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Autonomic dysfunction in reversible cerebral vasoconstriction syndromes.

Shih-Pin Chen1, Albert C Yang, Jong-Ling Fuh

  • 1Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan. sjwang@vghtpe.gov.tw.

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Autonomic imbalance, specifically reduced parasympathetic activity and increased sympathetic drive, is linked to reversible cerebral vasoconstriction syndromes (RCVS). These heart rate variability (HRV) changes persist even in remission, suggesting a potential biological trait in RCVS patients.

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Area of Science:

  • Neurology
  • Cardiology
  • Autonomic Neuroscience

Background:

  • Autonomic dysfunction is implicated in the pathogenesis of reversible cerebral vasoconstriction syndromes (RCVS).
  • Understanding autonomic function in RCVS is crucial for elucidating disease mechanisms.

Purpose of the Study:

  • To assess autonomic function in RCVS patients by analyzing heart rate variability (HRV).
  • To compare HRV parameters between RCVS patients and healthy controls.

Main Methods:

  • Recruited RCVS patients and age/gender-matched controls.
  • Conducted 24-hour ambulatory electrocardiographic (ECG) recordings for all participants.
  • Analyzed time and frequency domain HRV measures to evaluate autonomic functioning.

Main Results:

  • RCVS patients in the ictal stage exhibited reduced parasympathetic indices (RMSSD, pNN50, HF) and an increased LF/HF ratio compared to controls.
  • These HRV abnormalities showed partial improvement during remission but remained significantly different from controls.
  • Findings suggest a shift in sympathovagal balance in RCVS patients.

Conclusions:

  • RCVS patients demonstrate decreased parasympathetic modulation and accentuated sympathetic activity.
  • These autonomic alterations may represent a biological trait in individuals with RCVS.
  • Further research into autonomic dysfunction in RCVS is warranted.