CLINICAL AUTONOMIC RESEARCH临床自主神经研究
CLINICAL AUTONOMIC RESEARCH(英文缩写 CLIN AUTON RES),ISSN 0959-9851,eISSN 1619-1560,中文译名:临床自主神经研究 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 5.625 | Q1 |
| 2022 | 5.800 | Q1 |
| 2023 | 3.900 | Q1 |
| 2024 | 3.400 | Q2 |
| 2025 | 4.600 | Q1 |
CLINICAL AUTONOMIC RESEARCH 最新收录文献
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1. Baseline peripheral inflammatory profiles predict phenoconversion in prodromal Parkinson's disease: a longitudinal cohort study.
PMID:日期:2026-09-23Autonomic dysfunction is an early and prognostically important feature of Parkinson's disease, yet accessible biomarkers capturing systemic inflammatory processes potentially linked to autonomic dysfunction during the prodromal phase remain limited. We evaluated whether complete blood count-derived inflammatory indices predict phenoconversion in prodromal Parkinson's disease. We conducted a retrospective cohort analysis of 452 prodromal participants from the Parkinson's Progression Markers Initiative. Five complete blood count-derived inflammatory indices-the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and systemic inflammation response index-were evaluated using Cox proportional hazards models with penalized variable selection, sex-stratified analyses, and internal validation. During follow-up, 43 participants (9.5%) phenoconverted. The systemic inflammation response index showed the strongest and most consistent association with phenoconversion, remaining independently associated after penalized variable selection (hazard ratio 2.34 per log-unit, 95% confidence interval 1.28-4.29; optimism-corrected concordance statistic 0.683; calibration slope 0.864). Effect estimates were larger in male participants, while female estimates were imprecise as a result of limited events; no statistically significant biomarker-by-sex interaction was detected. Longitudinal analyses indicated that baseline inflammatory levels, rather than subsequent changes, carried the primary prognostic signal. Baseline systemic inflammation response index derived from routine complete blood counts was associated with phenoconversion risk in prodromal Parkinson's disease, although with a relatively low number of phenoconversion events. External validation of these findings with larger, independent cohorts would further support its utility in peripheral systemic inflammatory conditions such as those observed in autonomic dysfunctions.
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5. Utility and best practices for clinical diagnostic testing of the autonomic nervous system: A Consensus Statement Endorsed by the American Autonomic Society and the American Association of Neuromuscular & Electrodiagnostic Medicine.
PMID:日期:2026-09-21Disorders of the autonomic nervous system are prevalent and associated with substantial morbidity, mortality and diagnostic delay. Standardized, laboratory-based autonomic function testing provides objective physiological data essential for diagnosing, staging, and monitoring autonomic disorders, yet no current consensus statement establishes best practices for the conduct, interpretation, and minimum quality standards of such testing. The American Autonomic Society convened a writing committee of autonomic specialists to review published evidence and established practices governing standardized autonomic reflex function testing in clinical settings. This consensus statement builds upon prior position statements published by North American and European professional societies. We summarize the clinical evidence supporting standardized autonomic reflex function testing across a broad range of conditions, including neurodegenerative disorders, peripheral neuropathies, orthostatic intolerance syndromes, and autoimmune autonomic disorders. We describe the validated battery of tests -orthostatic challenge, Valsalva maneuver, cardiovagal heart rate variability testing, and sudomotor testing-with attention to physiological principles, technical standards, and clinical interpretation. Minimum standards are defined for the requisite roles in autonomic testing: the autonomic technician, supervising clinician, and interpreting autonomic physician. Special considerations for pediatric, pregnant, and critically ill populations are addressed, and emerging adjunctive techniques are reviewed. Standardized autonomic reflex function testing is clinically useful, well validated, evidence-based, and non-investigational when performed by qualified personnel adhering to best practices. Autonomic testing is irreplaceable for clinical decision-making in certain circumstances and should be integrated into clinical practice when appropriate.
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6. Hyperadrenergic and neuropathic features based on clinical autonomic testing in individuals with POTS: an observational cross-sectional study.
