EC) cells communicate with spinal (and vagal) afferents. Evidence now suggests that EC cells release substances (like serotonin), which activate the terminals of spinal (and vagal) afferent endings via a paracrine, not synaptic, transmission. Here, we review the latest findings regarding spinal afferent endings and point to outstanding questions and future directions for research into this complex and clinically relevant area of neuroscience.
Gastric myoelectrical activity and autonomic dysfunction in children with IBD and IBS: An electrogastrographic and autonomic correlation study.
Pavić AM, Ruška P, Mišak Z … +3 more , Krbot Skorić M, Habek M, Hojsak I
Auton Neurosci · 2026 Jun · PMID 42302324 · Publisher ↗
Sixty-two children (18 with inflammatory bowel disease [IBD], 28 with irritable bowel syndrome [IBS], 18 healthy controls) underwent pre- and postprandial electrogastrography and autonomic assessment with the Composite A...
Sixty-two children (18 with inflammatory bowel disease [IBD], 28 with irritable bowel syndrome [IBS], 18 healthy controls) underwent pre- and postprandial electrogastrography and autonomic assessment with the Composite Autonomic Symptom Score-31 (COMPASS-31) and Composite Autonomic Severity Scale (CASS). No between-group differences in EGG parameters were observed. Children with IBS showed increased postprandial normogastria. Higher autonomic symptom burden correlated with lower postprandial power dominant frequency, and symptomatic dysautonomia was associated with reduced postprandial power dominant frequency. These exploratory findings suggest a link between autonomic symptoms and postprandial gastric activity and warrant confirmation in larger cohorts.
Acute isometric handgrip exercise enhances cardiac baroreflex sensitivity and lowers systolic blood pressure in chronic kidney disease.
Sabino-Carvalho JL, Niu A, Mekonnen E … +1 more , Park J
Auton Neurosci · 2026 Jun · PMID 42287825 · Publisher ↗
Chronic kidney disease (CKD) impairs cardiac baroreflex sensitivity (cBRS), contributing to poor blood pressure (BP) control and heightened cardiovascular risk. Emerging evidence indicates that isometric handgrip (IHG) e...
Chronic kidney disease (CKD) impairs cardiac baroreflex sensitivity (cBRS), contributing to poor blood pressure (BP) control and heightened cardiovascular risk. Emerging evidence indicates that isometric handgrip (IHG) exercise may enhance cBRS in healthy individuals; however, its effects in CKD remain unclear. Therefore, this study tested the hypothesis that a single IHG session increases cBRS and reduces beat-to-beat BP variability (BPV) in CKD patients. In 21 patients (61 ± 12 yr; stages III-IV), beat-to-beat BP (finger photoplethysmography), heart rate (HR, electrocardiography), and respiration were continuously measured before and 10-, 20-, and 30-min post IHG vs. sham exercise in a crossover design. cBRS was assessed via the sequence technique and cardiac autonomic modulation via time- and frequency-domain HR variability (HRV). BPV was quantified using time domain indexes. cBRS increased following IHG exercise (10-min: Δ20 ± 4%; 20-min: Δ23 ± 5%; 30-min: Δ17 ± 5%; all P < 0.004 vs rest). This increase was significantly different from sham at 10-min and 20-min (all P < 0.006 vs sham), but not at 30-min post-IHG (P = 0.074). HR decreased throughout recovery (all P = 0.001 vs rest). Systolic BP decreased 30-min following IHG exercise (Δ-5 ± 2 mmHg; P = 0.047 vs. rest). Time-domain HRV increased during recovery (P = 0.005) whereas BPV remained unchanged following IHG exercise. After sham, all variables remained similar to rest, except systolic BP was significantly higher 20-min after sham. A single IHG session increased cBRS and vagal modulation, with a modest reduction in systolic BP and no change in BPV, in CKD patients. Overall, these findings suggest that IHG may serve as a non-pharmacological intervention for cardiovascular regulation in CKD.
