Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"Antioxidant tempol reverses autonomic dysregulation and neurogenic hypertension in acid-sensing ion channel 2 deficient mice","authors":"Rasna Sabharwal ,&nbsp;Francois M. Abboud ,&nbsp;Mark W. Chapleau","doi":"10.1016/j.autneu.2025.103376","DOIUrl":"10.1016/j.autneu.2025.103376","url":null,"abstract":"<div><div>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 (<em>P</em> &lt; 0.05). Oxidative stress measured by mRNA expression of NADPH oxidase subunits (Nox2, Nox4, p22phox) and dihydroethidium (DHE) fluorescence was increased significantly (<em>P</em> &lt; 0.05) in ASIC2^−/− mice in a tissue-specific manner (sympathetic and nodose ganglia &gt; &gt; brain stem &gt; &gt; 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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103376"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840682","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":"Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension","authors":"Tadayuki Hirai ,&nbsp;Hisayoshi Murai ,&nbsp;Hiroyuki Sugimoto ,&nbsp;Yusuke Mukai ,&nbsp;Hideki Tokuhisa ,&nbsp;Tatsunori Ikeda ,&nbsp;Daisuke Kobayashi ,&nbsp;Shigeo Takata ,&nbsp;Kenji Sakata ,&nbsp;Soichiro Usui ,&nbsp;Masayuki Takamura","doi":"10.1016/j.autneu.2025.103366","DOIUrl":"10.1016/j.autneu.2025.103366","url":null,"abstract":"<div><div>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, <em>P</em> &lt; 0.05) and burst incidence (61.1 ± 21.3 vs. 44.6 ± 11.1 bursts/100 heartbeats, P &lt; 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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103366"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694536","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":"The orthostatic tolerance of service personnel of the Household Division of the British Army","authors":"Iain Parsons ,&nbsp;Michael Stacey ,&nbsp;Nick Gall ,&nbsp;David Woods","doi":"10.1016/j.autneu.2025.103374","DOIUrl":"10.1016/j.autneu.2025.103374","url":null,"abstract":"<div><div>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 (<em>p</em> = 0.0003), improving to 0.85 (<em>p</em> &lt; 0.0001) in the ORTHOSTATIC group but was non-significant in NON-ORTHOSTATIC participants (<em>p</em> = 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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103374"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919212","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":"Neuromodulation of heart rate variability: A systematic review","authors":"Rodrigo Souza ,&nbsp;Irinaldo Capítulino de Souza ,&nbsp;Suellen Mary Marinho do Santos Andrade ,&nbsp;Marcelo Rodrigo Portela Ferreira","doi":"10.1016/j.autneu.2026.103379","DOIUrl":"10.1016/j.autneu.2026.103379","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103379"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926547","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":"Characterisation of Postural Orthostatic Tachycardia Syndrome (POTS): Findings from a physician chart-audit pre- and post-COVID-19","authors":"Joost J. van Middendorp ,&nbsp;Martina Orlovic ,&nbsp;Femke De Ruyck ,&nbsp;Montserrat Roset ,&nbsp;Mayara Torres ,&nbsp;Daniel Cuadras ,&nbsp;Josep Maria Garcia-Alamino ,&nbsp;Satish R. Raj ,&nbsp;Pam R. Taub ,&nbsp;Artur Fedorowski","doi":"10.1016/j.autneu.2025.103378","DOIUrl":"10.1016/j.autneu.2025.103378","url":null,"abstract":"<div><h3>Introduction</h3><div>Postural orthostatic tachycardia syndrome (POTS) is a complex disorder with challenging diagnosis and management.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Physicians (<em>n</em> = 153), primarily cardiologists (77.1 %), reported data from 599 patients from two cohorts: 1) POTS not triggered by COVID-19 (<em>n</em> = 361) and 2) POTS triggered by COVID-19 (<em>n</em> = 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.</div></div><div><h3>Conclusion</h3><div>This study highlights the challenges faced by POTS patients, while providing insights into the diagnostic and treatment approaches in real-world settings.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103378"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884324","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":"Neuroendocrine, behavioral, cardiovascular and autonomic responses to acute and repeated restraint stress in male rats","authors":"Cristiane Busnardo ,&nbsp;Lucas Barreto-de-Souza ,&nbsp;Luana Omena-Giatti ,&nbsp;Taíz F.S. Brasil ,&nbsp;Heloísa H. Vilela-Costa ,&nbsp;Fernando M.A. Corrêa ,&nbsp;Carlos C. Crestani","doi":"10.1016/j.autneu.2025.103375","DOIUrl":"10.1016/j.autneu.2025.103375","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103375"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821886","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":"Selective sympathetic action on heart rate variability after ultrasound-guided stellate ganglion block","authors":"Ole C. Keim ,&nbsp;Raoul C. Raum ,&nbsp;Robert E. Feldmann Jr ,&nbsp;Dieter Kleinboehl ,&nbsp;Justus Benrath","doi":"10.1016/j.autneu.2025.103367","DOIUrl":"10.1016/j.autneu.2025.103367","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>The current study demonstrates that usSGB renders HRV changes indicating selective sympathetic inhibition of the heart without affecting vagal tone.