Autonomic Neuroscience-Basic & Clinical最新文献

Neuromodulation of heart rate variability: A systematic review 心率变异性的神经调节：系统综述

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2026-01-05 DOI: 10.1016/j.autneu.2026.103379

Rodrigo Souza , Irinaldo Capítulino de Souza , Suellen Mary Marinho do Santos Andrade , Marcelo Rodrigo Portela Ferreira

Background

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.

Methods

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.

Results

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.

Conclusion

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.

背景：自主神经系统（ANS）功能障碍会增加心血管事件的风险。非侵入性神经调节方法，如经颅直流电刺激（tDCS）、经颅磁刺激（TMS）和经皮迷走神经刺激（tVNS），已被用于调节ANS，然而，由于研究的异质性，它们的比较效果和最佳方案仍不确定。本研究旨在验证这些神经调节方法对心率变异性（HRV）和交感迷走神经平衡影响的证据水平。方法本系统评价和荟萃分析遵循PRISMA指南，并在PROSPERO注册。检索截止到2024年10月的数据库包括Cochrane Library、Web of Science、PubMed和Embase。随机对照试验（rct）将tDCS、TMS或tVNS与人类对照或假条件进行比较，并将HRV变量作为结果。结果共纳入13项随机对照试验：tDCS 5例，tVNS 6例，TMS 2例。在神经调节方案中观察到显著的异质性。meta分析发现tDCS对频域变量的影响没有统计学意义。同样，tVNS对频域和时域变量均无显著影响。tDCS和tVNS的主要结局证据质量均为中等。结论目前关于tDCS、TMS和tVNS对HRV影响的证据有限且具有异质性。这些发现加强了刺激方案方法学标准化的必要性，并需要更大样本量的研究来提供更有力的临床发现。

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引用次数: 0

From lab to life: Wearables, real-world data, and the future of autonomic research 从实验室到生活：可穿戴设备、真实世界的数据和自主研究的未来

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-26 DOI: 10.1016/j.autneu.2025.103377

Julien Rimok , Kelly A. Larkin-Kaiser

Traditional methods for assessing autonomic nervous system (ANS) function are constrained by conventional clinical settings, limited timeframes, and exclusionary protocols. These limitations prevent the accurate capture of dynamic physiological fluctuations, particularly in underserved populations and those with complex or rare autonomic disorders. This paper outlines how wearable technologies and mobile health (mHealth) platforms are redefining the landscape of ANS research. By enabling continuous, real-world monitoring and integrating multimodal data, including comprehensive physiological and behavioral signals, patient-reported outcomes, these tools offer unprecedented opportunities for personalization, decentralized and pragmatic clinical trial designs, and enable early detection and intervention. We examine the evolution of wearable sensors, the role of artificial intelligence in translating raw data into clinically actionable insights, and the economic and equity implications of digital-first research. With regulatory momentum growing and real-world evidence gaining traction, the convergence of wearable technology and autonomic science signals not just a methodological shift, but a fundamental redefinition of how, where, and for whom clinical science is conducted.

评估自主神经系统（ANS）功能的传统方法受到传统临床环境、有限的时间框架和排除协议的限制。这些限制阻碍了对动态生理波动的准确捕捉，特别是在服务不足的人群和患有复杂或罕见自主神经疾病的人群中。本文概述了可穿戴技术和移动健康（mHealth）平台如何重新定义ANS研究的景观。通过实现持续的、真实的监测和整合多模式数据，包括全面的生理和行为信号、患者报告的结果，这些工具为个性化、分散和实用的临床试验设计提供了前所未有的机会，并使早期发现和干预成为可能。我们研究了可穿戴传感器的发展，人工智能在将原始数据转化为临床可操作见解方面的作用，以及数字优先研究的经济和公平影响。随着监管力度的增强和现实证据的增加，可穿戴技术和自主科学的融合不仅标志着方法的转变，而且标志着临床科学如何、在哪里以及为谁进行的根本重新定义。

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引用次数: 0

Characterisation of Postural Orthostatic Tachycardia Syndrome (POTS): Findings from a physician chart-audit pre- and post-COVID-19 体位性站立性心动过速综合征（POTS）的特征：来自covid -19前后医师图表审计的发现

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-22 DOI: 10.1016/j.autneu.2025.103378

Joost J. van Middendorp , Martina Orlovic , Femke De Ruyck , Montserrat Roset , Mayara Torres , Daniel Cuadras , Josep Maria Garcia-Alamino , Satish R. Raj , Pam R. Taub , Artur Fedorowski

Introduction

Postural orthostatic tachycardia syndrome (POTS) is a complex disorder with challenging diagnosis and management.