Validity of the Polar H10 for heart rate variability and cardiac autonomic reflex tests.
Blalock ACE, Riemann BL, Flatt AA
Auton Neurosci · 2026 Jun · PMID 42275859 · Publisher ↗
We tested the validity of the Polar H10 chest strap against criterion electrocardiography (ECG) for heart rate variability (HRV) and cardiac autonomic reflex assessment in young adults and examined associations between s...
We tested the validity of the Polar H10 chest strap against criterion electrocardiography (ECG) for heart rate variability (HRV) and cardiac autonomic reflex assessment in young adults and examined associations between supine HRV and other cardiovagal markers. Forty-three healthy adults (18-39 years, 44% male) completed an 8-min protocol: 3 min supine rest (HRV assessed in minute 2 after 1-min stabilization), 1 min paced deep breathing (minute 4; 0.1 Hz), 1 min supine washout, and 3 min active standing (30:15 ratio assessed post-transition; HRV assessed in minute 6 after 1-min post-transition stabilization). Simultaneous RR intervals were recorded via ECG and H10. Agreement was evaluated for time-domain HRV (mean RR interval, root-mean square of successive differences [RMSSD], and standard deviation of normal RR intervals) and reflex tests (deep breathing expiratory [E] to inspiratory [I] ratio, E - I difference, heart rate response; orthostatic 30:15 ratio). Excellent agreement was observed between devices for all metrics (concordance correlation ≥0.99; mean absolute percentage error < 1%; and narrow 95% limits of agreement (widest = -1.5 to 1.7 ms). Supine RMSSD shared 39-53% of variance with deep breathing outcomes, 34% with standing RMSSD, and < 1% with the 30:15 ratio. The H10 provides measurements effectively interchangeable with laboratory ECG for time-domain HRV and standard cardiovagal reflex tests in healthy young adults. Supine RMSSD shares approximately half or less of the variance with other cardiovagal markers, reinforcing the importance of incorporating complementary reflex and orthostatic tests for comprehensive cardiac autonomic assessment.
Vagal sensory neurons profusely innervate the mouse gall bladder.
Neuhuber WL, Yu S, Williams J … +4 more , Burk DH, Morrison CD, Münzberg H, Berthoud HR
Auton Neurosci · 2026 May · PMID 42258898 · Full text
The biliary system consisting of bile ducts and the gall bladder plays a crucial role in digestion and its function is controlled by both humoral and neural mechanisms. Despite the intense pain associated with gall bladd...
The biliary system consisting of bile ducts and the gall bladder plays a crucial role in digestion and its function is controlled by both humoral and neural mechanisms. Despite the intense pain associated with gall bladder and bile duct pathologies, little is known about the sensory innervation, particularly sensory innervation by the vagus nerve. Here using anterograde viral tracing from either the left or right nodose ganglion, we demonstrate the presence of a dense sensory innervation of the murine gall bladder by vagal afferents. Entering via the cystic duct, bundles of vagal sensory axons travel along blood vessels from the neck towards the fundus of the gall bladder, where individual axons divide copiously to innervate large territories of the gall bladder wall. Reminiscent of the stomach wall, some vagal afferent axons end in intramuscular array-like endings or in laminar endings within gall bladder ganglia or in the tunica fibromuscularis. However, most axons form a variety of non-distinct endings mostly in the muscle layer. The innervation pattern is consistent with the detection of both mechanical and chemical stimuli. This calls for functional studies determining specific sensory modalities, and translational studies exploring their possible involvement in immune regulation, pain sensation, and interoceptive capacity.
Combined peripheral cannabinoid CB1 and CB2 receptor activation abolishes cystitis-induced bladder hyperalgesia.
