The University of Leeds publish new paper on novel test to evaluate neuro-cardiovascular autonomic dysfunction

Published on the 8th of August 2022 in the ACNR
 

‘The adapted Autonomic Profile (aAP) home-based test for the evaluation of neuro-cardiovascular autonomic dysfunction’

The abstract of the article can be read here. For the full article, please follow the link above.

Autonomic dysfunction is an increasingly recognised complication in chronic neurological conditions such as Parkinson’s disease, and other medical conditions, including diabetes mellitus, chronic fatigue syndrome, postural tachycardia syndrome (PoTS) with and without Ehlers-Danlos syndrome, fibromyalgia and recently Long COVID. Despite laboratory-based tests to evaluate normal and abnormal autonomic function, there are no home-based tests to record neuro-cardiovascular autonomic responses to common stimuli in daily life that are dependent on normal functioning of the autonomic nervous system. We have developed an adapted blood pressure/heart rate Autonomic Profile (aAP) that can be used by an individual independently and repeatedly in a domiciliary setting to determine the physiological and symptomatic response to standing, food, and physical or mental (cognitive, emotional) activities. The aAP aids separating autonomic failure (often irreversible) from autonomic dysfunction. This helps the individual and attending healthcare professional understand the relationship between symptoms and common triggers in daily life and informs on self-management in debilitating conditions such as the postural tachycardia syndrome (PoTS) and Long COVID.

Concluding Points: 

  • This novel test is a neccasary step forward in being able to confirm autonomic dysfunction in Long COVID and PoTS. 
  • In Long COVID it appears commonly and with fluctuant symptoms, which often are related to specific stimuli in daily life, therefore the aAP provides both subjective and objective evaluation of the physiological and symptom variation with common stimuli. 
  • This approach may also explain Post-Exertion Malaise (PEM) or Post-Exertional Symptom Exacerbation (PESE), which are both described in Long COVID.
  • The benefits of this test can be further evaluated in large-scale Long COVID studies such as the NIHR-funded LOCOMOTION. 
 

Authors: 

  • Manoj Sivan, FRCP Edin, MD – Associate Clinical Professor and Honorary Consultant in Rehabilitation Medicine at University of Leeds and and Leeds Teaching Hospitals and Community Healthcare NHS Trust
  • Joanna Corrado, MRCP (UK), DTM&H, MB ChB – ST5 Rehabilitation Medicine Trainnee and Clinical Research Fellow based in Leeds, West Yorkshire, UK. 
  • Christopher Mathias, MBBS, LRCP&S, DPhil, DSc, FRCP, FMedSci – Emerutis Professor at the Queen Square Institute of Neurology, University College London, UK.