Topic Editors

UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
Dr. Francesca Vitali
1. Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Sede di Roma, L.go F. Vito 1, 00168 Rome, Italy
2. Fondazione Policlinico, Universitario Agostino Gemelli IRCCS, UOC Neurologia, L.go A. Gemelli 8, 00168 Rome, Italy.

Dysautonomia in Neurological Disorders

Abstract submission deadline
closed (20 October 2025)
Manuscript submission deadline
closed (20 December 2025)
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Topic Information

Dear Colleagues,

Dysautonomia refers to a broad spectrum of disorders affecting the autonomic nervous system (ANS), leading to impairments in vital functions such as cardiovascular regulation, gastrointestinal function, thermoregulation, and respiratory control. Over the past three decades, significant progress in autonomic disorders has been driven by advances in noninvasive autonomic testing, which have improved diagnostic accuracy, deepened our understanding of pathophysiological mechanisms, and enabled more targeted therapeutic approaches. In neurological disorders, ANS involvement can occur at various levels of the neural axis, from the brain to the spinal cord and peripheral nerves, contributing to a wide spectrum of disabling symptoms that significantly impact quality of life. Autonomic dysfunction represents a critical yet often underdiagnosed feature of diseases such as Parkinson’s disease, multiple system atrophy and other α-synucleinopathies, autoimmune autonomic ganglionopathy, and metabolic, immune-mediated, or genetic neuropathies. Moreover, innovations in neurorepair and neuromodulation for conditions once considered irreversible, such as spinal cord injuries, have led to growing interest in the frequent autonomic complications affecting these patients. This Topic aims to highlight the latest research and clinical advancements in the ANS associated with neurological disorders. We welcome contributions focusing on pathophysiological insights, multimodal diagnostic approaches, and emerging treatment strategies. By fostering interdisciplinary collaboration between neurosciences and other involved medical disciplines, we hope to expand our understanding of and improve management strategies for autonomic dysfunction in neurological diseases.

Dr. Marco Luigetti
Dr. Francesca Vitali
Topic Editors

Keywords

  • autonomic nervous system
  • sympathetic nervous system
  • parasympathetic nervous system
  • pupillary function
  • gastrointestinal motility disorders
  • sudomotor function
  • thermoregulation
  • urogenital disorders
  • autonomic failure
  • autonomic neuropathies

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
Brain Sciences
brainsci
2.8 5.6 2011 17.6 Days CHF 2200
Neurology International
neurolint
3.0 4.8 2009 21.5 Days CHF 1800

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Published Papers (1 paper)

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15 pages, 346 KB  
Review
Treating the Patient, Not Only the Amyloid: Symptomatic Management in Transthyretin Amyloidosis
by Christian Messina
Neurol. Int. 2026, 18(3), 53; https://doi.org/10.3390/neurolint18030053 - 13 Mar 2026
Viewed by 493
Abstract
Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder characterized by extracellular deposition of misfolded transthyretin fibrils, leading to neurological, cardiac, gastrointestinal, urogenital, sexual, and ophthalmological involvement. While disease-modifying therapies have significantly improved survival and slowed disease progression, a substantial proportion of patients continue [...] Read more.
Transthyretin amyloidosis (ATTR) is a progressive multisystem disorder characterized by extracellular deposition of misfolded transthyretin fibrils, leading to neurological, cardiac, gastrointestinal, urogenital, sexual, and ophthalmological involvement. While disease-modifying therapies have significantly improved survival and slowed disease progression, a substantial proportion of patients continue to experience a high symptomatic burden that markedly impairs quality of life. Symptomatic manifestations often occur early, may precede the diagnosis, and frequently persist despite etiological treatment. This review provides a comprehensive overview of the symptomatic management of ATTR, with particular emphasis on autonomic dysfunction and its systemic consequences. We discuss current therapeutic strategies for orthostatic hypotension, gastrointestinal dysmotility, nutritional impairment, sexual dysfunction, lower urinary tract dysfunction, and ophthalmological involvement, highlighting both pharmacological and non-pharmacological approaches. Special attention is given to treatment limitations related to cardiac involvement, autonomic failure, and drug tolerability. Despite the clinical relevance of symptom control in ATTR, evidence-based recommendations remain scarce, and no dedicated guidelines currently exist. Most therapeutic approaches are derived from observational studies, expert opinion, and clinical experience. Improved awareness of symptomatic manifestations, early intervention, and a multidisciplinary, individualized approach are essential to optimize patient outcomes. Future research should focus on prospective studies and the development of structured symptomatic treatment algorithms to complement disease-modifying therapies and enhance patient-centered care in ATTR. Full article
(This article belongs to the Topic Dysautonomia in Neurological Disorders)
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