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103367"},"PeriodicalIF":3.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665710","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":"The potential of taVNS in attenuating blood-brain barrier damage, promoting angiogenesis and improving impaired cognitive function in a rat model of vascular cognitive impairment and dementia by activating the Wnt7/β-catenin signaling pathway","authors":"Rongshan Sun ,&nbsp;Hong Li ,&nbsp;Meng Wang ,&nbsp;Long Yan ,&nbsp;Jinglei Jiang ,&nbsp;Qidi Liu ,&nbsp;Shijun Li ,&nbsp;Ying Liang ,&nbsp;Yulin Qian ,&nbsp;Tao Yu","doi":"10.1016/j.autneu.2025.103353","DOIUrl":"10.1016/j.autneu.2025.103353","url":null,"abstract":"<div><h3>Background</h3><div>Studies consistently demonstrate that vascular cognitive impairment and dementia (VCID) onset and progression are associated with diminished activity in the Wnt/β-catenin signaling pathway, crucial for maintaining blood-brain barrier (BBB) integrity and promoting angiogenesis in the central nervous system. Transcutaneous auricular vagal nerve stimulation (taVNS) has shown potential to enhance cognitive function by reducing BBB permeability and stimulating angiogenesis, yet its direct linkage to the Wnt7/β-catenin pathway activation remains uncertain and requires mechanistic validation.</div></div><div><h3>Methods</h3><div>A rat model of VCID was established by inducing temporary bilateral common carotid artery occlusion (tBCCAO) in rats. Following surgery, rats received daily taVNS treatments for 14 consecutive days (Days 13–26). Cognitive function was assessed on postoperative day 26. Additionally, the hippocampal region was analyzed to detect changes in the Wnt7/β-catenin signaling pathway-related proteins, neuronal injury and apoptosis, angiogenesis, BBB tight junction integrity, and astrocyte activation.</div></div><div><h3>Results</h3><div>TaVNS treatment resulted in significant cognitive improvements, alongside marked reductions in neuronal damage and apoptosis within the hippocampal CA1 region. It effectively decreased BBB permeability and enhanced angiogenesis. Mechanistically, taVNS suppressed astrocyte activation, promoted a shift from pro-inflammatory (A1) to anti-inflammatory (A2) phenotypes, and consequently upregulated the Wnt7/β-catenin signaling pathway, boosting expression of its downstream targets to foster neuroprotection and vascular repair.</div></div><div><h3>Conclusions</h3><div>This study confirms that taVNS effectively alleviates neurological damage in VCID by upregulating the Wnt7/β-catenin pathway, potentially through astrocyte phenotypic modulation. These findings underscore taVNS as a promising non-invasive intervention for cognitive deficits in vascular disorders, warranting further clinical investigation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103353"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318961","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":"Asymmetric neuroplasticity in stellate ganglia: Unveiling side-specific adaptations to aerobic exercise","authors":"Fernando Vagner Lobo Ladd ,&nbsp;Aliny Antunes Barbosa ,&nbsp;Renato Albuquerque de Oliveira Cavalcanti ,&nbsp;Larissa Freitas ,&nbsp;Reinaldo Barreto Oriá ,&nbsp;Ricardo Mario Arida ,&nbsp;Mariana Pereira de Melo ,&nbsp;Andrzej Loesch ,&nbsp;A. Augusto Coppi","doi":"10.1016/j.autneu.2025.103338","DOIUrl":"10.1016/j.autneu.2025.103338","url":null,"abstract":"<div><div>The stellate ganglia (SG) are a cluster of sympathetic nerve cells situated in the neck, positioned ventrally to the longus colli muscle and play a vital role in regulating cardiovascular function, especially by modulating cardiac sympathetic nerve activity. While the cardiovascular effects of exercise have been extensively studied, little is known about how physical activity influences the three-dimensional structure of SG neurons. Previous research in Wistar rats demonstrated that aerobic exercise training affects cardiovascular physiology, notably by decreasing heart rate without altering arterial pressures. Remarkably, hypertrophy of