Clinical Autonomic Dysfunction

Colombo, Joseph; Arora, Rohit; DePace, Nicholas L.; Vinik, Aaron I.

doi:10.1007/978-3-319-07371-2

Cited by 24 publications

(28 citation statements)

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“…Autonomic function tests have been extraordinarily useful in diagnosing, treating, and better understanding of the complex mechanisms behind disturbances in balance of the function of the two domains of the autonomic nervous system, namely sympathetic and parasympathetic (14). The ability to capture time and frequency domains of heart rate variability (14), as well as baroreceptor sensitivity, has facilitated the evaluation of balance between the two arms of the autonomic nervous system, providing information on functional changes prior to the development of permanent structural damage and allowing the use of rebalancing therapeutic options (15). Small unmyelinated C and Aδ fibers in the periphery subserve somatic and autonomic nerve functions such as warm, cold, and pain perception, as well as innervating sweat glands.…”

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confidence: 99%

The New Age of Sudomotor Function Testing: A Sensitive and Specific Biomarker for Diagnosis, Estimation of Severity, Monitoring Progression, and Regression in Response to Intervention

Névoret²,

2015

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Sudorimetry technology has evolved dramatically, as a rapid, non-invasive, robust, and accurate biomarker for small fibers that can easily be integrated into clinical practice. Though skin biopsy with quantitation of intraepidermal nerve fiber density is still currently recognized as the gold standard, sudorimetry may yield diagnostic information not only on autonomic dysfunction but also enhance the assessment of the small somatosensory nerves, disease detection, progression, and response to therapy. Sudorimetry can be assessed using Sudoscan™, which measures electrochemical skin conductance (ESC) of hands and feet. It is based on different electrochemical principles (reverse iontophoresis and chronoamperometry) to measure sudomotor function than prior technologies, affording it a much more practical and precise performance profile for routine clinical use with potential as a research tool. Small nerve fiber dysfunction has been found to occur early in metabolic syndrome and diabetes and may also be the only neurological manifestation in small fiber neuropathies, beneath the detection limits of traditional nerve function tests. Test results are robust, accomplished within minutes, require little technical training and no calculations, since established norms have been provided for the effects of age, gender, and ethnicity. Sudomotor testing has been greatly under-utilized in the past, restricted to specialized centers capable of handling the technically demanding and expensive technology. Yet, evaluation of autonomic and somatic nerve function has been shown to be one of the best estimates of cardiovascular risk. Evaluation of sweating has the appeal of quantifiable non-invasive determination of the integrity of the peripheral autonomic nervous system, and can now be accomplished rapidly at point of care clinics with the determination of ESC, allowing intervention for morbid complications prior to permanent structural nerve damage. We review here sudomotor function testing technology, the research evidence accumulated supporting the clinical utility of measuring ESC, the medical applications of sudorimetry now available to physicians with this device, and clinical vignettes illustrating its use in the clinical decision-making process.

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confidence: 99%

The New Age of Sudomotor Function Testing: A Sensitive and Specific Biomarker for Diagnosis, Estimation of Severity, Monitoring Progression, and Regression in Response to Intervention

Névoret²,

2015

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“…One of the mechanisms of acquiring health by self-regulation is the active balancing of opposite functions in the organism, which is increasingly described in the literature on, for example, apoptosis [69] (programmed cell death as an opposite function to ongoing cell division in organisms), wound healing [70], and chronobiology [71]. Imbalances of one of the two opposite functions is related to disease states [72].…”

Section: Resultsmentioning

confidence: 99%

The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies

Baars

Zoen

Breitkreuz

et al. 2019

Evidence-Based Complementary and Alternative Medicine

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Aim. The aim of this narrative review was to explore the potential contributions of CAM to reduce antibiotic use. Methods. We searched PubMed, Embase, and Cochrane Database of Systematic Reviews with a specific, limited set of search terms and collected input from a group of expert CAM researchers to answer the question: What is known about the contribution of CAM health and health promotion concepts, infection prevention, and infection treatment strategies to reduce antibiotic use? Results. The worldview-related CAM health concepts enable health promotion oriented infection prevention and treatment aimed at strengthening or supporting the self-regulating ability of the human organism to cope with diseases. There is some evidence that the CAM concepts of health (promotion) are in agreement with current conceptualization of health and that doctors who practice both CAM and conventional medicine prescribe less antibiotics, although selection bias of the presented studies cannot be ruled out. There is some evidence that prevention and some treatment strategies are effective and safe. Many CAM treatment strategies are promising but overall lack high quality evidence. Conclusions. CAM prevention and treatment strategies may contribute to reducing antibiotic use, but more rigorous research is necessary to provide high quality evidence of (cost-)effectiveness.

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“… 1 Chronic stress alters autonomic nervous system reactivity, and changes in the dopamine systems of people undergoing chronic stress have been well documented in the literature. 2 In Figure 1 , we hypothesize a model regarding the vicious cycle that exists between psychiatric disorders and chronic stress.…”

Section: Faith and Sciencementioning

confidence: 99%

“…a Autonomic nervous system dysfunction under chronic stress with the interplay between its two branches: the parasympathetic and sympathetic nervous systems. 2 b Epigenetic changes in the central nervous system are crucial in the development of a myriad of psychiatric disorders. 4 c Psychiatric disorders could mainly consist of mood disorders and stress-related disorders such as major depressive disorder, PTSD, and substance use disorders.…”

Section: Faith and Sciencementioning

confidence: 99%

Role of Spirituality in the Management of Major Depression and Stress-Related Disorders

2021

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Clinical Autonomic Dysfunction

Cited by 24 publications

References 0 publications

The New Age of Sudomotor Function Testing: A Sensitive and Specific Biomarker for Diagnosis, Estimation of Severity, Monitoring Progression, and Regression in Response to Intervention

The New Age of Sudomotor Function Testing: A Sensitive and Specific Biomarker for Diagnosis, Estimation of Severity, Monitoring Progression, and Regression in Response to Intervention

The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies

Role of Spirituality in the Management of Major Depression and Stress-Related Disorders

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