Aaem minimonograph #48: Autonomic nervous system testing

Ravits, John

doi:10.1002/(sici)1097-4598(199708)20:8<919::aid-mus1>3.0.co;2-9

Cited by 161 publications

(122 citation statements)

References 90 publications

(124 reference statements)

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“…Consequently, a number of studies have now documented that individuals classed as AIS A or B exhibit evidence of preserved spinal autonomic pathways, 3,29,30 as determined by the sympathetic skin response test, which is an established test for sudomotor autonomic nervous system function. [31][32][33][34] Those studies support the concern that the sole use of the AIS scale for assessing completeness of SCI may result in individuals who have autonomically complete and incomplete injuries being analyzed together, which would be a major confounder when the outcomes of interest include CV or other autonomic parameters. Thus, future studies that aim to examine the effect of completeness of injury on CV parameters should consider the inclusion of a more robust measure of autonomic function.…”

Section: Effect Of Motor and Sensory Completeness Of Sci On CV Paramementioning

confidence: 78%

Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis

2012

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Background: Although motor and sensory deficits following spinal cord injury (SCI) are well known, there are still contrasting reports on how SCI affects baseline cardiovascular (CV) parameters and other autonomic functions. Study design: Meta-analysis is performed. Objectives: To examine the effect of injury level on supine and seated CV function in individuals with SCI. Methods: A total of 98 studies representing 1968 individuals were retrieved for analysis. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were abstracted from the studies and compared between four groups according to the neurological lesion level, cervical (C) SCI (C4-C8), high-thoracic (HT) SCI (T1-T6), low-thoracic lumbar (LTL) SCI (below T6) and able-bodied (AB) controls. Results: In the supine position, SBP, DBP and HR were lower in C compared with HT, LTL and AB (all Po0.04). In the seated position, SBP and DBP were significantly lower in C compared with LTL and AB (all Po0.003) and HR was significantly lower in C compared with LTL only (P¼0.01). A final finding was that C exhibited a lower resting SBP in the seated compared with the supine position (Po0.001). Conclusion: Individuals with SCI exhibit a lesion-dependent impairment in resting CV function, whereby those with the highest injury had the greatest degree of CV dysfunction. A further finding was that individuals with a C injury exhibited a lower resting SBP in the seated vs supine position. Thus, clinicians and researchers should consider lesion level and body position when measuring and interpreting CV parameters in individuals with SCI.

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Section: Effect Of Motor and Sensory Completeness Of Sci On CV Paramementioning

confidence: 78%

Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis

2012

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“…The age specific norms are more precise: 41-60 years > 1.45, 61-70 years >1.35 (Low, 2004). 16,17 Normal values for single deep breath E-I ratio at different age are 41-50 years > 1.12, 51-60 years >1.09, 61-70 years >1.07.…”

Section: Autonomic Function Testsmentioning

confidence: 97%

“…The advantage of studying sinus arrhythmia is that it is sensitive and can be easily carried out on most EMG equipments. 8,15 Valsalva manoeuvre and valsalva ratio 16,17 Valsalva manoeuvre helps in assessing the parasympathetic cholinergic functions. Valsalva manoeuvre has four phases.…”

Section: Important Tests Used For Evaluation Of Autonomic Functionsmentioning

confidence: 99%

“…This test is relatively independent of age (Ewing et al). 11 Blood Pressure to mental arithmetic 16,17 Blood pressure response to mental stress such as arithmetic, sudden noise or emotional stress can result in increase in BP and heart rate due to excessive sympathetic outflow. It is a useful test of sympathetic efferent function.…”

Section: Blood Pressure Response To Isovolumetric Exercisementioning

confidence: 99%

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Autonomic nervous system dysfunction in Parkinson’s disease patients

Ezhumalai

Ravikumar

2017

Int J Res Med Sci

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Background: Parkinson’s disease (PD) PD ranks second among the common neurodegenerative disease next only to Alzheimer’s dementia. Autonomic symptoms in Parkinson’s disease is very common. This study assesses the autonomic dysfunction in PD, their prevalence, type and severity in related to staging.Methods: The study was conducted in Rajiv Gandhi government general hospital, Institute of neurology Madras medical college between 2011 to 2013, 141 patients fulfilling the criteria of Parkinson’s disease brain bank society were included in the study. All the patients were clinically examined with special attention to history, clinical features and symptoms and signs of Autonomic dysfunction. The patients were graded using the Hoehn and Yahr staging system.Results: Among 141 patients, 118 (83.7%) had autonomic dysfunction. Among 87 males, 72 patients had ANS dysfunction and among 54 females, 46 patients had ANS dysfunction. Stage wise 39 patients of 53 patients (73.6%) belonging to Stage I; 37 of 44 (84.1%) belonging to Stage II; 26 of 28 (92.8%) belonging to Stage III and all patients belonging to Stage IV and V had ANS dysfunction.Conclusions: ANS dysfunction in Parkinson’s disease is a common problem and the prevalence of it is 82.75% in males and 85.2% in females and overall in 83.7% of patients. The prevalence of ANS dysfunction in Males and females increases as the Hoehn and Yahr stage increases as evidenced by 68.7% of males and 80.9% of females have ANS dysfunction in stage I, while 100% of males and females in stage IV and V have ANS dysfunction. Sexual dysfunction (84.7%) ranks first followed by gastrointestinal (56.9%), and thermoregulatory (51.3%) autonomic disturbances in males and urinary disturbances (78.3%), ranks first followed by thermoregulatory (65.2%), and cardiovascular disturbances (56.5%) in females.

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“…The CPTexamination has been reported to be useful for the detection, screening, diagnosis, and management of diseases of the peripheral nervous system (5,(7)(8)(9). Onthe other hand, the sympathetic skin response (SSR) involves C fibers (10)(11)(12)(13). Our hypothesis is that CPT to 5 Hz stimulation and SSR are impaired concurrently in diabetic and alcoholic polyneuropathies.…”

Section: Introductionmentioning

confidence: 99%

Current Perception Threshold and Sympathetic Skin Response in Diabetic and Alcoholic Polyneuropathies.

et al. 2002

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Objective Correlation between current perception threshold and sympathetic skin response was investigated in patients with diabetic or alcoholic polyneuropathy.Methods Current perception threshold was measured using Neurometer CPT/C, and the sympathetic skin response was measured using Neuropack X. Patients Fourteen patients with diabetic polyneuropathy and 10 patients with alcoholic polyneuropathy were studied.Results There was a significant negative correlation between the current perception threshold to 5 Hz stimulation and the amplitude of sympathetic skin response.Conclusion Since both current perception threshold to 5 Hz stimulation and sympathetic skin response are related to C fibers, these two are considered to be impaired concurrently in diabetic and alcoholic polyneuropathies. (Internal Medicine 41: 819-822, 2002)

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Aaem minimonograph #48: Autonomic nervous system testing

Cited by 161 publications

References 90 publications

Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis

Influence of the neurological level of spinal cord injury on cardiovascular outcomes in humans: a meta-analysis

Autonomic nervous system dysfunction in Parkinson’s disease patients

Current Perception Threshold and Sympathetic Skin Response in Diabetic and Alcoholic Polyneuropathies.

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