Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"Age-related decrease in heat pain tolerance is associated with a simultaneous decline in C-fiber functionality and local cutaneous vasodilation","authors":"Bruno Rojas-Roel ,&nbsp;Julia Devanne ,&nbsp;Olivier Després ,&nbsp;Thierry Pebayle ,&nbsp;André Dufour ,&nbsp;Ségolène Lithfous","doi":"10.1016/j.autneu.2025.103361","DOIUrl":"10.1016/j.autneu.2025.103361","url":null,"abstract":"<div><div>This study aimed to investigate the role of cutaneous vasodilation in heat pain tolerance during aging. We hypothesized that reduced vasodilation in response to heat would lead to a less efficient heat dissipation, and thus be associated with diminished heat pain tolerance. Due to their efferent role in vasomotor function, we hypothesized that C-fiber functionality would be associated to the efficacy of cutaneous vasodilation. Twenty younger and forty older subjects participated in a 15-min heat pain tolerance test, during which pain ratings were continuously measured, along with skin temperature. Participants could terminate the test at any time if the pain became unbearable. A local thermal hyperemia protocol was conducted to assess cutaneous vasodilation using laser Doppler flowmetry. Warm detection and heat pain thresholds were measured to evaluate small fiber functionality. Older subjects were divided into two groups according to their pain tolerance duration. The older MAX group (n = 22; i.e., 55 %) completed the tolerance test, while the older LOW group did not. Older MAX had preserved cutaneous vasodilation compared to young subjects, whereas older LOW had reduced heat-induced vasodilation. In addition, the skin temperature of older LOW subjects reached a higher level during the pain tolerance test, which was associated to higher pain ratings compared to the two other groups. Older LOW also had higher warm detection threshold, pointing to diminished C-fiber functionality. Reduced cutaneous vasodilation, possibly linked to impaired C-fiber functionality in aging, affects heat pain tolerance due to less efficient heat dissipation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103361"},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356829","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":"Antihypertensive effects of the treatment with ATZ and losartan in L-NAME hypertensive rats","authors":"Roberto Braz Pontes,&nbsp;Paulo Ricardo Lopes,&nbsp;Débora S.A. Colombari,&nbsp;Patrícia M. De Paula,&nbsp;Eduardo Colombari,&nbsp;Carina A.F. Andrade,&nbsp;Laurival A. De Luca Jr,&nbsp;José V. Menani","doi":"10.1016/j.autneu.2025.103359","DOIUrl":"10.1016/j.autneu.2025.103359","url":null,"abstract":"<div><div>Previous works suggest that hydrogen peroxide (H₂O₂), a reactive oxygen species, attenuates brain angiotensin II-mediated hypertension in rats. Moreover, the subcutaneous (s.c.) administration of 3-amino-1,2,4-triazole (ATZ), a catalase inhibitor that increases H₂O₂ availability, reduces hypertension and sympathetic activity simultaneously with an increase in angiotensinergic activity in spontaneously hypertensive rats (SHRs). It is not clear how much the increase in angiotensinergic activity affects the sympatho-inhibition and the antihypertensive effect of ATZ, and if this is specific for SHRs. The present study evaluated the effects of s.c. ATZ and losartan (angiotensin II AT1 antagonist), alone or combined for 7 days, on mean arterial pressure (MAP) in nitric oxide synthase-inhibited hypertensive rats (L-NAME model). In addition, angiotensinergic and sympathetic activities were also investigated using acute intravenous losartan and hexamethonium (ganglionic blocker) in the same rats. The treatment with ATZ + losartan s.c. reduced MAP slightly below to normotensive levels in L-NAME hypertensive rats (88 ± 8, vs. L-NAME + saline: 162 ± 7 mmHg), whereas s.c. losartan alone partially reduced MAP (133 ± 7 mmHg). The hypotensive responses produced by hexamethonium were reduced in rats treated with ATZ + losartan s.c. (−44 ± 12, vs. L-NAME + saline: −71 ± 6 mmHg), suggesting that the treatment with ATZ + losartan s.c. significantly reduced sympathetic activation in L-NAME-treated rats. These findings suggest that the combination of ATZ and losartan efficiently blocks sympathetic and angiotensinergic activation in L-NAME hypertensive rats, abolishing hypertension. Further research is necessary on the mechanisms of H₂O₂ and ATZ antihypertensive action.