Autonomic Nervous System Testing

A utonomic nervous system testing is used to document diabetic autonomic failure. Diabetic autonomic failure is defined as impaired function of the peripheral autonomic nervous system and can be divided into two categories: 1) autonomic neuropathy, in which there is a structural lesion of the peripheral autonomic neuron and 2) functional autonomic failure, in which no known structural lesion occurs. In addition to the classic neurotransmitters (acetylcholine and norepinephrine), newer neurotransmitters and neuromodulators such as substance P, neuropeptide K, calcitonin gene-related peptide, and nitric oxide are also involved. Also, the adrenal medullae are an integral part of the autonomic nervous system. With these caveats, the following definition is proposed, wherein autonomic abnormalities are classified as structural or functional with further subdivisions based on the overt or subclinical nature of the disorder, the specific subdivisions of the autonomic nervous system, and the specific organ systems involved.