RESEARCH: The nature of the autonomic dysfunction in multiple system atrophy

[Guest guest]

Now this is interesting.... " possible development of a bionic baroreflex for

better control of blood pressure. " I have no idea exactly what a bionic

baroreflex is but it sounds like an implant.

Regards,

Pam

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The nature of the autonomic dysfunction in multiple system atrophy

Samir M. Parikh, André Diedrich, Italo Biaggioni and on,

Autonomic Dysfunction Center, Departments of Medicine, Pharmacology and

Neurology, Vanderbilt University, AA 3228 MCN, Nashville, TN 37232-2195, USA

Received 26 November 2001; revised 29 March 2002; accepted 29 April 2002.

Available online 4 June 2002.

Abstract

The concept that multiple system atrophy (MSA, Shy-Drager syndrome) is a

disorder of the autonomic nervous system is several decades old. While there

has been renewed interest in the movement disorder associated with MSA, two

recent consensus statements confirm the centrality of the autonomic disorder

to the diagnosis. Here, we reexamine the autonomic pathophysiology in MSA.

Whereas MSA is often thought of as " autonomic failure " , new evidence

indicates substantial persistence of functioning sympathetic and

parasympathetic nerves even in clinically advanced disease. These findings

help explain some of the previously poorly understood features of MSA.

Recognition that MSA entails persistent, constitutive autonomic tone

requires a significant revision of our concepts of its diagnosis and

therapy. We will review recent evidence bearing on autonomic tone in MSA and

discuss their therapeutic implications, particularly in terms of the

possible development of a bionic baroreflex for better control of blood

pressure.