ArticleJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2017
Cerebral autoregulation and symptoms of orthostatic hypotension in familial dysautonomia.
Article in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Mapping cerebral blood flow in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and orthostatic intolerance: insights from a systematic review.Journal of translational medicine · 2025Pooled it
- Cerebral Blood Flow Dynamics in Neurogenic Orthostatic Hypotension: A Systematic Review and Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2025Pooled it
- Trial
- Association of blood pressure variability with white matter hyperintensities and nigrostriatal dopaminergic deficits in drug-naïve Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2026Article
- Familial dysautonomia.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2023Review
- Spreading Diffusion-Restriction Events in the Gyrencephalic Brain After Subarachnoid Hemorrhage Revealed by Continuous Magnetic Resonance Imaging.Neurocritical care · 2022Article
- The new frontier in pure autonomic failure: getting a grip on cerebral blood flow.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2021Article
- Clinical Trials for Neurogenic Orthostatic Hypotension: A Comprehensive Review of Endpoints, Pitfalls, and Challenges.Seminars in neurology · 2020Review
- Cerebral Blood Flow Is Reduced in Severe Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients During Mild Orthostatic Stress Testing: An Exploratory Study at 20 Degrees of Head-Up Tilt Testing.Healthcare (Basel, Switzerland) · 2020Article
- Symptom Recognition Is Impaired in Patients With Orthostatic Hypotension.Hypertension (Dallas, Tex. : 1979) · 2020Article
- Orthostatic Hypotension in Parkinson Disease.Clinics in geriatric medicine · 2020Review
- Cerebral blood flow is reduced in ME/CFS during head-up tilt testing even in the absence of hypotension or tachycardia: A quantitative, controlled study using Doppler echography.Clinical neurophysiology practice · 2020Article
- Transcranial Doppler in autonomic testing: standards and clinical applications.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2018Review
- Early changes in cerebral autoregulation among youth hospitalized after sports-related traumatic brain injury.Brain injury · 2018Article
- Dexmedetomidine for refractory adrenergic crisis in familial dysautonomia.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2017Article
- Epidemiology, Diagnosis, and Management of Neurogenic Orthostatic Hypotension.Movement disorders clinical practiceArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
Familial dysautonomia is an inherited autonomic disorder with afferent baroreflex failure. We questioned why despite low blood pressure standing, surprisingly few familial dysautonomia patients complain of symptomatic hypotension or have syncope. Using transcranial Doppler ultrasonography of the middle cerebral artery, we measured flow velocity (mean, peak systolic, and diastolic), area under the curve, pulsatility index, and height of the dictrotic notch in 25 patients with familial dysautonomia and 15 controls. In patients, changing from sitting to a standing position, decreased BP from 124 ± 4/64 ± 3 to 82 ± 3/37 ± 2 mmHg (p < 0.0001, for both). Despite low BP, all patients denied orthostatic symptoms. Middle cerebral artery velocity fell minimally, and the magnitude of the reductions were similar to those observed in healthy controls, in whom BP upright did not fall. While standing, patients had a greater fall in cerebrovascular resistance (p < 0.0001), an increase in pulsatility (p < 0.0001), and a deepening of the dicrotic notch (p = 0.0010), findings all consistent with low cerebrovascular resistance. No significant changes occurred in controls. Patients born with baroreflex deafferentation retain the ability to buffer wide fluctuations in BP and auto-regulate cerebral blood flow. This explains how they can tolerate extremely low BPs standing that would otherwise induce syncope.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.