[Recent advances in autonomic function tests].

Abstract

Recent advances in medical technology introducing various new autonomic function tests. We introduced five new autonomic function tests, these are initial heart rate response to postural change, monitoring of cerebral circulation by near infrared spectroscopy, sympathetic skin tests including sympathetic sweat response and sympathetic flow response, pressure flow study and videourodynamics. Initial heart rate response to voluntary standing reveals two types of heart rate increase, initial one is due to parasympathetic suppression and late one is due to sympathetic activity. Near-infrared spectroscopy could detect the amount of local blood volume, and by using this test we occasionally noted a discrepancy of systemic blood pressure and cerebral circulation. Sympathetic skin test revealed relatively well preserved flow response whereas sweat response is often severely impaired in central nervous system disease. Pressure flow study could differentiate the impaired detrusor contraction and increased outlet resistance in patients with impaired micturition. Videourodynamics is the useful method to visualize the lower urinary disorders.