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103359"},"PeriodicalIF":3.3,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363495","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":"Autonomic dysfunction in polycystic ovary syndrome","authors":"Zoe H. Adams ,&nbsp;Lydia L. Simpson ,&nbsp;Emma C. Hart ,&nbsp;Rachel N. Lord","doi":"10.1016/j.autneu.2025.103357","DOIUrl":"10.1016/j.autneu.2025.103357","url":null,"abstract":"<div><div>Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting premenopausal females. Alongside the endocrine, reproductive and psychological consequences of the condition, PCOS has now been linked to increased risk of cardiovascular and metabolic disease e.g., insulin resistance. The mechanisms behind this excess risk are not fully understood and multiple characteristics of PCOS (e.g., hyperandrogenism, obesity and vascular dysfunction) likely contribute to individual risk. Autonomic dysfunction may also drive cardiovascular risk in PCOS, via its effects on both blood pressure control and the modulation of sex hormone release at the ovaries. Whilst current studies are limited by moderate sample sizes and one-off measurements, evidence broadly suggests that sympathetic activity may be increased, and vagal control of heart rate may be reduced in PCOS. In this review, we examine the potential mechanisms by which autonomic dysfunction may occur in PCOS. Finally, we discuss how PCOS may interact with ageing and ethnicity to modulate cardiovascular risk secondary to autonomic dysfunction.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103357"},"PeriodicalIF":3.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350160","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":"Clinical features of paroxysmal sympathetic hyperactivity in brain tumor: a retrospective case series study and literature review","authors":"Ying Zhou,&nbsp;Guangqiang Chen,&nbsp;Guangzhi Shi","doi":"10.1016/j.autneu.2025.103352","DOIUrl":"10.1016/j.autneu.2025.103352","url":null,"abstract":"<div><h3>Background</h3><div>Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of brain tumor, mostly occurred after craniotomy for brain tumor resection. The purpose of this study is to characterize the pathogenesis and clinical features of PSH in brain tumor.</div></div><div><h3>Methods</h3><div>All PSH cases with brain tumor at a single center over a 4-year period were retrospectively identified based on medical records. A systematic literature review of the PSH cases with brain tumor was also conducted. PubMed and Web of Science databases were searched.</div></div><div><h3>Results</h3><div>We identified nine patients at our center and 14 patients in the literature with brain tumor and PSH. There were 10 adult patients and 13 pediatric patients with a median age of 13 years. Most tumors (96 %) were located in deep brain regions. The brainstem and adjacent structures were the most common tumor locations, accounting for 70 %. Glioma (39 %) was the most common pathology type. The onset of PSH occurred after tumor resection or biopsy in 18 patients, during tumor resection in two patients, and during conservative treatment in three patients. The most common PSH symptoms in brain tumor were hypertension (100 %) and tachycardia (96 %).</div></div><div><h3>Conclusions</h3><div>PSH is not only an underlying complication of brain tumor resection, but also a rare clinical manifestation of brain tumor. We speculate that damage to the midbrain or pons, especially close to the midline of the tegmentum, might be one of the lesion patterns underlying PSH.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103352"},"PeriodicalIF":3.3,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423527","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":"Autonomic symptom burden, comorbidities and quality of life in women with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos syndrome","authors":"Meagan L. Collins Hutchinson ,&nbsp;Emily Liang ,&nbsp;Emily Fuster ,&nbsp;Svetlana Blitshteyn","doi":"10.1016/j.autneu.2025.103356","DOIUrl":"10.1016/j.autneu.2025.103356","url":null,"abstract":"<div><h3>Background</h3><div>Hypermobility Spectrum Disorders (HSD) and hypermobile Ehlers-Danlos syndrome (h-EDS) are multisystemic connective tissue disorders involving joint hypermobility and numerous other manifestations. Autonomic dysfunction, chronic pain, and chronic fatigue are known comorbidities of HSD and h-EDS that can affect patient quality of life (QoL), but there are limited data on the severity of autonomic symptoms, prevalence of comorbid conditions and QoL in patients with HSD/h-EDS.