自律神経疾患の治療の進歩

抄録

We reviewed articles on the novel development of treatment for autonomic disorders published in 2022. Hypovitaminosis D is significantly associated with orthostatic hypotension (OH) in older adults but another study does not support use of vitamin D3 supplementation as an intervention to prevent OH. Long–term studies are still needed on the efficacy of vitamin D supplementation in treating OH. Among patients with recurrent vasovagal syncope (VVS), a supervised program of tilt training and aerobic exercise reduced syncopal recurrence. Patients with refractory VVS undergoing regular psychotherapeutic intervention had less recurrence of events. Yoga as adjunctive therapy is superior to standard therapy alone in reducing the symptomatic burden in patients with recurrent VVS. Midodrine is effective in preventing syncope induced by head–up tilt testing. Posterior tibial nerve stimulation is a beneficial treatment option for neurogenic over active bladder symptoms in males with multiple sclerosis. Intradetrusor abobotulinumtoxinA is an effective treatment and alternative option for patients with neurogenic detrusor overactivity incontinence. Prune intake significantly decreased hard and lumpy stools and not increasing loose and watery stools. The probiotics were effective in improving the symptoms of functional constipation and constipation of Parkinson disease patients. Prucalopride improves not only constipation but also abdominal bloating. Two gold kiwifruit daily are effective in treating constipation. Daily dietary fibre supplementation by using partially hydrolyzed guar gum for 4 weeks in long term care facility residents results in significantly less laxative use than placebo. Use of topical glycopyrronium tosylate improved the symptoms of primary axillary hyperhidrosis.