Ramsay S, Hibberd TJ, Spencer NJ … +1 more , Zagorodnyuk VP
Auton Neurosci · 2026 May · PMID 42247877 · Publisher ↗
Cannabinoid agonists may ameliorate bladder pain associated with interstitial cystitis/bladder pain syndrome. Visceromotor responses (VMRs) to bladder distension were recorded in urethane-anesthetised control and protami...
Cannabinoid agonists may ameliorate bladder pain associated with interstitial cystitis/bladder pain syndrome. Visceromotor responses (VMRs) to bladder distension were recorded in urethane-anesthetised control and protamine/zymosan-treated guinea pigs. The peripherally restricted preferential CB1 receptor agonist PrNMI and the selective CB2 receptor agonist 4Q3C each reduced cystitis-induced enhancement of VMRs at high intravesical pressures. Co-activation of CB1 and CB2 receptors abolished cystitis-induced bladder hyperalgesia. These findings indicate that simultaneous targeting of peripheral CB1 and CB2 receptors may provide clinically meaningful benefits for the treatment of bladder pain associated with cystitis.
Sympathetic nervous system control across the menstrual cycle.
Mei Y, Allison EY, Stone JC … +1 more , Al-Khazraji BK
Auton Neurosci · 2026 May · PMID 42247876 · Publisher ↗
The menstrual cycle is characterized by fluctuations in ovarian hormones that influence the regulation of physiological systems, including homeostatic adjustments in cardiovascular control. The sympathetic nervous system...
The menstrual cycle is characterized by fluctuations in ovarian hormones that influence the regulation of physiological systems, including homeostatic adjustments in cardiovascular control. The sympathetic nervous system maintains refined control over cardiovascular homeostasis through adjustments in systemic and local hemodynamics, and via neural reflexes and sympathetic neurovascular transduction. However, the extent to which these autonomic pathways are modulated by endogenous hormonal shifts remains a significant knowledge gap. This narrative review consolidates current evidence on autonomic function across the menstrual cycle, with a focus on muscle sympathetic nerve activity, sympathetic neurovascular transduction, sympathetic neural reflexes, and heart rate variability. Additionally, we briefly explore the influence of exogenous hormone use, primarily oral contraceptive pills, on autonomic regulation. A critical and often overlooked distinction in the literature is that while resting sympathetic drive is significantly elevated during the mid-luteal phase, the sensitivity of most neural reflexes remains functionally stable. This stability suggests that the mid-luteal surge in estradiol acts as a vital vascular buffer, enhancing sympatholysis and nitric oxide bioavailability to offset the increase in underlying neural drive. We further examine exceptions to this stability, specifically the peripheral chemoreflex, and explore the impact of exogenous hormones on neurovascular homeostasis. Characterizing these interactions is essential for understanding physiological and pathophysiological changes across the female lifespan.
Understanding nocturnal polyuria in cardiovascular autonomic failure: Pathophysiological mechanisms and clinical implications.
Umbertini E, Calandra-Buonaura G, Carrozzo G
Auton Neurosci · 2026 May · PMID 42241932 · Publisher ↗
BACKGROUND: Nocturnal polyuria (NP), characterized by excessive nighttime urine production, is a common non-motor symptom in synucleinopathies, particularly in the presence of cardiovascular autonomic failure (AF). NP co...
BACKGROUND: Nocturnal polyuria (NP), characterized by excessive nighttime urine production, is a common non-motor symptom in synucleinopathies, particularly in the presence of cardiovascular autonomic failure (AF). NP contributes to sleep fragmentation, increased fall risk, and exacerbation of morning orthostatic hypotension. Diagnosis requires a comprehensive assessment of lower urinary tract symptoms, comorbidities and medication use. METHODS: We conducted a scoping review of the existing literature on PubMed up to December 2024 regarding NP associated with synucleinopathies and AF. RESULTS: NP is frequent in patients with AF. In Multiple System Atrophy, NP is associated with hypothalamic degeneration and impaired arginine vasopressin secretion. In Pure AF, NP appears multifactorial, while Lewy body disease-related NP is influenced by hypothalamic dysfunction and fluid redistribution. Therapeutic strategies include desmopressin, antihypertensive agents (e.g., clonidine, losartan) and non-pharmacological interventions such as CPAP and head-up tilt sleeping. CONCLUSIONS: Although NP affects disease severity and quality of life in patients with AF, several research gaps emerged concerning prevalence, pathophysiology and specific treatments.
