✓Perform standardized autonomic function tests across cardiovagal, adrenergic, and sudomotor domains
✓Interpret deep breathing, Valsalva maneuver, and tilt-table responses quantitatively
✓Calculate Composite Autonomic Severity Scores to assess dysautonomia severity and distribution
✓Conduct quantitative sudomotor testing using QSART methodology
Protocol
Biopharma Insights Standardized, comprehensive and fully quantitative testing of autonomic functions is described. The autonomic tests consist of evaluation of all three major autonomic domains including cardiovagal, adrenergic and sudomotor. The severity and distribution of dysautonomia is quantitated using Composite Autonomic Severity Scores.
Difficulty
intermediate
Total time
~1–2 hours per subject
Steps
1
Perform deep breathing test for cardiovagal function
Instruct subject to breathe deeply at a standardized rate and measure heart rate variability response. This evaluates parasympathetic (vagal) autonomic function.
▶ 01:36
2
Conduct Valsalva maneuver to assess sympathetic response
Have subject perform a sustained forced expiration against resistance while measuring blood pressure and heart rate changes. This evaluates adrenergic sympathetic function.
▶ 03:32
3
Perform head-up tilt table testing
Tilt subject upright while monitoring cardiovascular response to postural challenge. This assesses integrated autonomic compensation to gravitational stress.
▶ 06:56
4
Execute quantitative sudomotor axon reflex test
Apply acetylcholine iontophoresis to skin and quantify sweat response (QSART). This measures postganglionic sudomotor function.
▶ 08:20
5
Calculate Composite Autonomic Severity Scores
Integrate quantitative results across all three autonomic domains to determine overall dysautonomia severity and regional distribution.
▶ 10:43
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