Medullary autonomic pathology in carotid sinus hypersensitivity
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Aims Carotid sinus hypersensitivity (CSH) is an ageing-related autonomic disorder, rarely occurring before the age of 50 years but increasing in incidence thereafter. Clinical symptoms of CSH include falls and dizziness, thought to be precipitated by dysfunctional baroreflex responses. CSH is highly prevalent in Alzheimer's disease (AD), Parkinson's disease (PD) and dementia with Lewy bodies (DLB); diseases that are associated with variable degeneration of medullary autonomic nuclei which regulate baroreflex responses. Currently, there are no descriptions of the integrity of medullary autonomic nuclei in CSH. We hypothesized medullary autonomic degeneration is found in elderly patients with CSH. Methods Using in vitro digital imaging, we quantified the burden of tau, amyloid beta and alpha-synuclein in autonomic nuclei of 12 patients prospectively assessed with CSH (age 83 years) compared with 14 (80 years) control subjects. Results We found increased tau (P Conclusions We suggest that hyperphosphorylated tau accumulation particularly in tyrosine hydroxylase containing neurones may impair central regulation of baroreflex responses in patients with CSH. Future clinic-pathological investigations should reveal whether medullary degeneration is the cause of CSH symptoms.
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Carotid sinus syndrome is due to an abnormal reflex attributed to baroreceptor and possibly medulla dysfunction.
“It occurs more commonly in men >40 years of age (413,414) and is due to an abnormal reflex attributed to baroreceptor and possibly medulla dysfunction (415,416).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [416]
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Diagnostic Criteria for Neuropathologic Assessment of Alzheimer’s Disease
Braak, H., & Braak, E. (1997) · Neurobiology of Aging · doi:10.1016/s0197-4580(97)00062-6 · Cited by 410 · see citing works
Kerr, S. R. J., Pearce, M. S., Brayne, C., Davis, R. J., & Kenny, R. A. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.5.515 · Cited by 194 · see citing works
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2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.03.004 · Cited by 484 · see citing works
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.003 · Cited by 327 · see citing works
A Review of the Etiology, Asssociated Comorbidities, and Treatment of Orthostatic Hypotension
Perlmuter, L. C., Sarda, G., Casavant, V., & Mosnaim, A. D. (2013) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e31828bfb7f · Cited by 53 · see citing works
- Authors
- Miller, V. M., Kenny, R. A., Slade, J. Y., Oakley, A. E., & Kalaria, R. N.
- Affiliations
- Royal Victoria Infirmary (GB)
- Trinity College Dublin (IE)
- Corresponding author
- Miller, V. M.
- Venue
- Neuropathology and Applied Neurobiology
- Publisher
- Wiley
- Published
- 2008-07-08
- Volume
- 34
- Issue
- 4
- Pages
- 403-411
- ISSN
- 0305-1846 (ISSN-L)
- 1365-2990
- OpenAlex
- W2116729291
- Cited by
- 43
- References
- 2
- Citations by year
- 2025: 2 · 2023: 1 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 1 · 2017: 6 · 2016: 1 · 2015: 4 · 2014: 3 · 2013: 6 · 2012: 2
- FWCI
- 2.32
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Neuropathology and Applied Neurobiology (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Medical Research Council (G0400074, G0500247)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Keywords
- carotid sinus hypersensitivity, baroreflex dysfunction, tau accumulation, tyrosine hydroxylase, catecholaminergic neurons, alpha-synuclein, amyloid-beta, microglia, Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies
- MeSH terms
- Aged, Aged, 80 and over, Cadaver, Carotid Sinus, Female, Humans, Hypersensitivity, Male, Medulla Oblongata, Neurons, Reference Values, Amyloid beta-Peptides, Lewy Bodies, tau Proteins, Microglia
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