Patient-reported perspectives of a temporal relationship between autonomic dysfunction and mental health symptoms in a pediatric population.
Frye WS, Ward SR, Johnston JD
Auton Neurosci · 2026 Jun · PMID 42241931 · Publisher ↗
PURPOSE: Autonomic dysfunction, characterized by orthostatic intolerance and presyncope, is understudied in youth. Mental health comorbidities are commonly reported and sometimes blamed for the onset of autonomic dysfunc...
PURPOSE: Autonomic dysfunction, characterized by orthostatic intolerance and presyncope, is understudied in youth. Mental health comorbidities are commonly reported and sometimes blamed for the onset of autonomic dysfunction; however, no studies have yet examined this relationship. This study aimed to establish the prevalence rate of mental health diagnoses in a pediatric sample of patients with autonomic dysfunction, characterize the temporal relationship between autonomic and mental health symptom onset, and understand patients' perspectives on this relationship. METHODS: Pediatric patients completed surveys at autonomic dysfunction clinic follow-up appointments. Surveys obtained patient self-reported metal health conditions, autonomic symptoms, and patient-perceived timelines. Patients then described their understanding of the relationship between their mental and physical health. Authors analyzed qualitative data using content analysis. RESULTS: Of 142 patients approached, 127 completed surveys (response rate 88.8%; Mean age = 16.1); 70.1% reported a mental health diagnosis, and 4.7% suspected a mental health condition. Anxiety was the most reported concern (72.4%). Patients reported mental health concerns preceding (37.6%), co-occurring (12.2%), or succeeding (38.1%) their autonomic dysfunction symptoms. Qualitative responses revealed patients perceived bidirectional or unidirectional relationships between mental health and autonomic dysfunction, although some patients were uncertain. CONCLUSION: Patients described varied relationships between mental health symptoms and autonomic dysfunction, emphasizing the individualized nature of these experiences. Although the rate of mental health diagnoses was pointedly high, temporal associations appeared patient-specific rather than consistent across the sample. Providers should consider routine screening and treatment of mental health concerns as part of comprehensive care for youth with autonomic dysfunction.
To tilt or not? Role of the active stand test in the evaluation of postural orthostatic tachycardia syndrome (POTS).
Uppal J, Sheldon RS, Raj SR
Auton Neurosci · 2026 Jun · PMID 42235469 · Publisher ↗
Abstract loading — click title to view on PubMed.
Neuromodulation techniques for managing overactive bladder.
Rosato E, Di Rocco F, Cerrelli G … +3 more , Mollo L, Bianchi D, Finazzi Agrò E
Auton Neurosci · 2026 May · PMID 42202535 · Publisher ↗
Overactive bladder (OAB) represents a significant burden and has a considerable impact on the quality of life (QoL) of affected patients. The treatment of this condition poses notable challenges due to its multifactorial...
Overactive bladder (OAB) represents a significant burden and has a considerable impact on the quality of life (QoL) of affected patients. The treatment of this condition poses notable challenges due to its multifactorial pathophysiology and the frequent refractoriness to standard pharmacological therapies. In recent years, neuromodulation has gained increasing relevance as an effective and minimally invasive therapeutic strategy, offering promising results in selected patients. Among the currently available modalities, sacral neuromodulation is considered the gold standard, supported by long-term data demonstrating its efficacy, safety, and positive impact on QoL. Conversely, tibial nerve stimulation, characterized by its reduced invasiveness, is indicated as a second- or third-line treatment for OAB patients who have not responded to pharmacological therapies. More recently, other forms of neurostimulation, such as pudendal nerve or spinal cord stimulation, have attracted attention, although they remain in the experimental phase, with preliminary data suggesting potential benefits in highly selected populations. Despite the growing use of neuromodulation in urological practice, the choice of technique and the prediction of therapeutic response remain complex and not yet fully standardized. In this context, the application of artificial intelligence may offer new opportunities to support clinical decision-making, enabling more accurate patient selection, optimization of treatment outcomes, and a step toward precision medicine in the management of lower urinary tract dysfunctions.
