Quantitative Autonomic Testing
Quantitative Autonomic Testing
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DOI：
10.3791/2502
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发表时间：
2011-07-01
影响因子：
1.2
通讯作者：
Novak, Peter
中科院分区：
文献类型：
--
作者：
Novak, Peter
与自主神经系统功能障碍相关的疾病是相当常见的，但经常被忽视。定量自主神经测试可以在临床和研究中成为评估这些疾病的宝贵工具。有许多自主神经测试，但是，只有少数被临床验证或定量。在这里，完全定量和临床验证协议的自主神经功能的测试。作为最低限度，临床自主神经实验室应配备倾斜试验台、ECG监测仪、连续无创血压监测仪、呼吸监测仪和用于评估催汗域的方法。用于记录和评估自主测试的软件对于正确评估数据至关重要。所提出的协议评估3个主要的自主领域：心迷走神经，肾上腺素能和催汗。测试包括深呼吸、瓦尔萨尔瓦动作、头高位倾斜和定量汗肌轴突测试（QSART）。使用复合自主神经严重程度评分（卡斯）定量自主神经功能障碍的严重程度和分布。提供了详细的协议，强调测试的基本方面，重点是正确的数据采集，获得相关参数和自主信号的无偏评估。并提供了解释结果的规范数据和卡斯算法。
Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be invaluable tool for evaluation of these disorders, both in clinic and research. There are number of autonomic tests, however, only few were validated clinically or are quantitative. Here, fully quantitative and clinically validated protocol for testing of autonomic functions is presented. As a bare minimum the clinical autonomic laboratory should have a tilt table, ECG monitor, continuous noninvasive blood pressure monitor, respiratory monitor and a mean for evaluation of sudomotor domain. The software for recording and evaluation of autonomic tests is critical for correct evaluation of data. The presented protocol evaluates 3 major autonomic domains: cardiovagal, adrenergic and sudomotor. The tests include deep breathing, Valsalva maneuver, head-up tilt, and quantitative sudomotor axon test (QSART). The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores (CASS). Detailed protocol is provided highlighting essential aspects of testing with emphasis on proper data acquisition, obtaining the relevant parameters and unbiased evaluation of autonomic signals. The normative data and CASS algorithm for interpretation of results are provided as well.