Pub Date : 2025-12-26DOI: 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.
{"title":"From lab to life: Wearables, real-world data, and the future of autonomic research","authors":"Julien Rimok , Kelly A. Larkin-Kaiser","doi":"10.1016/j.autneu.2025.103377","DOIUrl":"10.1016/j.autneu.2025.103377","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"264 ","pages":"Article 103377"},"PeriodicalIF":3.3,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928915","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}
Pub Date : 2025-12-22DOI: 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.
{"title":"Characterisation of Postural Orthostatic Tachycardia Syndrome (POTS): Findings from a physician chart-audit pre- and post-COVID-19","authors":"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","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":"2025-12-22","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}
Pub Date : 2025-12-19DOI: 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.
{"title":"Antioxidant tempol reverses autonomic dysregulation and neurogenic hypertension in acid-sensing ion channel 2 deficient mice","authors":"Rasna Sabharwal , Francois M. Abboud , 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<sup>−/−</sup> 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<sup>−/−</sup> 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<sup>−/−</sup> mice, compared with controls (<em>P</em> < 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> < 0.05) in ASIC2<sup>−/−</sup> 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<sup>−/−</sup> mice, while not affecting these phenotypes in control mice. We conclude: (1) oxidative stress in ASIC2<sup>−/−</sup> 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<sup>−/−</sup> 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":"2025-12-19","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}
Pub Date : 2025-12-17DOI: 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.
{"title":"Neuroendocrine, behavioral, cardiovascular and autonomic responses to acute and repeated restraint stress in male rats","authors":"Cristiane Busnardo , Lucas Barreto-de-Souza , Luana Omena-Giatti , Taíz F.S. Brasil , Heloísa H. Vilela-Costa , Fernando M.A. Corrêa , 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":"2025-12-17","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}
Pub Date : 2025-12-13DOI: 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.
{"title":"The orthostatic tolerance of service personnel of the Household Division of the British Army","authors":"Iain Parsons , Michael Stacey , Nick Gall , 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> < 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":"2025-12-13","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}
Pub Date : 2025-12-08DOI: 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.
{"title":"Wearable ANS monitoring in real life: A critical review of context-sensitive interpretation and implications for psychophysiology","authors":"Greg J. Norman , Eric Morgan , Sabina Raja , Gary G. Berntson","doi":"10.1016/j.autneu.2025.103364","DOIUrl":"10.1016/j.autneu.2025.103364","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103364"},"PeriodicalIF":3.3,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926546","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}
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。
{"title":"Differences in muscle sympathetic nerve activity between patients with orthostatic hypertension and those with orthostatic normotensive hypertension","authors":"Tadayuki Hirai , Hisayoshi Murai , Hiroyuki Sugimoto , Yusuke Mukai , Hideki Tokuhisa , Tatsunori Ikeda , Daisuke Kobayashi , Shigeo Takata , Kenji Sakata , Soichiro Usui , 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> < 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.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"263 ","pages":"Article 103366"},"PeriodicalIF":3.3,"publicationDate":"2025-12-04","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}
Pub Date : 2025-12-04DOI: 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。
{"title":"Selective sympathetic action on heart rate variability after ultrasound-guided stellate ganglion block","authors":"Ole C. Keim , Raoul C. Raum , Robert E. Feldmann Jr , Dieter Kleinboehl , 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":"2025-12-04","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}
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