PMID:日期:2026-09-18Hyperadrenergic and neuropathic features have been described in postural tachycardia syndrome (POTS). This study describes the prevalence, autonomic testing characteristics, and symptom severity of individuals with hyperadrenergic and neuropathic features in a laboratory-diagnosed POTS cohort. We performed a cross-sectional study of individuals with a laboratory diagnosis of POTS. Hyperadrenergic POTS (HyperPOTS) features were defined as an upright norepinephrine level of > 600 pg/mL and/or > 3 times their respective supine norepinephrine. Neuropathic POTS (NeuroPOTS) features were defined by a CASS ≥ 2 and/or ≥ 1 sudomotor abnormalities. Autonomic symptom severity was determined by the Composite Autonomic Symptom Score (COMPASS-31). Other standard autonomic reflex testing components, including heart rate response to deep breathing (HRDB), Valsalva, and 10-min head-up tilt testing, were also performed. Of the 223 participants (mean age 31.6 years; female 89%), 161 (41%) had HyperPOTS features, 113 (29%) exhibited NeuroPOTS features, and 40 (18%)/48 (22%) demonstrated neither or both, respectively. NeuroPOTS features were associated with higher supine HR and rates of abnormal HRDB than those without NeuroPOTS. No significant differences in COMPASS-31 scores were found between all groups studied. HyperPOTS and NeuroPOTS are common, co-occurring features in adults with POTS. Autonomic symptom burden did not differ significantly between phenotypes, likely reflecting insensitivity of the COMPASS-31 to phenotype-specific domains. NeuroPOTS was associated with impaired cardiovagal function, consistent with involvement in cardiac postganglionic parasympathetic pathways, though this is partly confounded by HRDB's inclusion in our NeuroPOTS definition. These findings support the concept that POTS phenotyping may aid in therapy selection, and the need for phenotype-sensitive symptom instruments.
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7. Resting sympathetic transduction in veterans with PTSD.
PMID:日期:2026-08-25Posttraumatic stress disorder (PTSD) is associated with autonomic dysregulation characterized by heightened sympathetic nervous system and reduced parasympathetic nervous system activity that contribute to increased cardiovascular risk. Prior work has shown that individuals with PTSD have augmented increases in muscle sympathetic nerve activity (MSNA) during sympathoexcitatory stressors and increased vascular alpha-1 adrenergic receptor sensitivity. However, sympathetic transduction, defined as the blood pressure (BP) response to MSNA, has not been previously examined in PTSD. We investigated whether resting sympathetic transduction is increased in combat veterans with PTSD. In 18 veterans with PTSD and 10 age-matched controls, beat-to-beat blood pressure (finger photoplethysmography), heart rate (electrocardiography), and MSNA (microneurography) were recorded at rest for 10 min. Sympathetic BP transduction was quantified using signal averaging, whereby the BP response to each MSNA burst was tracked over 15 cardiac cycles and averaged to derive the peak change in BP. Baseline characteristics, resting MSNA, BP, and heart rate were similar between groups. Sympathetic transduction did not differ between veterans with PTSD and controls (1.16 ± 0.74 vs 1.04 ± 0.67 mmHg; p = 0.67). In the PTSD group, resting MSNA was inversely associated with sympathetic transduction (r = - 0.494, p = 0.037). No associations were found with PTSD symptom severity or psychiatric comorbidities and sympathetic transduction. These findings suggest that resting sympathetic transduction is not altered in veterans with PTSD.
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8. Cutaneous alpha-synuclein deposition informs autonomic function in individuals with early-stage multiple system atrophy.
PMID:日期:2026-08-12Multiple system atrophy is a progressive neurodegenerative disorder characterized by autonomic failure, parkinsonism, and cerebellar ataxia. Phosphorylated alpha-synuclein in skin nerves has emerged as a promising biomarker, but longitudinal studies remain limited. This study evaluated changes in cutaneous alpha-synuclein deposition over time, its association with autonomic dysfunction, and its concordance with seed amplification assay findings. Seventeen participants with probable multiple system atrophy were followed up for 12 months with clinical assessments, skin biopsies from posterior cervical and distal thigh regions, standardized orthostatic vital signs, and cerebrospinal fluid biomarker collection. Phosphorylated alpha-synuclein deposition was quantified using immunofluorescence microscopy and correlated with autonomic measures and seed amplification assay results. Cutaneous alpha-synuclein deposition increased from baseline to the12-month follow-up visit. Total deposition was associated with orthostatic systolic blood pressure drop (p = 0.80, p = 0.0001) and with higher scores on the Orthostatic Hypotension Questionnaire and Composite Autonomic Symptom Score. Posterior cervical deposition showed stronger autonomic associations than distal thigh deposition. No associations were found with global disease severity or neurofilament light chain levels. Two participants with negative seed amplification assay results showed phosphorylated alpha-synuclein on skin biopsy. In this cohort, cutaneous phosphorylated alpha-synuclein increased over time and correlated with objective orthostatic hypotension and autonomic symptom burden in early synucleinopathy. Skin biopsy may serve as a minimally invasive tool to support diagnosis, monitor progression, and stratify clinical trial participants.