Methods

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.

Results

Physicians (n = 153), primarily cardiologists (77.1 %), reported data from 599 patients from two cohorts: 1) POTS not triggered by COVID-19 (n = 361) and 2) POTS triggered by COVID-19 (n = 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.

Conclusion

This study highlights the challenges faced by POTS patients, while providing insights into the diagnostic and treatment approaches in real-world settings.

体位性体位性心动过速综合征（POTS）是一种复杂的疾病，具有挑战性的诊断和治疗。方法这项横断面、多国、基于网络的医师图表审计描述了POTS的临床特征和管理，为COVID-19大流行前后的疾病负担和结局提供了见解。结果内科医生（n = 153），主要是心脏病专家（77.1%），报告了来自两个队列的599例患者的数据：1)非COVID-19引发的POTS （n = 361）和2)COVID-19引发的POTS （n = 238）。总体而言，大多数患者在18至39岁之间出现POTS症状（33%），其中13%在18岁之前出现症状。超过70%的人至少有一种先前存在的疾病。大多数患者通过5-8项检查来确定POTS的诊断。大约80%的人在确诊POTS之前得到了错误的诊断，25%的人等了一年多才得到诊断。虽然一些患者症状严重程度随时间减轻，但在最后一次咨询时症状仍持续存在。非药物干预在一线治疗中很常见。在随后的研究中，药物治疗有所增加，受体阻滞剂和伊瓦布雷定是最常用的处方药。对比分析发现，由COVID-19引发的POTS患者年龄稍大，合并症较少，但差异无临床意义，提示诊断、管理和治疗模式相似。美国和欧洲在诊断和治疗模式上存在区域差异。结论本研究突出了POTS患者面临的挑战，同时为现实环境中的诊断和治疗方法提供了见解。

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引用次数: 0

Antioxidant tempol reverses autonomic dysregulation and neurogenic hypertension in acid-sensing ion channel 2 deficient mice 抗氧化tempol逆转酸敏感离子通道2缺陷小鼠的自主神经失调和神经源性高血压

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-19 DOI: 10.1016/j.autneu.2025.103376

Rasna Sabharwal , Francois M. Abboud , Mark W. Chapleau

Acid-Sensing Ion Channel 2 (ASIC2) has been implicated in mechanosensation. We reported previously that ASIC2 is highly expressed in aortic baroreceptor neurons and contributes to baroreceptor mechanotransduction; and that ASIC2 deficient mice exhibit decreased baroreflex sensitivity (BRS), sympathovagal imbalance and neurogenic hypertension. Oxidative stress is widely considered an important contributor to hypertension. The major goal of this study was to determine if treatment of ASIC2^−/− mice with the antioxidant tempol attenuates baroreflex/autonomic dysfunction and hypertension. Blood pressure (BP), heart rate (HR) and locomotor activity were measured by telemetry in conscious, control C57BL/6 and ASIC2^−/− male mice, before and after administration of tempol in drinking water (1 mM) for two weeks. Cardiac sympathetic tone, mean arterial BP and BP variability were higher, and cardiac vagal tone and BRS were lower in ASIC2^−/− mice, compared with controls (P < 0.05). Oxidative stress measured by mRNA expression of NADPH oxidase subunits (Nox2, Nox4, p22phox) and dihydroethidium (DHE) fluorescence was increased significantly (P < 0.05) in ASIC2^−/− mice in a tissue-specific manner (sympathetic and nodose ganglia > > brain stem > > skeletal muscle, with no change in aorta). Treatment with tempol strongly attenuated DHE fluorescence and restored autonomic regulation and BP to control levels in ASIC2^−/− mice, while not affecting these phenotypes in control mice. We conclude: (1) oxidative stress in ASIC2^−/− mice is prominent in the autonomic nervous system but not present in aorta; and (2) the antioxidant tempol reverses decreased BRS, sympathovagal imbalance and hypertension in ASIC2^−/− mice; effects that are associated with decreased oxidative stress.

