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Related Experiment Videos

Cold face test: adrenergic phase.

Ramesh K Khurana1

  • 1The Union Memorial Hospital, 201 East University Parkway, Room 411, 33rd Street Building, Baltimore, MD 21218, USA. ramesh.khurana@medstar.net

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|May 29, 2007
PubMed
Summary
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The cold face test (CFT) effectively assesses autonomic nervous system function. The pressor response, independent of vagal activity, helps evaluate sympathetic pathways in conditions like baroreflex failure.

Area of Science:

  • Cardiovascular Physiology
  • Autonomic Nervous System Function
  • Clinical Neurophysiology

Background:

  • The cold face test (CFT) elicits reflex bradycardia and pressor responses.
  • Bradycardia is a known indicator of vagal function.
  • The pressor response's physiological basis and clinical utility require further evaluation.

Purpose of the Study:

  • To investigate the physiological characteristics of the pressor response during CFT.
  • To assess the clinical applicability of the pressor response in patients with autonomic dysfunction.
  • To determine the independence of the pressor response from cholinergic activity and baroreceptors.

Main Methods:

  • Continuous blood pressure (Finapres) and heart rate (EKG) monitoring during CFT in healthy subjects and patients.

Related Experiment Videos

  • CFT involved applying cold packs to the face for 1 minute.
  • Groups included normal subjects, subjects post-atropine administration, and patients with baroreflex or pure autonomic failure.

    • Main Results:

    • The latency of systolic blood pressure (SBP) rise was longer than bradycardia in normal subjects.
    • Atropine abolished bradycardia but did not affect the SBP response.
    • Patients with baroreflex failure showed normal responses; pure autonomic failure patients had absent or subnormal SBP responses.

    Conclusions:

    • The pressor response during CFT is mediated by the adrenergic system and is independent of the cholinergic system and baroreceptors.
    • CFT's pressor response is valuable for assessing the efferent sympathetic pathway, especially in baroreflex failure.
    • Absence of SBP rise in CFT may diagnose the sympathetic deficit in pure autonomic failure.