</div></div><div><h3>Methods</h3><div>We utilized the Composite Autonomic Symptom Scale (COMPASS-31) to assess autonomic symptom severity, Short-Form 36 (SF-36) to assess QoL, and the Beck Depression Inventory Second Edition (BDI-II) in a cohort of women with physician-diagnosed HSD or h-EDS, who completed these questionnaires anonymously.</div></div><div><h3>Results</h3><div>84 women (mean age of 37.1 ± 8.4 years) completed the study. 58.3 % reported having physician-diagnosed postural orthostatic tachycardia syndrome (POTS), 32.1 % had mast cell activation syndrome (MCAS), 54.8 % had migraine, 26.2 % had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and 98.8 % reported experiencing chronic pain. Importantly, 25 % of patients reported having all three diagnoses: HSD/h-EDS, POTS and MCAS. Mean COMPASS-31 score was 54.45 (range 18.79–80.93), indicating severe autonomic dysfunction, which was significantly higher than in patients with multiple sclerosis, diabetic neuropathy, scleroderma, and psoriatic arthritis as shown in prior studies. Mean SF-36 score was 32.38 (SD = 22.91) indicating poor QoL, which was worse than in patients with POTS, multiple sclerosis, rheumatoid arthritis, and lupus as determined by prior studies.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that women with HSD/h-EDS experience severe autonomic dysfunction, chronic pain, chronic comorbid conditions and reduced QoL. More than half of participants in this cohort had POTS and migraine, with one in four having a clinical triad of HSD/h-EDS, POTS and MCAS.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103356"},"PeriodicalIF":3.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350233","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":"Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study","authors":"Smriti Badhwar ,&nbsp;Tania J. Pereira ,&nbsp;Kathleen Kerr ,&nbsp;Riina Bray ,&nbsp;Farah Tabassum ,&nbsp;Lauren Sergio ,&nbsp;Heather Edgell","doi":"10.1016/j.autneu.2025.103358","DOIUrl":"10.1016/j.autneu.2025.103358","url":null,"abstract":"<div><div>Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the prolonged sequelae after COVID-19 (&gt;3 months; Long COVID) have similar symptomology, are both associated with autonomic dysfunction, and a growing proportion of Long COVID patients are developing ME/CFS. We aimed to determine an autonomic phenotype of patients with ME/CFS vs Long COVID. We hypothesized that the groups would differ from controls yet be similar to one another. We recruited sedentary controls (<em>n</em> = 10), mild/moderate ME/CFS patients (<em>n</em> = 12), and Long COVID patients (<em>n</em> = 9) to undergo 1) breathing 5 % CO₂, 2) breathing 10 % O₂, and 3) 5-minutes of 70° head-up tilt. Respiratory, hemodynamic, and cerebrovascular variables were measured throughout the 3 trials. Resting vascular function and cognitive-motor-integration were also assessed. ME/CFS and Long COVID were similar to the healthy controls and each other with regard to resting vascular function and the hemodynamic responses to hypoxia, hypercapnia, and head-up tilt (<em>p</em> &gt; 0.05). However, in ME/CFS we observed a greater reduction of cerebrovascular resistance (<em>p</em> = 0.041) and impaired autoregulation (<em>p</em> = 0.042) during hypercapnia alongside impaired cognitive-motor integration (<em>p</em> &lt; 0.02), and in Long COVID we observed reduced peripheral and end-tidal oxygen (<em>p</em> &lt; 0.04) and less vagal withdrawal during tilt (<em>p</em> = 0.028). Our findings suggest unique phenotypes when comparing ME/CFS and Long COVID whereby we have shown that Long COVID patients experience hypoxia while upright contributing to less vagal withdrawal, and ME/CFS patients experience impaired cerebrovascular control during hypercapnia potentially leading to reduced cognitive-motor integration. These differences could stem from disease severity/duration or some unique aspect of the COVID-19 virus.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103358"},"PeriodicalIF":3.