酸感离子通道2 （ASIC2）与机械感觉有关。我们之前报道过ASIC2在主动脉压力感受器神经元中高度表达，并参与压力感受器的机械转导；ASIC2缺陷小鼠表现出压力反射敏感性（BRS）下降、交感神经迷走神经失衡和神经源性高血压。氧化应激被广泛认为是高血压的一个重要因素。本研究的主要目的是确定抗氧化tempol治疗ASIC2 - / -小鼠是否能减轻压力反射/自主神经功能障碍和高血压。用遥测法测量了清醒对照C57BL/6和ASIC2 - / -雄性小鼠在给药2周后（1 mM）的血压（BP）、心率（HR）和运动活动。与对照组相比，ASIC2−/−小鼠的心脏交感神经张力、平均动脉血压和血压变异性较高，心脏迷走神经张力和BRS较低（P < 0.05）。通过NADPH氧化酶亚基（Nox2, Nox4, p22phox）和二氢乙胺（DHE）荧光mRNA表达测量的氧化应激在ASIC2−/−小鼠中以组织特异性方式（交感神经节和结节神经节>； >；脑干>； >；骨骼肌，主动脉无变化）显著增加（P < 0.05）。在ASIC2 - / -小鼠中，tempol处理强烈减弱DHE荧光，并将自主调节和血压恢复到控制水平，而在对照小鼠中不影响这些表型。我们得出结论：(1)ASIC2 - / -小鼠的氧化应激在自主神经系统中突出，但在主动脉中不存在；(2)抗氧化tempol逆转ASIC2−/−小鼠BRS下降、交感迷走神经失衡和高血压；与减少氧化应激有关的作用。

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引用次数: 0

Neuroendocrine, behavioral, cardiovascular and autonomic responses to acute and repeated restraint stress in male rats 雄性大鼠对急性和重复约束应激的神经内分泌、行为、心血管和自主神经反应。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-17 DOI: 10.1016/j.autneu.2025.103375

Cristiane Busnardo , Lucas Barreto-de-Souza , Luana Omena-Giatti , Taíz F.S. Brasil , Heloísa H. Vilela-Costa , Fernando M.A. Corrêa , Carlos C. Crestani

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.

生物系统似乎受到不同的压力影响，导致表达适应和不适应的反应。本研究旨在比较神经内分泌（血浆皮质酮）、行为（焦虑和抑郁样效应）、心血管（血压和心率）和自主神经（尾皮温度和血压的频域分析和脉搏间隔变异）在急性（单次2小时）和第21次（连续21天每天2小时）约束应激期间观察到的反应。我们发现，急性约束应激降低了探索升高+迷宫（EPM）张开双臂，尾部皮肤温度和心脏副交感神经张力；随着血浆皮质酮水平升高，血压，心率和交感神经调节血压和脉搏间隔。反复暴露于约束完全抑制或降低血压，心动过速和交感/副交感神经反应；表明自主神经和心血管反应的习惯化。慢性应激动物在强迫游泳试验中也表现出更强的不动性，在飞溅试验和EPM张开双臂探索中表现出更短的梳理时间，表明了焦虑和抑郁样的作用。此外，慢性约束应激提高了基础血浆皮质酮和尾皮温度反应。总之，对慢性同种型应激源的广泛生理和行为反应的分析表明，适应性调节的表达主要表现为自主神经/心血管变化的习惯化。然而，也观察到诸如焦虑和抑郁样效应以及基础皮质酮增加等适应不良变化。

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引用次数: 0

The orthostatic tolerance of service personnel of the Household Division of the British Army 英国陆军家庭部队服役人员的直立容忍度。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-13 DOI: 10.1016/j.autneu.2025.103374

Iain Parsons , Michael Stacey , Nick Gall , David Woods

Reflex syncope is common among UK Armed Forces (UKAF) personnel in the Household Division, particularly during ceremonial duties involving prolonged orthostatic stress. This study aimed to (1) assess orthostatic tolerance (OT) using head-up tilt combined with lower body negative pressure (HUT/LBNP), (2) evaluate the retrospective diagnostic accuracy of HUT/LBNP based on syncope trigger, and (3) examine test repeatability. Seventy-three service personnel were categorized into ORTHOSTATIC (27 %), NON-ORTHOSTATIC (16 %), or CONTROL (56 %) groups based on prior syncopal history. OT was measured to presyncope using a standardized HUT/LBNP protocol with continuous cardiovascular monitoring. Repeatability was assessed in a subset of 17 participants one week apart. Mean OT across participants was 32 ± 12 min. The ability of HUT/LBNP-derived OT to identify prior reflex syncope yielded an AUC of 0.75 (p = 0.0003), improving to 0.85 (p < 0.0001) in the ORTHOSTATIC group but was non-significant in NON-ORTHOSTATIC participants (p = 0.44). HUT/LBNP demonstrated high repeatability (bias: 1.1 ± 4.2 min; 3 ± 11 %). UKAF personnel with orthostatic-mediated syncope had significantly lower OT compared to both non-fainters and those with non-orthostatic syncope. HUT/LBNP is a reproducible tool that can discriminate between syncope subtypes and may be useful in monitoring intervention efficacy and guiding management in high-risk occupational settings.

