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Autonomic Disorders

Program Duration: 2–5 years

18F-Dopamine heart and 18F-DOPA brain scans in a healthy volunteer (left) and a patient with Parkinson disease (right).



This program trains Fellows in patient-oriented and bench research related to disorders of the autonomic nervous system and of catecholamine systems in the brain and periphery and more generally to scientific integrative medicine (SIM). SIM is a way of thinking that applies systems concepts (e.g., stability by negative feedback regulation, multiple effectors, effector sharing, instability by positive feedback loops, allostasis, allostatic load) to acute and chronic disorders of regulation. The clinical research consists of developing and testing diagnostic and pathophysiologic biomarkers, natural history studies, and pathophysiologically relevant therapeutic interventions. Major emphasis is on disorders of catecholamine systems such as Parkinson’s disease (PD) and other synucleinopathies, evaluated by physiological, pharmacologic, neurochemical, and neuroimaging approaches. Bench research is largely focused on cellular and tissue indices of pathophysiology and novel therapeutics for catecholamine-related disorders. The program uses a variety of clinical assessment techniques such as physiological autonomic function testing, catecholamine neurochemistry, and visualization of catecholaminergic innervation by positron emission tomography (PET) scanning.

Area of Current Research

Diagnostic biomarkers and mechanisms of loss of catecholaminergic neurons in the brain and periphery
   in PD and related disorders
Relationships of catecholamine systems to non-motor and pre-motor aspects of PD
Clinical laboratory evaluation and natural history of chronic autonomic failure
Experimental therapeutics of neurogenic orthostatic hypotension
Clinical autonomic function testing
Collaborative clinical and preclinical studies of catecholamine systems

Faculty

David S. Goldstein, M.D., Ph.D., Chief, Clinical Neurocardiology Section, goldsteind@ninds.nih.gov

Irwin J. Kopin, M.D., Scientist Emeritus, kopini@ninds.nih.gov