A narrative review of the mechanisms and consequences of intermittent hypoxia and the role of advanced analytic techniques in pediatric autonomic disorders.

Journal: Clinical autonomic research : official journal of the Clinical Autonomic Research Society
PMID:

Abstract

Disorders of autonomic functions are typically characterized by disturbances in multiple organ systems. These disturbances are often comorbidities of common and rare diseases, such as epilepsy, sleep apnea, Rett syndrome, congenital heart disease or mitochondrial diseases. Characteristic of many autonomic disorders is the association with intermittent hypoxia and oxidative stress, which can cause or exaggerate a variety of other autonomic dysfunctions, making the treatment and management of these syndromes very complex. In this review we discuss the cellular mechanisms by which intermittent hypoxia can trigger a cascade of molecular, cellular and network events that result in the dysregulation of multiple organ systems. We also describe the importance of computational approaches, artificial intelligence and the analysis of big data to better characterize and recognize the interconnectedness of the various autonomic and non-autonomic symptoms. These techniques can lead to a better understanding of the progression of autonomic disorders, ultimately resulting in better care and management.

Authors

  • Jan-Marino Ramirez
    Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 Ninth Avenue, Seattle, WA, 98101, USA. nino1@uw.edu.
  • Michael S Carroll
    Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago (ME Heffernan, MM Davis, M Carroll, and ML Macy), Chicago, Ill; Data Analytics and Reporting, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine (A Bendelow and M Carroll), Chicago, Ill.
  • Nicholas Burgraff
    Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 Ninth Avenue, Seattle, WA, 98101, USA.
  • Casey M Rand
    Division of Autonomic Medicine, Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
  • Debra E Weese-Mayer
    Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.