7,665 results match your criteria Autonomic Neuropathy


A practical approach to peripheral autonomic neuropathies.

Curr Opin Neurol 2021 May 11. Epub 2021 May 11.

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Purpose Of The Review: The review focuses on the practical evaluation and management of patients with autonomic neuropathies.

Recent Findings: Autonomic neuropathies are complex disorders and result in diverse clinical manifestations that affect the cardiovascular, gastrointestinal, urogenital, and sudomotor systems. The autonomic medical history is key when seeing a patient with suspected autonomic neuropathy. Read More

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Ocular Manifestations and Neuropathy in Type 2 Diabetes Patients With Charcot Arthropathy.

Front Endocrinol (Lausanne) 2021 21;12:585823. Epub 2021 Apr 21.

Department of Ophthalmology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.

Objective: Diabetes can affect the eye in many ways beyond retinopathy. This study sought to evaluate ocular disease and determine any associations with peripheral neuropathy (PN) or cardiac autonomic neuropathy (CAN) in type 2 diabetes (T2D) and Charcot arthropathy (CA) patients.

Design: A total of 60 participants were included, 16 of whom were individuals with T2D/CA, 21 of whom were individuals with T2D who did not have CA, and 23 of whom were healthy controls. Read More

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Heart Rate Variability as a Non-invasive Objective Parameter for Predicting the Occurrence of Chemotherapy-induced Peripheral Neuropathy in Patients With Gastrointestinal Cancer.

Anticancer Res 2021 May;41(5):2637-2645

Division of Hematology-Oncology, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

Background/aim: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common chemotoxicities. However, no effective clinical CIPN screening methods have been reported. This study aimed to investigate whether changes in heart rate variability (HRV) could predict the development of CIPN for early symptom control in chemotherapy-prescribed patients with gastrointestinal (GI) cancer. Read More

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Intensive Risk Factor Management and Cardiovascular Autonomic Neuropathy in Type 2 Diabetes in the ACCORD Trial: a post-hoc analysis.

Authors:
Yoshimasa Aso

J Diabetes Investig 2021 May 5. Epub 2021 May 5.

Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Shimotsuga, 321-0293, Japan.

In people with type 1 or 2 diabetes, cardiovascular autonomic neuropathy (CAN) is associated with the development of atherosclerotic cardiovascular disease (CVD) and with a high risk of lethal arrhythmias and sudden death. In the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, which included people with type 2 diabetes, participants with CAN at baseline were 1.55 to 2. Read More

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Late-onset hereditary sensory and autonomic neuropathy type 2B caused by novel compound heterozygous mutations in FAM134B presenting as chronic recurrent ulcers on the soles.

Indian J Dermatol Venereol Leprol 2021 May-Jun;87(3):455

Department of Dermatology The East Division of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

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Small Fibre Neuropathy Is Associated With Impaired Vascular Endothelial Function in Patients With Type 2 Diabetes.

Front Endocrinol (Lausanne) 2021 14;12:653277. Epub 2021 Apr 14.

Diabetes and Vascular Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, United Kingdom.

Diabetic polyneuropathy (DPN) and endothelial dysfunction are prevalent complications of diabetes mellitus. Currently, there are two non-invasive markers for endothelial dysfunction: flow-mediated dilation and reactive hyperaemia peripheral arterial tonometry (RH-PAT). However, the relationship between diabetic small fibre neuropathy and macroangiopathy remains obscure thus far. Read More

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Immune Axonal Neuropathies Associated With Systemic Autoimmune Rheumatic Diseases.

Front Pharmacol 2021 14;12:610585. Epub 2021 Apr 14.

Colentina-Research and Development Center, Colentina Clinical Hospital, Bucharest, Romania.

Immune axonal neuropathies are a particular group of immune-mediated neuropathies that occasionally accompany systemic autoimmune rheumatic diseases such as connective tissue dissorders and primary systemic vasculitides. Apart from vasculitis of vasa nervorum, various other mechanisms are involved in their pathogenesis, with possible therapeutic implications. Immune axonal neuropathies have highly heterogeneous clinical presentation and course, ranging from mild chronic distal sensorimotor polyneuropathy to severe subacute mononeuritis multiplex with rapid progression and constitutional symptoms such as fever, malaise, weight loss and night sweats, underpinning a vasculitic process. Read More

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COVID-19 Dysautonomia.