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363496","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":"Aging impairs urethral function in male rats: Increased outlet resistance and oxidative stress","authors":"Eduardo Costa Alexandre ,&nbsp;Alline Araujo Curiel ,&nbsp;Jessica Mariana Dias ,&nbsp;Fabio H. da Silva ,&nbsp;Edson Antunes ,&nbsp;Mariana G. de Oliveira","doi":"10.1016/j.autneu.2025.103355","DOIUrl":"10.1016/j.autneu.2025.103355","url":null,"abstract":"<div><div>Epidemiological studies identify age as the primary unmodifiable risk factor for male lower urinary tract symptoms (LUTS). While research has focused on the bladder and prostate, the urethra remains understudied. This study investigates aging-induced changes in rat urethral structure and function and their impact on voiding. Male Wistar rats, young (3.5 months) and middle-aged (10 months), were used. Cystometry assessed voiding in vivo, and isolated urethras were used in vitro. Middle-aged rats showed irregular micturition with increased basal pressure, bladder capacity, compliance, and non-voiding contractions, suggesting elevated outlet resistance. Histology showed no significant differences. Contractions to electrical-field stimulation and the α1-adrenoceptor agonist phenylephrine were enhanced, along with a twofold increase in α1A-adrenoceptor mRNA. Conversely, relaxation to nitric oxide (NO) donors sodium nitroprusside (SNP) and glyceryl trinitrate (GTN) was reduced, while responses to the cGMP analog 8Br-cGMP and the soluble guanylate cyclase (sGC) stimulator BAY 41-2272 were unchanged. Lower NO levels, despite increased endothelial NO synthase (eNOS) mRNA, were observed in middle-aged urethras, with no changes in neuronal NOS (nNOS) or sGC subunit β1. Phosphodiesterase type 5 (PDE5) mRNA was elevated, correlating with reduced basal and SNP-stimulated cGMP. Oxidative stress was evident, with increased superoxide and reduced expression of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT). NADPH oxidase 2 (NOX2) and xanthine dehydrogenase (XDH) mRNA were upregulated, while hypoxia-inducible factor 1-alpha (HIF1α) remained unchanged. In summary, middle-aged rats show urethral hypercontractility, impaired relaxation, and oxidative stress, without tissue remodeling or ischemia.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103355"},"PeriodicalIF":3.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314191","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":"2025-10-13","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":"Vericiguat attenuates the dynamic gain of open-loop baroreflex function in a low-frequency range","authors":"Aimi Yokoi ,&nbsp;Toru Kawada ,&nbsp;Nana Hiraki ,&nbsp;Midori Kakuuchi ,&nbsp;Takuya Nishikawa ,&nbsp;Masafumi Fukumitsu ,&nbsp;Kei Sato ,&nbsp;Joe Alexander Jr ,&nbsp;Ryou Tanaka ,&nbsp;Keita Saku","doi":"10.1016/j.autneu.2025.103354","DOIUrl":"10.1016/j.autneu.2025.103354","url":null,"abstract":"<div><div>Vericiguat, a soluble guanylate cyclase stimulator, enhances the production of cyclic guanosine monophosphate through nitric oxide (NO)-dependent and -independent mechanisms. We examined the effects of vericiguat on the open-loop dynamic characteristics of the carotid sinus baroreflex. In anesthetized Wistar–Kyoto rats (<em>n</em> = 8), sympathetic nerve activity (SNA), arterial pressure (AP), and aortic flow were measured while varying carotid sinus pressure (CSP) according to a Gaussian white noise signal with a mean of 120 mmHg and a standard deviation of 20 mmHg. The neural arc transfer function from CSP to SNA, peripheral arc transfer function from SNA to AP, and total arc transfer function from CSP to AP were compared between the baseline conditions and during intravenous administrations of vericiguat (10 μg·kg⁻¹·min⁻¹). Vericiguat treatment reduced the asymptotic dynamic gain in the peripheral arc but not in the neural arc. It also reduced the asymptotic dynamic gain and increased the corner frequency in the total arc. These findings indicate low-frequency-dominant attenuation of dynamic gain, suggesting that vericiguat enhances the negative feedback regulation of vasoconstriction mediated by endogenous NO.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103354"},"PeriodicalIF":3.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309840","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":"2025-10-06","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}