Reduced baroreflex sensitivity in situational syncope compared with vasovagal syncope: Evidence for different baroreflex profile.
Russo V, Parente E, Comune A … +6 more , Colalillo N, Valentino GB, Rago A, Papa AA, Brignole M, Nigro G
Auton Neurosci · 2026 May · PMID 42202534 · Publisher ↗
BACKGROUND: Baroreflex sensitivity (BRS) reflects short-term cardiovascular autonomic regulation and contributes to blood pressure stability, a key determinant of cerebral perfusion. We aimed to assess BRS in patients wi...
BACKGROUND: Baroreflex sensitivity (BRS) reflects short-term cardiovascular autonomic regulation and contributes to blood pressure stability, a key determinant of cerebral perfusion. We aimed to assess BRS in patients with situational syncope (SS) and to compare it with that of patients with vasovagal syncope (VVS) under standardized conditions. METHODS AND RESULTS: We prospectively evaluated consecutive patients with suspected reflex syncope. Patients with confirmed SS or VVS and available BRS assessment at rest and during early orthostatic phase were included. The nearest neighbor propensity score matching (PSM) method with a 1:1 ratio was applied to balance baseline characteristics. Among 182 patients, 45 with SS were matched to 45 with VVS. Compared with VVS, SS patients exhibited significantly lower BRS both in the supine position (5.8±2.5 vs 7.4±4.0 ms/mmHg; p=0.02) and during orthostatic stress (5.3±2.7 vs 6.8±3.4 ms/mmHg; p=0.02). No differences in BRS were observed across different situational triggers. CONCLUSIONS: Situational syncope is associated with reduced baroreflex sensitivity compared with vasovagal syncope, supporting the presence of distinct baroreflex profiles within reflex syncope. These findings may have implications for pathophysiological classification and personalized management strategies.
Physiological and clinical comparison of active stand and head-up tilt tests in Postural Orthostatic Tachycardia Syndrome (POTS).
Robbins NM
Auton Neurosci · 2026 May · PMID 42191429 · Publisher ↗
Abstract loading — click title to view on PubMed.
Pathophysiological mechanisms underlying the overactive bladder.
Sihra N, Malde S
Auton Neurosci · 2026 May · PMID 42184480 · Publisher ↗
Overactive bladder is a heterogenous condition, with several phenotypes, and a complex pathophysiology. The principal pathophysiological mechanisms for the development of OAB are based on the urotheliogenic, myogenic, ne...
Overactive bladder is a heterogenous condition, with several phenotypes, and a complex pathophysiology. The principal pathophysiological mechanisms for the development of OAB are based on the urotheliogenic, myogenic, neurogenic and urethrogenic theories. The most well-described contributors to these pathophysiological mechanisms are metabolic syndrome, sex hormone deficiency, altered urinary microbiota, functional gastrointestinal disorders, affective disorders, autonomic nervous system dysfunction, and bladder outflow obstruction. This review describes the normal physiology of the lower urinary tract, and summaries the pathophysiological mechanisms behind overactive bladder.
How changes in salinity modify patterns of gastrointestinal motility in the intestine of freshwater barramundi.
Rhodes H, Travis L, Hibberd T … +2 more , Spencer NJ, Harris J
Auton Neurosci · 2026 May · PMID 42139807 · Publisher ↗
Salinity is a fundamental geophysical property of water that continuously challenges the physiology of teleost fish. The gastrointestinal tract of teleosts plays a pivotal role for osmoregulation in both marine and fresh...