Front Neurol 2021 13;12:624968. Epub 2021 Apr 13.

Department of Neurology, Mayo Clinic, Scottsdale, AZ, United States.

To report a case series of dysautonomia associated with COVID-19 infection. This is a retrospective review of patients evaluated in the autonomic clinic at our institution with suspected signs and symptoms of dysautonomia who underwent formal evaluation, including autonomic testing. Six patients were identified with signs and symptoms suggestive of dysautonomia who underwent autonomic testing. Read More

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Essential Oil of Prevents Conduction Alterations Produced by Diabetes Mellitus on Vagus Nerve.

Plants (Basel) 2021 Apr 28;10(5). Epub 2021 Apr 28.

Laboratory of Electrophysiology, Superior Institute of Biomedical Science, State University of Ceará, Fortaleza CEP 60.740-000, Brazil.

Autonomic diabetic neuropathy (ADN) is a complication of diabetes mellitus (DM), to which there is no specific treatment. In this study, the efficacy of the essential oil of (EOCz) in preventing ADN was evaluated in the rat vagus nerve. For the two fastest conducting myelinated types of axons of the vagus nerve, the conduction velocities and rheobase decreased, whilst the duration of the components of the compound action potential of these fibers increased. Read More

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Vincristine-Induced Peripheral Neuropathy (VIPN) in Pediatric Tumors: Mechanisms, Risk Factors, Strategies of Prevention and Treatment.

Int J Mol Sci 2021 Apr 16;22(8). Epub 2021 Apr 16.

Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy.

Vincristine-induced peripheral neurotoxicity (VIPN) is a very common side effect of vincristine chemotherapy among pediatric patients with cancer. Neuropathy may be sensory, motor and/or autonomic, with consequent reduction, delay or discontinuation of vincristine-chemotherapy, but also pain, disability, reduced quality of life of patients and an increase in medical costs. Vincristine acts out its antineoplastic function by altering the normal assembly and disassembly of microtubules, with their consequent mitosis block and death. Read More

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The long chain base unsaturation has a stronger impact on 1-deoxy(methyl)-sphingolipids biophysical properties than the structure of its C1 functional group.

Biochim Biophys Acta Biomembr 2021 Apr 27;1863(8):183628. Epub 2021 Apr 27.

Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto, Ed F, 1649-003 Lisbon, Portugal. Electronic address:

1-deoxy-sphingolipids, also known as atypical sphingolipids, are directly implicated in the development and progression of hereditary sensory and autonomic neuropathy type 1 and diabetes type 2. The mechanisms underlying their patho-physiological actions are yet to be elucidated. Accumulating evidence suggests that the biological actions of canonical sphingolipids are triggered by changes promoted on membrane organization and biophysical properties. Read More

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Novel and Emerging Electrophysiological Biomarkers of Diabetic Neuropathy and Painful Diabetic Neuropathy.

Clin Ther 2021 Apr 24. Epub 2021 Apr 24.

Musculoskeletal Biology, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom; Department of Clinical Neurophysiology, The Walton Centre, Liverpool, United Kingdom; Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom. Electronic address:

Purpose: Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes. Small and large peripheral nerve fibers can be involved in DPN. Large nerve fiber damage causes paresthesia, sensory loss, and muscle weakness, and small nerve fiber damage is associated with pain, anesthesia, foot ulcer, and autonomic symptoms. Read More

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[Screening of cardiac autonomic neuropathy in a group of adolescents and young adult Cameroonians with type 1 diabetes].

Ann Cardiol Angeiol (Paris) 2021 Apr 23. Epub 2021 Apr 23.

Faculté de Médecine et des Sciences Biomédicales, Université de Yaoundé 1, Yaoundé, Cameroun; Centre national d'obésité, Hôpital central de Yaoundé, Yaoundé, Cameroun.

Aim: We aimed to describe cardiac autonomic neuropathy in a group of young Cameroonians type 1 diabetic patients.

Patients And Methods: We conducted a descriptive cross-sectional study including consenting patients with type 1 diabetes and without any other comorbidity, who were followed-up at the type 1 diabetic children's clinic at the Yaoundé central hospital. Cardiac autonomic neuropathy was diagnosed and stage using the five functional tests described by Ewang et al. Read More

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Asymptomatic urinary tract infections and associated risk factors in Pakistani Muslim type 2 diabetic patients.