SG neurons was observed, suggesting a potential overload-induced adaptation. However, whether these structural changes exhibit side-specific patterns remain unclear. To address this gap, we investigated the effects of moderate-intensity aerobic exercise on SG structure with a focus on body-side asymmetry. Using advanced 3D image analysis and stereological methods, we quantified total neuron count, mean neuronal volume, and overall SG volume in four experimental groups: (1) untrained left SG, (2) trained left SG, (3) untrained right SG, and (4) trained right SG. After 10 weeks of treadmill exercise, trained animals displayed a fourfold increase in neuron count in the right SG compared to the left, an asymmetry absent in untrained animals. Additionally, exercise produced divergent effects on neuronal size: right-side neurons underwent atrophy (1.2-fold decrease), whereas left-side neurons exhibited hypertrophy (1.8-fold increase). In trained animals SG volume was reduced by 1.04- (left SG) or 1.4-fold (right SG) depending on the body side considered. These findings reveal a complex, side-specific neuroplastic response of the autonomic nervous system to physical exercise. The observed asymmetric changes in neuron count, size, and ganglia volume challenge traditional views on exercise-induced neuroplasticity, suggesting a more nuanced and functionally relevant adaptation. This study advances our understanding of autonomic nervous system plasticity in response to exercise and encourages further research into side-specific adaptations, with potential implications for targeted interventions in autonomic disorders, including those impacting cardiovascular function.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103338"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139578","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":"Supportive self-management in postural orthostatic tachycardia syndrome (POTS): A systematic review","authors":"Helen Eftekhari ,&nbsp;Gemma Pearce ,&nbsp;Akansha Singh ,&nbsp;Sophie Staniszewska ,&nbsp;Kate Seers","doi":"10.1016/j.autneu.2025.103342","DOIUrl":"10.1016/j.autneu.2025.103342","url":null,"abstract":"<div><h3>Aim</h3><div>This systematic review aimed to identify components of supportive self-management for postural orthostatic tachycardia syndrome and critically appraise the evidence base.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Data sources</h3><div>EMBASE, MEDLINE, CINHAL and charity databases, trial registries and grey literature were searched until December 14th, 2023.</div></div><div><h3>Review methods</h3><div>The PRISMA guidelines were followed for the search strategy. Data were mapped to the Practical Reviews in Self-management Support taxonomy components and the Middle Range Theory of Self-Care in Chronic Illness. Synthesis and analysis followed guidance on reporting without meta-analysis with summary tables, a logic model, harvest plot, and narrative synthesis.</div></div><div><h3>Results</h3><div>36 studies were included. Components of supportive self-management were found in 1) lifestyle advice, 2) provision of equipment, and 3) support with adherence. No studies were found on 1) education, 2) psychological well-being, 3) communication needs with health professionals and social support networks, 4) reliable sources of information, 5) training for practical self-management, or clinical action plans, and 5) social support. Studies efficacy’ was hampered by poor research designs, short studies of one day duration, and appropriateness of outcome measures.</div></div><div><h3>Conclusions</h3><div>Significant gaps were identified requiring further research 1) self-care monitoring activities 2) self-care management activities, 3) provision of education, information and resources 4) addressing psychological well-being and 5) addressing social support. A specific gap exists in the POTS evidence base in nurse led interventions.</div></div><div><h3>Impact</h3><div>This review evaluates supportive self-management components and identifies key issues with the current evidence base that require addressing to improve and inform the support needs and services of this often disabling, and predominantly female condition. This review is a novel integration of the taxonomy and theory.</div></div><div><h3>Patient and public contribution</h3><div>Findings were discussed with a postural tachycardia syndrome advisory group, providing important insights into key issues with the studies validity, reliability and generalisability from their perspectives</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103342"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330916","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}