反射性晕厥在英国武装部队（UKAF）家庭部门的人员中很常见，特别是在涉及长时间站立压力的仪式职责期间。本研究旨在(1)评估直立性耐受性（OT）使用平视倾斜联合下体负压（HUT/LBNP），(2)评估基于晕厥触发器的HUT/LBNP回顾性诊断的准确性，(3)检验测试的重复性。73名服役人员根据既往晕厥病史分为正位组（27%）、非正位组（16%）和对照组（56%）。使用标准化的HUT/LBNP方案测量OT至晕厥前，并持续监测心血管。每隔一周对17名参与者进行重复性评估。参与者的平均OT时间为32±12分钟。HUT/ lbnp衍生OT识别既往反射性晕厥的AUC为0.75 (p = 0.0003)，改善至0.85 （p = 0.0003）

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引用次数: 0

Wearable ANS monitoring in real life: A critical review of context-sensitive interpretation and implications for psychophysiology 现实生活中的可穿戴式ANS监测：对情境敏感的解释和心理生理学意义的批判性回顾

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-08 DOI: 10.1016/j.autneu.2025.103364

Greg J. Norman , Eric Morgan , Sabina Raja , Gary G. Berntson

Wearable autonomic sensors are rapidly expanding the reach of psychophysiological research into real-world environments. These tools hold clear promise for advancing our understanding of how autonomic nervous system (ANS) function relates to emotion, stress, health, and disease. However, interpreting wearable ANS signals outside the laboratory presents unique conceptual and methodological challenges. In this critical review, we outline the theoretical foundations of ANS flexibility and context-sensitivity, summarize the technical capabilities and limitations of current wearable ANS devices, and highlight the critical role of contextual information—ranging from behavioral state to social environment—in shaping the meaning of ambulatory physiological data. We emphasize that ANS signals cannot be meaningfully interpreted in isolation and that understanding their relevance for health and behavior depends on careful consideration of both physiological and situational context. Finally, we discuss key challenges and future directions for wearable ANS monitoring, including improving signal quality, advancing data interpretation through context-aware modeling, and addressing privacy and ethical concerns. Together, these efforts are essential for realizing the potential of wearable ANS sensors to support both scientific discovery and clinical application.

可穿戴式自主传感器正迅速将心理生理学研究的范围扩展到现实环境中。这些工具对促进我们对自主神经系统（ANS）功能如何与情绪、压力、健康和疾病相关的理解有着明确的希望。然而，在实验室之外解释可穿戴ANS信号提出了独特的概念和方法挑战。在这篇重要的综述中，我们概述了ANS灵活性和上下文敏感性的理论基础，总结了当前可穿戴ANS设备的技术能力和局限性，并强调了上下文信息（从行为状态到社会环境）在塑造动态生理数据意义中的关键作用。我们强调，ANS信号不能孤立地进行有意义的解释，理解它们与健康和行为的相关性取决于仔细考虑生理和情境背景。最后，我们讨论了可穿戴式ANS监控的主要挑战和未来方向，包括提高信号质量，通过上下文感知建模推进数据解释，以及解决隐私和道德问题。总之，这些努力对于实现可穿戴ANS传感器的潜力至关重要，以支持科学发现和临床应用。

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引用次数: 0

Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension 直立性高血压与直立性血压正常者肌肉交感神经活动的差异

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-04 DOI: 10.1016/j.autneu.2025.103366

Tadayuki Hirai , Hisayoshi Murai , Hiroyuki Sugimoto , Yusuke Mukai , Hideki Tokuhisa , Tatsunori Ikeda , Daisuke Kobayashi , Shigeo Takata , Kenji Sakata , Soichiro Usui , Masayuki Takamura

Orthostatic hypertension (OrthoHT), an excessive pressor response to standing, increases cardiovascular risk; however, its relationship with sympathetic nerve activity is poorly understood. This study aimed to assess differences in muscle sympathetic nerve activity (MSNA) between patients with OrthoHT and those with orthostatic normotensive hypertension. We measured resting MSNA in seven patients with OrthoHT and 11 matched controls. The OrthoHT group exhibited significantly elevated MSNA burst frequency (38.4 ± 12.2 vs. 28.3 ± 5.7 bursts/min, P < 0.05) and burst incidence (61.1 ± 21.3 vs. 44.6 ± 11.1 bursts/100 heartbeats, P < 0.05). In conclusion, OrthoHT is strongly associated with sympathetic hyperactivity at rest, suggesting that this may be a key physiological mechanism contributing to the increased cardiovascular risk observed in these patients.

