The adapted Autonomic Profile (aAP) home-based test for the evaluation of neuro-cardiovascular autonomic dysfunction

Abstract

Autonomic dysfunction is an increasingly recognised complication in chronic neurological conditions such as Parkinson’s disease, and other medical conditions, including diabetes mellitus, chronic fatigue syndrome, postural tachycardia syndrome (PoTS) with and without Ehlers-Danlos syndrome, fibro-myalgia and recently Long COVID. Despite laboratory-based tests to evaluate normal and abnormal autonomic function, there are no home-based tests to record neuro-cardiovascular autonomic responses to common stimuli in daily life that are dependent on normal functioning of the autonomic nervous system. We have developed an adapted blood pressure/ heart rate Autonomic Profile (aAP) that can be used by an individual independently and repeatedly in a domiciliary setting to determine the physiological and symptomatic response to standing, food, and physical or mental (cognitive, emotional) activities. The aAP aids separating autonomic failure (often irreversible) from autonomic dysfunction. This helps the individual and attending healthcare professional understand the relationship between symptoms and common triggers in daily life and informs on self-management in debilitating conditions such as the postural tachycardia syndrome (PoTS) and Long COVID.