Neurovascular and Autonomic

Director: Professor Christopher J. Mathias DPhil DSc FRCP FMedSci

The Autonomic and Neurovascular Medicine Unit focuses on the role of the autonomic nervous system in health and in disease, serving as a National Referral Centre for a variety of autonomic diseases. The Unit's main focus is on autonomic disorders that affect the cardiovascular and sudomotor systems. The former includes cardiovascular autonomic responses to gravitational change and key stimuli that we are all subjected to in daily life, such as food and exercise: the latter deal with the sudomotor (sweat gland) responses to emotional and physiological stimuli. Autonomic dysfunction affects many neurological and medical disorders and the Neurovascular and Autonomic Medicine Unit aims to improve diagnosis, understand pathophysiological mechanisms and devise new treatments. The main clinical problems studied include syncope (fainting), orthostatic (postural) hypotension, neurogenic hypertension, excessive sweating (hyperhidrosis) and disorders of thermoregulation.

A newly recognised disorder, Postural Tachycardia Syndrome (PoTS), is also the basis of detailed studies within colleagues in Rheumatology, because a third of such cases are associated with the Joint Hypermobility Syndrome (Ehlers Danlos III). The Autonomic and Neurovascular Medicine Unit also researches the causes, neurogenetics, and treatment of the common condition, vasovagal syncope, as well as studying autonomic dysfunction in a variety of diseases, including Parkinson's Disease, spinal cord injury, familial amyloid polyneuropathy, multiple system atrophy and diabetes mellitus.

A substantial component of the Unit's research is in defining biomarkers of autonomic disease, neurogenetics, functional neuroanatomy of cerebral autonomic centres (using simultaneous neuroimaging and physiological measurement) and in deriving novel treatment strategies for autonomic disorders. There are also ongoing studies in determining pathophysiological mechanisms in various autonomic diseases, creating novel non-invasive diagnostic techniques, and thus improving management of autonomic disorders and their complications.

Central anatomy involved in autonomic function

Central neuroanatomy involved in autonomic function.

Clinical & Research Fellows & PhD Students.

Dr Valeria Iodice - Sir Roger Bannister Clinical Research Fellow.
Dr David Low - Clinical Reasearch Associate Fellow
Dr Ekawat Vichayanrat - PhD Scholar
Dr Anna Kuppuswamy - ISRT PhD Student.
Dr Radmilla Maksimovic - Post Doc Clinical Research Fellow.
Dr Juan Carlos Sanchez Manso - Clinical Research Fellow.
Mrs Giopalan Vijaya - PhD Scholar
Dr Allesia Nicotra - Clincal Research Fellow (pt).
Dr Andrea Humm - Clinical Research Fellow (pt).

Clinical Autonomic Scientists.

Madeline Tippetts - Senior Clinical Autonomic Scientist.
Micheal Peche - Clinical Automomic Scientist.
Vanessa Ponnusamy - Clinical Automomic Scientist.

_{(In association with Katharine Bleasdale-Barr, Ian Skeafington, Lydia Mason, Laura Watson, Natasha Roxborough and Olufunmilayo Osiguwa, National Hospital for Neurology and Neurosurgery, Queen Square).}

Tilt table testing

Tilt-table testing of cardiovascular autonomic function.

Support Staff.

Gemma Brennan - Academic Personal Assistant.
TBA - Clinical Secretary
Andrew Owens - Clinical Research Assistant.

Internal and External Collaborations:

Professor P Ellaway, Division of Neuroscience and Mental Health, Imperial College, London with Spinal Injuries Clinic, Royal National Orthopaedic Hospital Trust: Professor M Craggs.
Department of Neuroscience, University of Sussex and Functional Imaging Laboratory, Institute of Neurology, Queen Square, London: Professor H Critchley.
Department of Medicine, Hong Kong University, Hong Kong: Professor L Li.
Parkinsons and Aging Research Foundation, Bangalore, India, Dr U Muthane.
Department of Neurology, Chiba Medical School, Tokyo, Japan: Professor T Hattori and Dr M Asahina.
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury: Professor HL Frankel.
Institute of Neurology, Universities of Bologna: Professor P Cortelli and Dr P Guaraldi.
Institute of Neurology, Chennai, India: Professor A S Krishnamurthy.
The Royal Free Hospital Medical School, London: Professor R Unwin, Dr A Mehta and Dr P Jeeveratnam.
European Multiple System Atrophy Group: Professor G Wenning at Innsbruck University along with other European colleagues in Europe.