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The nature of the autonomic dysfunction in multiple system atrophyThe 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.
Document ID
20040088220
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Parikh, Samir M.
(Vanderbilt University AA 3228 MCN, Nashville, TN 37232-2195, United States)
Diedrich, Andre
Biaggioni, Italo
Robertson, David
Date Acquired
August 21, 2013
Publication Date
August 15, 2002
Publication Information
Publication: Journal of the neurological sciences
Volume: 200
Issue: 2-Jan
ISSN: 0022-510X
Subject Category
Life Sciences (General)
Funding Number(s)
CONTRACT_GRANT: M01 RR00095
CONTRACT_GRANT: 1U01NS33460
CONTRACT_GRANT: 5P01 HL56693
Distribution Limits
Public
Copyright
Other
Keywords
NASA Discipline Regulatory Physiology
Review
Non-NASA Center
Review, Tutorial

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