Full Text Journal Articles about
Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes

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Persistent unexplained chest pain and dyspnea in a patient with coronary artery disease: a case report.

Sameh K Mobarek,

BACKGROUND:Neurogenic orthostatic hypotension, a sustained decrease in blood pressure upon standing, is caused by autonomic nervous system failure and characterized by an insufficient increase in heart rate needed to maintain blood pressure upon standing. In this case, neurogenic orthostatic hypotension symptoms preceded a diagnosis of Parkinson disease. A diagnosis of ... Read more >>

BMC Cardiovasc Disord (BMC cardiovascular disorders)
[2020, 20(1):54]

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Classical and Delayed Orthostatic Hypotension in Patients With Unexplained Syncope and Severe Orthostatic Intolerance.

Parisa Torabi, Fabrizio Ricci, Viktor Hamrefors, Richard Sutton, Artur Fedorowski,

Background: Orthostatic hypotension (OH) is a major sign of cardiovascular autonomic failure leading to orthostatic intolerance and syncope. Orthostatic hypotension is traditionally divided into classical OH (cOH) and delayed OH (dOH), but the differences between the two variants are not well-studied. We performed a systematic clinical and neuroendocrine characterization of ... Read more >>

Front Cardiovasc Med (Frontiers in cardiovascular medicine)
[2020, 7:21]

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Relationship between the washout rate of I-123 MIBG scans and autonomic function in Parkinson's disease.

Young Jin Jeong, Ji-Eun Jeong, Sang-Myung Cheon, Byeol-A Yoon, Jae Woo Kim, Do-Young Kang,

PURPOSE:We have evaluated the clinical significance of the washout rate (WR) on I-123 MIBG scans through the analysis of the relationship between the I-123 MIBG scans and autonomic status in patients with Parkinson's disease (PD). MATERIALS AND METHODS:Sixty patients with clinical PD who had decreased HMR were enrolled. An autonomic ... Read more >>

PLoS ONE (PloS one)
[2020, 15(3):e0229860]

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α-Synuclein oligomers in skin biopsy of idiopathic and monozygotic twin patients with Parkinson's disease.

Samanta Mazzetti, Milo J Basellini, Valentina Ferri, Erica Cassani, Emanuele Cereda, Matilde Paolini, Alessandra M Calogero, Carlotta Bolliri, Mara De Leonardis, Giorgio Sacilotto, Roberto Cilia, Graziella Cappelletti, Gianni Pezzoli,

A variety of cellular processes, including vesicle clustering in the presynaptic compartment, are impaired in Parkinson's disease and have been closely associated with α-synuclein oligomerization. Emerging evidence proves the existence of α-synuclein-related pathology in the peripheral nervous system, even though the presence of α-synuclein oligomers in situ in living patients ... Read more >>

Brain (Brain : a journal of neurology)
[2020, 143(3):920-931]

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Autonomic ganglionic injection of α-synuclein fibrils as a model of pure autonomic failure α-synucleinopathy.

Xue-Jing Wang, Ming-Ming Ma, Le-Bo Zhou, Xiao-Yi Jiang, Miao-Miao Hao, Robert K F Teng, Erxi Wu, Bei-Sha Tang, Jia-Yi Li, Jun-Fang Teng, Xue-Bing Ding,

α-Synucleinopathies are characterized by autonomic dysfunction and motor impairments. In the pure autonomic failure (PAF), α-synuclein (α-Syn) pathology is confined within the autonomic nervous system with no motor features, but mouse models recapitulating PAF without motor dysfunction are lacking. Here, we show that in TgM83+/- mice, inoculation of α-Syn preformed ... Read more >>

Nat Commun (Nature communications)
[2020, 11(1):934]

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Spinal versus General Anesthesia for Patients with Parkinson's Disease.

Diab A Bani Hani, Abdelwahab J Aleshawi, Majd H Al Shalakhti, Alaa''a Alhowary, Osama Al-Jararahih, Abdel-Hameed Al-Mistarehi, Ahmed Yassin,

Background:Anesthesiologists prefer using general anesthesia (GA) in Parkinson's disease (PD). However, GA may mask neurological symptoms in the intraoperative period and exacerbate them postoperatively. Furthermore, the anesthetics used in GA have clear interactions with the drugs used to control PD. On the other hand, drugs used in spinal anesthesia (SA) ... Read more >>

Int J Gen Med (International journal of general medicine)
[2020, 13:9-15]

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Diagnosis and Treatment of Hereditary Transthyretin Amyloidosis (hATTR) Polyneuropathy: Current Perspectives on Improving Patient Care.

Marco Luigetti, Angela Romano, Andrea Di Paolantonio, Giulia Bisogni, Mario Sabatelli,

Hereditary transthyretin amyloidosis (hATTR) with polyneuropathy (formerly known as Familial Amyloid Polyneuropathy) is a rare disease due to mutations in the gene encoding transthyretin (TTR) and characterized by multisystem extracellular deposition of amyloid, leading to dysfunction of different organs and tissues. hATTR amyloidosis represents a diagnostic challenge for neurologists considering ... Read more >>

Ther Clin Risk Manag (Therapeutics and clinical risk management)
[2020, 16:109-123]

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Cerebral Oximetry in Syncope and Syndromes of Orthostatic Intolerance.

Isabella Kharraziha, Hannes Holm, Erasmus Bachus, Fabrizio Ricci, Richard Sutton, Artur Fedorowski, Viktor Hamrefors,

Cerebral autoregulation is crucial for maintaining cerebral blood flow and perfusion. In recent years, the importance of cerebral oxygenation in syncope and orthostatic intolerance (OI) has received increased attention. Cerebral tissue oxygenation can be measured by using near-infrared spectroscopy (NIRS), which determines the ratio of oxygenated hemoglobin to total hemoglobin ... Read more >>

Front Cardiovasc Med (Frontiers in cardiovascular medicine)
[2019, 6:171]

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Pure Autonomic Failure.

Elizabeth A Coon, Wolfgang Singer, Phillip A Low,

Pure autonomic failure (PAF) is a neurodegenerative disorder of the autonomic nervous system clinically characterized by orthostatic hypotension. The disorder has also been known as Bradbury-Eggleston syndrome, named for the authors of the 1925 seminal description. Patients typically present in midlife or later with orthostatic hypotension or syncope. Autonomic failure ... Read more >>

Mayo Clin. Proc. (Mayo Clinic proceedings)
[2019, 94(10):2087-2098]

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Reduced central sympathetic activity in Parkinson's disease.

Heidrun H Krämer, Gothje Lautenschläger, Michael de Azevedo, Kathrin Doppler, Anne Schänzer, Christoph Best, Wolfgang H Oertel, Iris Reuter, Claudia Sommer, Frank Birklein,

OBJECTIVE:With a combination of different sympathetic tests, we aimed to elucidate whether impairment of sympathetic function in Parkinson's disease (PD) is the consequence of a central or peripheral efferent dysfunction. METHODS:Thirty-five patients with early-to-intermediate PD (median age: 63 years; IQR: 57-67 years; disease duration 1-9 years, 15 women) and 20 age- and sex-matched ... Read more >>

Brain Behav (Brain and behavior)
[2019, 9(12):e01463]

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PURL: Best timing for measuring orthostatic vital signs?

Deborah Phipps, Erik Butler, Anne Mounsey, Michael M Dickman, David Bury, Ashley Smith, Nick Bennett, Ben Arthur, Bob Marshall,

We typically take a blood pressure within 3 minutes of a patient rising from a supine to a standing position. But is that too long? ... Read more >>

J Fam Pract (The Journal of family practice)
[2019, 68(9):512-514]

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Cognitive and Behavioral Changes in Patients Treated With Droxidopa for Neurogenic Orthostatic Hypotension: A Retrospective Review.

Katherine E McDonell, Cyndya A Shibao, Italo Biaggioni, Adam Hartman, David Robertson, Daniel O Claassen,

BACKGROUND:Droxidopa is a norepinephrine precursor that improves symptoms of neurogenic orthostatic hypotension in conditions such as Parkinson disease, multiple system atrophy, and pure autonomic failure by inducing a pressor effect. Unlike other pressor agents, droxidopa crosses the blood-brain barrier; however, its central effects are, as of yet, uncharacterized. OBJECTIVE:We present ... Read more >>

Cogn Behav Neurol (Cognitive and behavioral neurology : official journal of the Society for Behavioral and Cognitive Neurology)
[2019, 32(3):179-184]

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Neurogenic Orthostatic Hypotension in Parkinson Disease: A Primer.

Jeremy K Cutsforth-Gregory, Phillip A Low,

Parkinson disease (PD) is associated with a variety of motor and non-motor clinical manifestations, including cardiovascular autonomic dysfunction. Neurogenic orthostatic hypotension (nOH) is a potentially serious manifestation of cardiovascular sympathetic failure that occurs in approximately 30% of patients with PD. Here we review the pathophysiology and effects of the condition ... Read more >>

Neurol Ther (Neurology and therapy)
[2019, 8(2):307-324]

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Hypertension in older adults: Assessment, management, and challenges.

Estefania Oliveros, Hena Patel, Stella Kyung, Setri Fugar, Alan Goldberg, Nidhi Madan, Kim A Williams,

Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse ... Read more >>

Clin Cardiol (Clinical cardiology)
[2020, 43(2):99-107]

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Orthostatic hypotension in hereditary transthyretin amyloidosis: epidemiology, diagnosis and management.

Jose-Alberto Palma, Alejandra Gonzalez-Duarte, Horacio Kaufmann,

PURPOSE:Neurogenic orthostatic hypotension is a prominent and disabling manifestation of autonomic dysfunction in patients with hereditary transthyretin (TTR) amyloidosis affecting an estimated 40-60% of patients, and reducing their quality of life. We reviewed the epidemiology and pathophysiology of neurogenic orthostatic hypotension in patients with hereditary TTR amyloidosis, summarize non-pharmacologic and ... Read more >>

Clin. Auton. Res. (Clinical autonomic research : official journal of the Clinical Autonomic Research Society)
[2019, 29(Suppl 1):33-44]

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Strategies to improve the quality of life in patients with hereditary transthyretin amyloidosis (hATTR) and autonomic neuropathy.

Thierry Gendre, Violaine Planté-Bordeneuve,

PURPOSE:Hereditary transthyretin amyloidosis (hATTR) is a severe adult-onset progressive disease mainly involving the peripheral nervous system and the heart, with a prominent impact on the autonomic nervous system. This review summarizes the clinical aspects of autonomic dysfunction in hATTR, and their impact on quality of life as well as potential ... Read more >>

Clin. Auton. Res. (Clinical autonomic research : official journal of the Clinical Autonomic Research Society)
[2019, 29(Suppl 1):25-31]

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Postural Orthostatic Tachycardia Syndrome Is Associated With Elevated G-Protein Coupled Receptor Autoantibodies.

William T Gunning, Heather Kvale, Paula M Kramer, Beverly L Karabin, Blair P Grubb,

Background The etiology of postural orthostatic tachycardia syndrome (POTS) is yet to be established. The disorder is often misdiagnosed as chronic anxiety or a panic disorder because the autonomic failure in these patients is not severe. A growing body of evidence suggests that POTS may be an autoimmune disorder. Antinuclear ... Read more >>

J Am Heart Assoc (Journal of the American Heart Association)
[2019, 8(18):e013602]

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Recurrent pulseless electrical activity and cardiac arrest caused by baroreceptor failure following neck irradiation.

Julian Yaxley, Tahira Scott,

Introduction:Baroreceptor damage and hypersensitivity can produce labile autonomic blood pressure control. Neck irradiation for malignancy is a well-known but under-recognised cause of baroreceptor failure. Case presentation:We describe a dramatic delayed complication of neck irradiation treatment. Our patient developed recurrent unexplained hypotension and pulseless electrical activity cardiac arrest upon connection to ... Read more >>

Turk J Emerg Med (Turkish journal of emergency medicine)
[2019, 19(4):152-153]

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Ganglionic Acetylcholine Receptor Antibodies and Autonomic Dysfunction in Autoimmune Rheumatic Diseases.

Michie Imamura, Akihiro Mukaino, Koutaro Takamatsu, Hiroto Tsuboi, Osamu Higuchi, Hideki Nakamura, Saori Abe, Yukio Ando, Hidenori Matsuo, Tadashi Nakamura, Takayuki Sumida, Atsushi Kawakami, Shunya Nakane,

Autonomic neuropathy has been reported in autoimmune rheumatic diseases (ARD) including Sjögren's syndrome, systemic sclerosis, rheumatoid arthritis, and systemic lupus erythematosus. However, the pathophysiological mechanism underlying autonomic dysfunction remains unknown to researchers. On the other hand, autoimmune autonomic ganglionopathy (AAG) is an acquired immune-mediated disorder, which causes dysautonomia that is ... Read more >>

Int J Mol Sci (International journal of molecular sciences)
[2020, 21(4):]

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High-salt diet does not boost neuroinflammation and neurodegeneration in a model of α-synucleinopathy.