BMC Infect Dis 2021 Apr 26;21(1):388. Epub 2021 Apr 26.

University of Karachi, Karachi, Pakistan.

Background: One of the leading long-term complications of type 2 diabetes mellitus (T2DM) includes renal dysfunction and urinary tract infections (UTI) which are considered to be prevalent in uncontrolled diabetes. Moreover, physiological factors like age, gender, duration of diabetes, other diabetic complications like neuropathy, autonomic neuropathy and glycosuria are also considered as predisposing factors for increased prevalence of UTI in diabetes which can be symptomatic or asymptomatic.

Methods: This was a cross-sectional, multi-centre study including diabetic patients from 12 clinical sites spread across major cities of Pakistan. Read More

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Diabetic heart disease: A clinical update.

World J Diabetes 2021 Apr;12(4):383-406

Department of Endocrinology and Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, United Kingdom.

Diabetes mellitus (DM) significantly increases the risk of heart disease, and DM-related healthcare expenditure is predominantly for the management of cardiovascular complications. Diabetic heart disease is a conglomeration of coronary artery disease (CAD), cardiac autonomic neuropathy (CAN), and diabetic cardiomyopathy (DCM). The Framingham study clearly showed a 2 to 4-fold excess risk of CAD in patients with DM. Read More

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Dysautonomia: A Forgotten Condition - Part 1.

Arq Bras Cardiol 2021 Apr;116(4):814-835

Serviço de Eletrofisiologia do Vitória Apart Hospital, Vitória, ES - Brasil.

Dysautonomia covers a range of clinical conditions with different characteristics and prognoses. They are classified as Reflex Syndromes, Postural Orthostatic Tachycardia Syndrome (POTS), Chronic Fatigue Syndrome, Neurogenic Orthostatic Hypotension (nOH) and Carotid Sinus Hypersensitivity Syndrome. Reflex (vasovagal) syndromes will not be discussed in this article. Read More

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RFC1 AAGGG repeat expansion masquerading as Chronic Idiopathic Axonal Polyneuropathy.

J Neurol 2021 Apr 21. Epub 2021 Apr 21.

Department of Neurosciences, Biomedicine, and Movement Sciences, University of Verona, Policlinico G.B. Rossi, Piazzale L.A. Scuro 10, 37134, Verona, VR, Italy.

Background: A biallelic intronic AAGGG repeat expansion in the Replication Factor C subunit 1 (RFC1) gene has been recently associated with Cerebellar Ataxia, Neuropathy, Vestibular Areflexia Syndrome, a disorder often presenting as a slowly evolving sensory neuropathy at the onset. "Chronic Idiopathic Axonal Polyneuropathy" (CIAP) is a common indolent axonal neuropathy of adulthood which remains without an identifiable cause despite thorough investigations.

Methods: We screened 234 probands diagnosed with CIAP for a pathogenic biallelic RFC1 AAGGG repeat expansion. Read More

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Expanding the Genotypic Spectrum of Congenital Sensory and Autonomic Neuropathies Using Whole-Exome Sequencing.

Neurol Genet 2021 Apr 3;7(2):e568. Epub 2021 Mar 3.

New York University School of Medicine (J.-A.P., L.N.-K., H.K.), New York, NY; and Massachusetts General Hospital Research Institute (R.Y., D.G., S.S), Boston.

Objective: To test the hypothesis that many patients presenting with congenital insensitivity to pain have lesser known or unidentified mutations not captured by conventional genetic panels, we performed whole-exome sequencing in a cohort of well-characterized patients with a clinical diagnosis of congenital hereditary sensory and autonomic neuropathy with unrevealing conventional genetic testing.

Methods: We performed whole-exome sequencing (WES) in 13 patients with congenital impaired or absent sensation to pain and temperature with no identified molecular diagnosis from a conventional genetic panel. Patients underwent a comprehensive phenotypic assessment including autonomic function testing, and neurologic and ophthalmologic examinations. Read More

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Association between neurosarcoidosis with autonomic dysfunction and anti-ganglionic acetylcholine receptor antibodies.

J Neurol 2021 Apr 21. Epub 2021 Apr 21.

Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.

