Book chapter
Testing the autonomic nervous system
Handbook of Clinical Neurology, pp.115-136
Elsevier Health Sciences
2013
DOI: 10.1016/B978-0-444-52902-2.00007-2
PMID: 23931777
Abstract
Autonomic testing is used to define the role of the autonomic nervous system in diverse clinical and research settings. Because most of the autonomic nervous system is inaccessible to direct physiological testing, in the clinical setting the most widely used techniques entail the assessment of an end-organ response to a physiological provocation. The noninvasive measures of cardiovascular parasympathetic function involve the assessment of heart rate variability while the measures of cardiovascular sympathetic function assess the blood pressure response to physiological stimuli. Tilt-table testing, with or without pharmacological provocation, has become an important tool in the assessment of a predisposition to neurally mediated (vasovagal) syncope, the postural tachycardia syndrome, and orthostatic hypotension. Distal, postganglionic, sympathetic cholinergic (sudomotor) function may be evaluated by provoking axon reflex mediated sweating, e.g., the quantitative sudomotor axon reflex (QSART) or the quantitative direct and indirect axon reflex (QDIRT). The thermoregulatory sweat test provides a nonlocalizing measure of global pre- and postganglionic sudomotor function. Frequency domain analyses of heart rate and blood pressure variability, microneurography, and baroreflex assessment are currently research tools but may find a place in the clinical assessment of autonomic function in the future.
Details
- Title: Subtitle
- Testing the autonomic nervous system
- Creators
- Roy Freeman - Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USAMark W Chapleau - Departments of Internal Medicine and Molecular Physiology and Biophysics, University of Iowa Carver College of Medicine, Veterans Affairs Medical Center, Iowa City, IA, USA
- Resource Type
- Book chapter
- Publication Details
- Handbook of Clinical Neurology, pp.115-136
- Publisher
- Elsevier Health Sciences
- DOI
- 10.1016/B978-0-444-52902-2.00007-2
- PMID
- 23931777
- ISSN
- 0072-9752
- Language
- English
- Date published
- 2013
- Academic Unit
- Molecular Physiology and Biophysics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984025598702771
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