Salinity is a fundamental geophysical property of water that continuously challenges the physiology of teleost fish. The gastrointestinal tract of teleosts plays a pivotal role for osmoregulation in both marine and freshwater species. Despite this, little is known about how salinity influences gastrointestinal motility. Here, we characterised the patterns of intestinal motility in a euryhaline species, the barramundi (Lates calcarifer), for the first time; and determined how changes in salinity modify these patterns. Motility patterns were qualitatively and quantitatively characterised in ex vivo intestinal preparations from barramundi acclimated to a range of environmental salinities (0, 3, 6, 15 and 24 ppt), representative of hypo-, iso- and hyperosmotic conditions. Recordings of ex vivo intestinal preparations revealed that barramundi exhibit multiple distinct intestinal motility patterns that are responsive to mechanical and pharmacological manipulation, as well as changes in environmental salinity. Bayesian analysis revealed significant differences in the frequency, speed and extent of prominent motility patterns between hypoosmotic (0-9 ppt) and hyperosmotic (12-24 ppt) conditions. Findings show that mechanical distention results in a normalised frequency across the salinity gradient. Pharmacological blockade of synaptic transmission in the enteric nervous system revealed divergent motor responses between intestines derived from fish acclimated to hypo- and hyperosmotic conditions. Taken together, we suggest that intestinal motor patterns in barramundi are modified by environmental salinity which may involve different degrees of plasticity of enteric neuronal functions.
Circadian rhythm disturbances in nocturia and nocturnal polyuria: A systematic review.
Van de Steen L, Van den Ende M, Bou Kheir G … +5 more , Weiss J, Lazar J, Everaert K, Haddad R, Hervé F
Auton Neurosci · 2026 Apr · PMID 42090872 · Publisher ↗
BACKGROUND: Nocturia is a common symptom among adults and is often associated with disrupted sleep and diminished quality of life. In many cases, it is driven by nocturnal polyuria, an imbalance in nighttime urine produc...
BACKGROUND: Nocturia is a common symptom among adults and is often associated with disrupted sleep and diminished quality of life. In many cases, it is driven by nocturnal polyuria, an imbalance in nighttime urine production. Emerging evidence suggests that circadian rhythm disturbances, which regulate hormone secretion, renal function, and blood pressure, may play a role in this altered diuresis. This systematic review evaluated the contribution of circadian dysregulation to the pathophysiology of two distinct nocturnal voiding patterns: nocturia (defined by voiding frequency) and nocturnal polyuria (defined by urine production volume). METHODS: We systematically searched PubMed, Embase, and CINAHL for studies examining circadian factors, such as melatonin, vasopressin, natriuretic peptides, or nocturnal blood pressure patterns, in relation to nocturia or nocturnal polyuria. Eligible studies included adult populations, with no publication date restrictions. Studies addressing nocturnal polyuria and nocturia were analyzed separately to reflect distinct underlying mechanisms. Two reviewers independently screened articles, extracted data, and assessed study quality using the Newcastle-Ottawa Scale. Studies were categorized based on use of the clinical threshold for nocturia (≥2 voids per main sleep period), nocturnal polyuria, or subgroup analyses. RESULTS: Fourteen studies met inclusion criteria. Across diverse populations and methodologies, circadian dysregulation was consistently linked to altered nocturnal urine production. Common findings included reduced nighttime melatonin and vasopressin levels, elevated natriuretic peptide secretion, and diminished nocturnal blood pressure dipping. These abnormalities were observed in older adults, patients with obstructive sleep apnea, and individuals with neurological conditions. Several studies also reported a blunting of normal diurnal variation in sodium excretion and urine concentration. CONCLUSIONS: These findings underscore the importance of incorporating circadian rhythm assessment into the clinical evaluation of nocturnal urinary complaints.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe