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.
Original language | English (US) |
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Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | Journal of the Neurological Sciences |
Volume | 200 |
Issue number | 1-2 |
DOIs | |
State | Published - Aug 15 2002 |
Externally published | Yes |
Keywords
- Autonomic
- Multiple system atrophy
- Norepinephrine
- Orthostatic hypotensive
- Parasympathetic
- Sympathetic
ASJC Scopus subject areas
- Neurology
- Clinical Neurology