Antonio Heras-Garvin, Violetta Refolo, Markus Reindl, Gregor K Wenning, Nadia Stefanova,

AIM:Pre-clinical studies in models of multiple sclerosis and other inflammatory disorders suggest that high-salt diet may induce activation of the immune system and potentiate inflammation. However, high-salt diet constitutes a common non-pharmacological intervention to treat autonomic problems in synucleinopathies such as Parkinson's disease and multiple system atrophy. Since neuroinflammation plays ... Read more >>

J Neuroinflammation (Journal of neuroinflammation)
[2020, 17(1):35]

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Emergencies and critical issues in Parkinson's disease.

Cristina Simonet, Eduardo Tolosa, Ana Camara, Francesc Valldeoriola,

Complications from Parkinson's disease may develop over the disease course, sometimes unexpectedly, and require prompt or even urgent medical intervention. The most common are associated with aggravation of motor symptoms; serious non-motor complications, such as psychosis, orthostatic hypotension or sleep attacks, also occur. Here we review such complications, their clinical ... Read more >>

Pract Neurol (Practical neurology)
[2020, 20(1):15-25]

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Systemic lupus erythematosus in a patient with multiple system atrophy: A case report.

Dimitrios Pilalas, Georgios Chatzopoulos, Georgia D Kaiafa, Eleftheria Ztriva, Soultana Spyridonakou, Vasiliki Bisbinas, Panagiotis Ioannidis, Apostolos I Hatzitolios, Christos Savopoulos,

RATIONALE:Multiple system atrophy is a late-onset rare neurodegenerative movement disorder which results in debilitating disease. Fever frequently ensues in the context of infections which can be associated with significant morbidity and mortality, but among alternative diagnostic possibilities neoplasms and autoimmune disorders should be considered. PATIENT CONCERNS:We describe a case of ... Read more >>

Medicine (Baltimore) (Medicine)
[2019, 98(46):e18005]

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The Use of Neuromodulation for Symptom Management.

Sarah Marie Farrell, Alexander Green, Tipu Aziz,

Pain and other symptoms of autonomic dysregulation such as hypertension, dyspnoea and bladder instability can lead to intractable suffering. Incorporation of neuromodulation into symptom management, including palliative care treatment protocols, is becoming a viable option scientifically, ethically, and economically in order to relieve suffering. It provides further opportunity for symptom ... Read more >>

Brain Sci (Brain sciences)
[2019, 9(9):]

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Efficacy of atomoxetine versus midodrine for neurogenic orthostatic hypotension.

Jung-Ick Byun, Do-Yong Kim, Jangsup Moon, Hye-Rim Shin, Jun-Sang Sunwoo, Woo-Jin Lee, Han-Sang Lee, Kyung-Il Park, Soon-Tae Lee, Keun-Hwa Jung, Ki-Young Jung, Manho Kim, Sang Kun Lee, Kon Chu,

OBJECTIVE:The efficacy and safety of 1-month atomoxetine and midodrine therapies were compared. Three-month atomoxetine and combination therapies were investigated for additional benefits. METHODS:This prospective open-label randomized trial included 50 patients with symptomatic neurogenic orthostatic hypotension (nOH). The patients received either atomoxetine 18 mg daily or midodrine 5 mg twice daily and were ... Read more >>

Ann Clin Transl Neurol (Annals of clinical and translational neurology)
[2020, 7(1):112-120]

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Utility of autonomic testing for the efficient diagnosis and effective pharmacological management of neurogenic orthostatic hypotension.

Sami Bin Alam, Waiel Almardini, Amer Suleman,

A 62-year-old man presented with a 2-year history of syncope, collapse and fluctuating blood pressure (BP). His medications included midodrine (10 mg, three times per day) and fludrocortisone (0.1 mg, two times per day), but neither treatment afforded symptomatic relief. Autonomic testing was performed. Head-up tilt table testing revealed a supine BP ... Read more >>

BMJ Case Rep (BMJ Case Reports)
[2019, 12(8):]

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