Objective: To determine whether autonomic dysfunction in neurosarcoidosis is associated with anti-ganglionic acetylcholine receptor (gAChR) antibodies, which are detected in autoimmune autonomic ganglionopathy.

Methods: We retrospectively extracted cases of sarcoidosis from 1787 serum samples of 1,381 patients between 2012 and 2018. Anti-gAChR antibodies against the α3 and β4 subunit were measured by luciferase immunoprecipitation to confirm the clinical features of each case. Read More

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N-terminal deletion of specific phosphorylation sites on PHOX2B disrupts the formation of enteric neurons in vivo.

Am J Physiol Gastrointest Liver Physiol 2021 Apr 21. Epub 2021 Apr 21.

Surgery, Children's Hospital of Los Angeles, United States.

Mutations in the paired-like homeobox 2b (PHOX2B) gene are associated with congenital central hypoventilation syndrome (CCHS), which is a rare condition in which both autonomic dysregulation with hypoventilation and an enteric neuropathy may occur. The majority of CCHS patients have a polyalanine repeat mutation (PARM) in PHOX2B, but a minority of patients have non-polyalanine repeat mutations (NPARM), some of which have been localized to exon 1. A PHOX2B-Y14X nonsense mutation previously generated in a human pluripotent stem cell (hPSC) line results in an N-terminus truncated product missing the first 17 or 20 amino acids, possibly due to translational reinitiation at an alternate ATG start site. Read More

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Peripheral sensory nerve hyperaesthesia in women with polycystic ovary syndrome.

Minerva Endocrinol (Torino) 2021 Apr 21. Epub 2021 Apr 21.

Department of Medicine, University of Szeged, Szeged, Hungary.

Dysfunction of the nervous system is well-known in diabetes and also among patients with prediabetes, obesity and hypertension. However, there is only a limited amount of data available on the changes in neuronal function in polycystic ovary syndrome (PCOs), despite the fact that this condition is also accompanied by metabolic and vascular abnormalities. The aim of our study was to assess the cardiovascular autonomic and peripheral sensory function in patients with PCOs. Read More

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Serum Levels of Inflammatory Proteins Are Associated With Peripheral Neuropathy in a Cross-Sectional Type-1 Diabetes Cohort.

Front Immunol 2021 31;12:654233. Epub 2021 Mar 31.

Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States.

Chronic low-grade inflammation is involved in the pathogenesis of type-1 diabetes (T1D) and its complications. In this cross-section study design, we investigated association between serum levels of soluble cytokine receptors with presence of peripheral neuropathy in 694 type-1 diabetes patients. Sex, age, blood pressure, smoking, alcohol intake, HbA1c and lipid profile, presence of DPN (peripheral and autonomic), retinopathy and nephropathy was obtained from patient's chart. Read More

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Autonomic dysfunction following COVID-19 infection: an early experience.

Clin Auton Res 2021 Apr 16. Epub 2021 Apr 16.

Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Purpose: Post-COVID-19 syndrome is a poorly understood aspect of the current pandemic, with clinical features that overlap with symptoms of autonomic/small fiber dysfunction. An early systematic analysis of autonomic dysfunction following COVID-19 is lacking and may provide initial insights into the spectrum of this condition.

Methods: We conducted a retrospective review of all patients with confirmed history of COVID-19 infection referred for autonomic testing for symptoms concerning for para-/postinfectious autonomic dysfunction at Mayo Clinic Rochester or Jacksonville between March 2020 and January 2021. Read More

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Guillain-Barré Syndrome and Other Acute Polyneuropathies.

Clin Geriatr Med 2021 May 23;37(2):313-326. Epub 2021 Mar 23.

Department of Neurology, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street MSE#466, Houston, TX 77030, USA.

Guillain-Barré syndrome (GBS) is an acute autoimmune neuropathy that can cause motor, sensory, and autonomic symptoms. Although GBS primarily is a neuropathic disorder, multiple organ systems can be affected during the disease course, and older patients may be more vulnerable to systemic complications. Close clinical monitoring and early interventions using pharmacologic and nonpharmacological treatments may lead to an improved long-term outcome. Read More

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Diabetes and Peripheral Nerve Disease.

Clin Geriatr Med 2021 May 23;37(2):253-267. Epub 2021 Mar 23.

