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Current concepts in clinical and laboratory assessments of autonomic nervous system activity

100%

Dobrek L. , Thor P.

tom 09

nr 1

Introduction and objective. As the autonomic nervous system (ANS) dysfunction is present in course of many disorders, an objective assessment of the ANS function is very important. In practice, the assessment is difficult, and based rather on indirect analysis of autonomically-controlled cardiovascular reflexes, than on direct recording of activity of central or peripheral autonomic structures. The aim of our paper was to discuss briefly current, clinical and scientific ANS investigations, as well as possible future methods of autonomic activity evaluation. A brief description of the state of knowledge. The review presents a short outline of autonomic function assessments based on clinical autonomic tests (e.g. “Ewing’s battery”) and discusses the heart rate variability (HRV) study, as currently popular and widespread option of analysis of the ANS activity. Other, complementary methods, including the baroreceptor sensitivity testing, microneurography or plasma norepinephrine measurement were also mentioned. The article also provides premises related to the determination of selected neuropeptides in plasma or saliva as an innovative concept of autonomic activity assessment. Summary. The available, clinical, non-invasive methods used for assessment of the ANS function are still relatively sparse and, in fact, a surrogate for direct ANS assessment. New methods of autonomic tension determination are still needed that would allow a more complete and reliable assessment. Reports of potential new laboratory markers of the ANS activity (NPY and VIP assay) bring some hope.