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9. Diagnostic strategies, test accuracy, and misdiagnosis of POTS: a narrative review of diagnostic criteria, tests, and diagnostic delay.
PMID:日期:2026-08-10Postural orthostatic tachycardia syndrome is defined by a sustained heart rate increment upon upright posture without orthostatic hypotension. Despite established criteria, the condition remains frequently underdiagnosed. This narrative review evaluates diagnostic strategies, test accuracy, diagnostic delay, and misdiagnosis patterns. Following prospective registration in PROSPERO (CRD 1248964), 7 databases were searched without date restriction. Eligible studies enrolled individuals aged 12 years or older undergoing evaluation for postural orthostatic tachycardia syndrome and reported diagnostic accuracy, criteria performance, or delay and misdiagnosis data. Dual-reviewer screening and standardized data extraction were performed. Risk of bias was assessed using QUADAS-2 and ROBINS-I. Narrative synthesis followed PRISMA 2020 guidelines. In total, 26 studies met inclusion criteria, enrolling more than 30,000 participants across multiple countries. Diagnostic criteria varied in heart rate thresholds, tilt angle, and test duration. Abbreviated 2-min tilt testing missed 55% of confirmed cases (95% confidence interval 48-63%). Active standing tests achieved areas under the curve of 0.855-0.925 with time-of-day-standardized thresholds. Tachycardia mimicking the syndrome occurred in 26-44% of vasovagal syncope patients during tilt. Two large surveys (n = 13,754) documented a median diagnostic delay of 24 months; approximately 75-76% reported prior misdiagnosis, most frequently attributed to psychological or psychiatric conditions. Postural orthostatic tachycardia syndrome diagnosis is compromised by protocol heterogeneity, abbreviated testing, physiological mimicry, and a pattern of psychiatric misattribution. Standardization of tilt and standing test protocols, clinician education, and structured diagnostic pathways are warranted. PROSPERO Registration: CRD1248964.
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10. Transcutaneous vagus nerve stimulation and exercise-induced autonomic regulation: a systematic review.
PMID:日期:2026-08-01To synthesise current evidence regarding whether transcutaneous vagus nerve stimulation modulates autonomic recovery following exercise-induced physiological stress in healthy individuals, with particular emphasis on vagal reactivation, spontaneous cardiovagal baroreflex sensitivity, sympathetic modulation and inflammatory responses. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement and registered in the Open Science Framework. Six electronic databases were searched. Fifteen randomised controlled trials involving 566 participants met inclusion criteria. Methodological quality, risk of bias and certainty of evidence were evaluated using the Physiotherapy Evidence Database scale, the revised Cochrane Risk-of-Bias tool and the Grading of Recommendations Assessment, Development and Evaluation framework. Transcutaneous vagus nerve stimulation was associated with protocol-dependent modulation of autonomic recovery dynamics following exercise-induced physiological stress. Several studies reported changes consistent with enhanced vagal reactivation, reflected by increases in selected vagally mediated heart rate variability indices and improvements in spontaneous cardiovagal baroreflex sensitivity, alongside reductions in sympathetic activity in selected protocols. However, autonomic responses were not uniform across studies, with some investigations demonstrating null or divergent findings depending on stimulation parameters, timing and participant characteristics. Repeated stimulation paradigms demonstrated reductions in selected inflammatory markers, whereas acute stimulation occasionally induced transient cytokine elevations, suggesting context-dependent autonomic-immune interactions. Effects on maximal physical performance remained limited and inconsistent. Certainty of evidence ranged from very low to low, primarily because of methodological heterogeneity, small sample sizes and short follow-up durations. Current evidence suggests that transcutaneous vagus nerve stimulation may influence autonomic mechanisms involved in recovery from exercise-induced stress, particularly processes related to vagal regulation, spontaneous cardiovagal baroreflex responsiveness and autonomic recalibration. Nevertheless, substantial heterogeneity in stimulation protocols and outcome assessment limits definitive interpretation. Larger, rigorously controlled and longitudinal investigations using standardised autonomic assessment methodologies are required to clarify the consistency, magnitude and physiological relevance of these effects. The review protocol was registered in the Open Science Framework (OSF; https://doi.org/10.17605/OSF.IO/H9VRX ).