Department of Neurology, University of Maryland School of Medicine & Maryland VA Healthcare System, 3S-130, 110 South Paca Street, Baltimore, MD 21201-1595, USA. Electronic address:

It is increasingly recognized that diabetic neuropathy is associated with early diabetes, prediabetes, and the metabolic syndrome. Early detection and diagnosis are important to slow progression and prevent complications. Although strict glucose control is an effective treatment in type 1 diabetes, it is less effective in type 2 diabetes. Read More

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Isoniazid induced palmoplantar hyperhidrosis.

Trop Doct 2021 Apr 15:494755211007966. Epub 2021 Apr 15.

Assitant professor, Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India.

Secondary focal hyperhidrosis is usually due to peripheral or central neuronal defects and is a complex dysfunction of the parasympathetic and sympathetic nervous system. Palmoplantar hyperhidrosis has been described with various types of polyneuropathies such as diabetic but has not previously been described with isoniazid. We report a 15-year-old boy, being followed for neurotuberculosis, who presented with burning sensation and hyperhidrosis of both palms and soles five months after starting antitubercular therapy. Read More

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Clinical, neuroimaging, and molecular spectrum of TECPR2-associated hereditary sensory and autonomic neuropathy with intellectual disability.

Hum Mutat 2021 Apr 13. Epub 2021 Apr 13.

Oxford Centre for Genomic Medicine, Oxford, UK.

Bi-allelic TECPR2 variants have been associated with a complex syndrome with features of both a neurodevelopmental and neurodegenerative disorder. Here, we provide a comprehensive clinical description and variant interpretation framework for this genetic locus. Through international collaboration, we identified 17 individuals from 15 families with bi-allelic TECPR2-variants. Read More

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Diagnostic tools, biomarkers, and treatments in diabetic polyneuropathy and cardiovascular autonomic neuropathy.

Curr Diabetes Rev 2021 Apr 12. Epub 2021 Apr 12.

Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf. Germany.

The various manifestations of diabetic neuropathy including distal symmetric sensorimotor polyneuropathy (DSPN) and cardiovascular autonomic neuropathy (CAN) are among to the most prevalent chronic complications of diabetes. Major clinical complications of diabetic neuropathies such as neuropathic pain, chronic foot ulcers, and orthostatic hypotension are associated with considerable morbidity, increased mortality, and diminished quality of life. Despite the substantial individual and socioeconomic burden, the strategies to diagnose and treat diabetic neuropathies remain insufficient. Read More

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Small Fiber Neuropathy in Diabetes Polyneuropathy: Is It Time to Change?

J Diabetes Sci Technol 2021 Apr 12:1932296821996434. Epub 2021 Apr 12.

Diabetes Trails unit, Ipswich Hospital (ESNEFT), Ipswich, UK.

Diabetes polyneuropathy is an important complication of diabetes polyneuropathy, and its notable sequelae of foot ulceration, autonomic dysfunction, and neuropathic pain are associated with significant morbidity and mortality. Despite the major impact on quality of life and health economic costs, it remains underdiagnosed until late in its natural history, and there is lack of any intervention that can reverse its clinical progress. Assessment of small fiber neuropathy (SFN) in diabetes offers an opportunity to detect abnormalities at an early stage so that both interventional studies and preventative measures can be enacted to prevent progression to the devastating complications of foot ulceration and cardiac dysautonomic death. Read More

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The Prevalence of Diabetic Microvascular Complications in China and the USA.

Curr Diab Rep 2021 Apr 9;21(6):16. Epub 2021 Apr 9.

Renal Division, Department of Medicine, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing, 100034, China.

Purpose Of Review: Diabetes can lead to development of devastating microvascular complications, such as nephropathy, retinopathy, and peripheral sensory and autonomic neuropathy. While China and the USA both face the threat of this major public health challenge, the literature is limited in describing similarities and differences in the prevalence, and risk factors for the development, of diabetic microvascular complications between these two countries.

Recent Findings: The current review discusses the following: (1) the most recent evidence on prevalence of diabetic microvascular complications in China and the USA (including downtrends of diabetes retinopathy and neuropathy in the USA); (2) differences in patient risk factors of these complications; (3) challenges and current knowledge gaps (such as lacking national epidemiological data of diabetic complications in China); and (4) potential future clinical and research opportunities (including needs in diabetes evaluation and management in remote areas and standardization of methods in evaluating diabetic complications across countries). Read More

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