Autonomic Dysfunction in Patients with Bartonella henselae IgM Seroreactivity: A Cross-Sectional Study

Area of Science:

• Infectious Diseases
• Neurology
• Autonomic Neuroscience

Background:

• Bartonella henselae infections are linked to diverse neurological and autonomic symptoms.
• Autonomic nervous system function in Bartonella henselae infection is not well understood.
• This study investigates autonomic function in patients with symptoms and Bartonella henselae IgM antibodies.

Purpose of the Study:

• To evaluate autonomic nervous system function in patients with Bartonella henselae IgM seroreactivity.
• To identify specific patterns of autonomic dysfunction associated with Bartonella henselae infection.
• To compare autonomic function between seroreactive patients and healthy controls.

Main Methods:

• Cross-sectional study comparing 75 Bartonella IgM-seroreactive patients with 75 healthy controls.
• Utilized cardiovascular autonomic reflex testing, heart rate variability (5-min and 24-h), and 24-h ambulatory blood pressure monitoring.
• Included head-up tilt testing for the Bartonella group.

Main Results:

• Significantly higher rates of abnormal autonomic reflex tests in the Bartonella group, especially affecting parasympathetic function.
• Reduced heart rate variability (low high-frequency components, lower long-term indices) observed.
• Head-up tilt testing showed varied responses (orthostatic hypotension, blood pressure variability); ambulatory monitoring revealed elevated nighttime blood pressure and reduced nocturnal dipping.

Conclusions:

• Patients with Bartonella henselae IgM seroreactivity exhibit a consistent autonomic imbalance, predominantly parasympathetic impairment.
• Altered blood pressure regulation, including nocturnal hypertension and reduced dipping, is evident.
• Further research is needed to elucidate mechanisms and clinical significance of these findings.