直立性高血压（OrthoHT），站立时过度的血压反应，增加心血管风险；然而，它与交感神经活动的关系尚不清楚。本研究的目的是评估肌肉交感神经活动（MSNA）的差异在矫形ht患者和直立性血压正常的高血压患者。我们测量了7名OrthoHT患者和11名匹配对照的静息MSNA。OrthoHT组的MSNA爆发频率（38.4±12.2次/min vs 28.3±5.7次/min， P < 0.05）和爆发发生率（61.1±21.3次vs 44.6±11.1次/100次心跳，P < 0.05）显著升高。总之，OrthoHT与静息时交感神经亢进密切相关，提示这可能是导致这些患者心血管风险增加的关键生理机制。

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引用次数: 0

Selective sympathetic action on heart rate variability after ultrasound-guided stellate ganglion block 超声引导星状神经节阻滞后选择性交感作用对心率变异性的影响

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-04 DOI: 10.1016/j.autneu.2025.103367

Ole C. Keim , Raoul C. Raum , Robert E. Feldmann Jr , Dieter Kleinboehl , Justus Benrath

Objective

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.

Methods

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.

Results

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.

Conclusion

The current study demonstrates that usSGB renders HRV changes indicating selective sympathetic inhibition of the heart without affecting vagal tone.

目的：星状神经节阻滞（SGB）可阻断自主神经系统交感神经分支，但其对心率变异性（HRV）的具体影响尚不清楚。此外，从解剖学角度看，迷走神经与星状神经节相邻。因此，迷走神经也可能受到SGB的影响。本研究旨在评估通过超声引导的SGB技术选择性阻断心脏和上肢传出交感神经纤维的可能性。方法在一项基于受试者内设计的安慰剂对照双盲试验中，12名健康男性志愿者分别接受了3 ml 1%罗比卡因（verum）或0.9%生理盐水溶液（安慰剂）的右侧超声引导SGB （usSGB）。在干预前和干预后分别评估HRV。结果两组患者在usSGB前后HRV时域指标无明显变化。然而，在手术前后，两者在低频/高频比（LF/HF ratio）方面存在显著差异。结论目前的研究表明，usSGB使HRV改变表明选择性交感抑制心脏，而不影响迷走神经张力。

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引用次数: 0

Psychosocial profiles of autonomic dysfunction 自主神经功能障碍的社会心理特征

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 DOI: 10.1016/j.autneu.2025.103365

William S. Frye , Sydney Ward , Daniel Mauriello , Brooke Mitchell , Jamie Decker

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.

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.

Symptom severity scores exceeded clinical cutoffs for the full sample (65.8) and across HR groups. Independent t-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.

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.

自主神经异常的各种形式，包括体位性站立性心动过速综合征（POTS），对年轻人的影响很大，但社会心理方面的研究仍不足，特别是在被诊断为POTS的患者之外。本研究考察了自主神经功能障碍青年的临床和社会心理特征，并比较了不同心率（HR）组对直立测试的反应。本回顾性研究分析了自主神经功能障碍青年的人口统计学、症状、生活质量（QoL）和心理健康变量（如焦虑、抑郁、多动症）。比较高、低HR反应组之间的差异。使用PedsQL™评估生活质量，使用Malmö POTS症状评分（MAPS）测量症状严重程度。从电子病历中提取病史和心理社会问题。症状严重程度评分超过了整个样本（65.8）和HR组的临床临界值。独立t检验显示各组间任何变量均无差异。疼痛（92.5%）和进食障碍（42.5%）在整个样本中普遍存在。所有领域的临床生活质量都受到损害，心理健康问题，如焦虑（83.3%）和抑郁（54.3%）是常见的。研究结果描述了自主神经功能障碍青年的普遍症状和心理社会负担，这在高HR反应组和低HR反应组中是一致的。该研究强调了解决所有自主神经功能障碍患者的医疗、心理健康和日常生活挑战的重要性。此外，它强调了扩大研究和临床重点的重要性，以包括所有患有自主神经功能障碍的青年，而不管HR的反应如何，以确保经历损伤的青年获得所需的全面护理。

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