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Biomedicines
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Autonomic Disorders: From Mechanisms to Therapeutic Approaches
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Autonomic Disorders: From Mechanisms to Therapeutic Approaches

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 January 2026) | Viewed by 16644

Editor

Dr. Svetlana Blitshteyn

E-Mail Website
Guest Editor
Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
Interests: autonomic disorders; postural orthostatic tachycardia syndrome; Long COVID; autoimmunity; immunotherapy; women’s health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The autonomic nervous system, consisting of sympathetic, parasympathetic and enteric divisions, is an integral part of the central and peripheral nervous systems and controls homeostasis, blood flow and responses to internal and external stimuli. Disorders of the autonomic nervous system—both common, such as POTS, neurocardiogenic syncope and orthostatic hypotension, and rare, such as multiple-system atrophy, amyloid neuropathy and familial dysautonomia—are an evolving area of research in basic and translational science as well as in clinical practice. In the past 5 years, the SARS-CoV-2 pandemic has further underscored the need to elucidate the heterogeneous mechanisms of autonomic disorders given their invovlement in post-acute infectious syndromes, including Long COVID. To this end, it is critical to understand the pathophysiology of and develop diagnostic biomarkers and therapeutic approaches for a wide variety of autonomic disorders to advance our understanding of the autonomic nervous system, as well as autonomic dysfunction that arises secondary to medical and neurologic disorders, and to improve clinical care for patients worldwide. The aim of this Special Issue of Biomedicines is to collect papers addressing the mechanisms, pathophysiology and diagnostic biomarkers of autonomic disorders and therapeutic approaches to their treatment. Original research studies, reviews and short communications on the potential biomarkers of and novel and repurposed therapeutic options  for autonomic disorders are of particular interest.

Dr. Svetlana Blitshteyn
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autonomic disorders
  • autonomic dysfunction
  • dysautonomia
  • orthostatic intolerance
  • therapeutics

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Published Papers (2 papers)

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Review

23 pages, 3009 KB  
Review
An Overview of Vascular Compression Syndromes and Associations with Autonomic Dysfunction: A Review
by Brandon M. Davis, Petra Rantanen, Grace Seo, Siya Thadani, Elizabeth B. Spencer, Edward Hepworth and Alexis Cutchins
Biomedicines 2026, 14(3), 689; https://doi.org/10.3390/biomedicines14030689 - 17 Mar 2026
Viewed by 9248
Abstract
Background: Vascular compression syndromes are increasingly recognized as underdiagnosed contributors to morbidity in patients exhibiting dysautonomia. Underlying vascular compression syndromes affecting the head and neck, abdomen, pelvis, and lower extremities may influence venous return, neurohormonal signaling, and autonomic regulation. There is considerable [...] Read more.
Background: Vascular compression syndromes are increasingly recognized as underdiagnosed contributors to morbidity in patients exhibiting dysautonomia. Underlying vascular compression syndromes affecting the head and neck, abdomen, pelvis, and lower extremities may influence venous return, neurohormonal signaling, and autonomic regulation. There is considerable clinical overlap among these syndromes, as well as between hypermobility spectrum disorders (HSD) and dysautonomia, indicating possible shared or interacting pathophysiological mechanisms. Purpose/Aims: This hypothesis-generating narrative review synthesizes current evidence linking vascular compression syndromes with dysautonomia, highlights potential mechanistic pathways, identifies patterns of syndromic overlap, and emphasizes the importance of systematic evaluation in affected patient populations. Key Findings: Evidence from retrospective studies, case series, and clinical observations indicates that vascular compression syndromes may be prevalent among patients with dysautonomia, particularly postural orthostatic tachycardia syndrome (POTS) and HSD, yet are often unrecognized. Proposed mechanisms based on limited data include impaired venous capacitance and preload reserve, increased intracranial pressure, altered renin–aldosterone and cortisol signaling, underlying autoimmune and systemic diseases, and sympathetic ganglion irritation. Several compression syndromes show symptom overlap and frequent co-occurrence, especially in patients with connective tissue disorders. Emerging data suggest that targeted interventions, such as surgical decompression or venous stenting, may improve orthostatic intolerance and quality-of-life measures in selected patients, though high-quality prospective data remain limited. Conclusions: Vascular compression syndromes may be an important yet underappreciated contributor to dysautonomia. Increased clinical awareness and systematic screening may reduce diagnostic delays and morbidity in this underserved population. Prospective studies are needed to clarify prevalence, establish causal relationships, and determine the impact of targeted treatments on autonomic outcomes. Full article
(This article belongs to the Special Issue Autonomic Disorders: From Mechanisms to Therapeutic Approaches)
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14 pages, 340 KB  
Review
Under a Spell: Neurologic Evaluation of Presyncope as a Feature of Dysautonomia
by Svetlana Blitshteyn, Kamal R. Chémali and Dennis H. Lau
Biomedicines 2025, 13(11), 2698; https://doi.org/10.3390/biomedicines13112698 - 3 Nov 2025
Viewed by 6501
Abstract
While syncope is characterized by a sudden and temporary loss of consciousness caused by decreased blood flow to the brain and is easily recognized by its clinical features, presyncope involves a sensation of impending fainting, often accompanied by autonomic symptoms. Presyncope is less [...] Read more.
While syncope is characterized by a sudden and temporary loss of consciousness caused by decreased blood flow to the brain and is easily recognized by its clinical features, presyncope involves a sensation of impending fainting, often accompanied by autonomic symptoms. Presyncope is less characterized and studied than syncope, presenting a particular diagnostic challenge in neurology clinics. Neurologists commonly encounter patients with presyncope in outpatient settings or during consultation at the emergency department after cardiopulmonary causes have been excluded. Differential diagnosis of recurrent presyncope is broad but from a neurologic standpoint falls into multiple neurologic categories, including complex partial seizures, basilar or vestibular migraine, dysautonomia, cataplexy, alteration in cerebrospinal fluid flow, Meniere’s disease, posterior circulation transient ischemic attacks and others. Here, we review presyncope as a feature of dysautonomia and common autonomic disorders, such as neurocardiogenic syncope, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic intolerance. We discuss clinical and neurologic exam findings, diagnostic tests, differential diagnosis and treatment of presyncope as a manifestation of common autonomic disorders. Full article
(This article belongs to the Special Issue Autonomic Disorders: From Mechanisms to Therapeutic Approaches)
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