Which is the horse and which the jockey?

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Study findings and aspects on the relation of autonomic function and neurological disorders

> Neurological diseases are very often associated with autonomic dysfunction – or the other way round?

Migraine, Multiple Sclerosis or Parkinson’s Disease are only a few examples for widespread and painful neurological diseases. Migraine, for example, has first been mentioned in 1,200 BC by the ancient Egyptians, who reported symptoms such as nausea, vomiting and fatigue related to painful attacks.1 Perhaps this is the first evidence of an association of a neurological disease to autonomic dysfunction. Or is it the other way round: is it an autonomic dysfunction that drives a neurological disease?

“Not only do many patients with migraine suffer from symptoms of autonomic impairment, many patients with primary autonomic disorders also suffer from migraine.[…] It is still unclear which is the horse and which is the jockey in the painful race of autonomic dysfunction in migraine.”1

By now, a wide range of studies have dealt with the assessment of cardiovascular autonomic parameters in order to better understand what is going on in patients with neurological disorders.

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Which is the horse and which the jockey?

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