Autonomic Disorders
The Autonomic Disorders section is focused on the diagnosis and treatment of disorders of autonomic nervous system function. The section is involved in clinical research, translational research, and advancing awareness of autonomic disorders at the national level.
The autonomic nervous system controls the automatic activities of the body, including regulation of blood pressure, heart rate, sweating, bowel, bladder and sexual function. The autonomic system includes a network of nerve cells in the brain and spinal cord that transmits information to most of the body, including the heart, bladder, gut, sweat glands, blood vessels, sexual organs, and eyes. Autonomic disorders can affect patients of all ages. Some conditions lead to autonomic failure, in which autonomic reflexes no longer work, whereas other forms of dysautonomia lead to inappropriate activity of the autonomic control systems. Common symptoms of autonomic disorders include fainting (and lightheadedness on standing), problems with body temperature regulation, and gastrointestinal complaints.
Clinical
The Autonomic Disorders program at UT Southwestern started in 2006 with the opening of the clinical autonomic function laboratory, and the Autonomic section was formally created in 2020. We currently provide clinical service and operate three outpatient autonomic function testing laboratories (UT Southwestern, Parkland Hospital, and the VA North Texas Health Care System), performing more than 500 autonomic function tests each year. Patients are referred to our clinic from all over the United States.
The Autonomic Disorders section offers a monthly multidisciplinary care clinic for patients with multiple system atrophy (MSA), a progressive neurodegenerative disorder associated with autonomic failure. This unique clinic is one of the first in the nation and incorporates clinicians who have subspecialty expertise in autonomic disorders, movement disorders, sleep medicine, palliative care, nutrition, urology, and physical medicine.
We also offer a multidisciplinary approach for patients with postural tachycardia syndrome (POTS), the most common manifestation of dysautonomia, including access to clinicians with expertise in autonomic disorders, cardiology, gastroenterology, and physical therapy.
Research
The Autonomic Disorders section conducts translational and clinical research efforts. We have received funding from the National Institutes of Health (NIH), Dysautonomia International, and other partners. Clinical research includes observational studies as well as novel therapeutic trials for MSA, POTS, orthostatic hypotension, and other forms of dysautonomia. Translational research focuses on the identification and characterization of autoimmune autonomic disorders and autoantibody biomarkers of these disorders.
Education
The Autonomic Disorders section is committed to education. Most physicians receive fewer than two hours of instruction on the autonomic nervous system during medical training, and yet autonomic disorders are estimated to affect up to 6% of the population. We provide education to UTSW medical students and Neurology residents and participate in national education efforts as part of the American Autonomic Society.
We offer fellowship training in autonomic disorders (one of five fellowship programs accredited by the United Council for Neurological Subspecialties). Autonomic fellows spend a year in our multidisciplinary program participating in clinical care, autonomic testing, and research.
Autonomic Disorders Fellowship
Conditions Treated
The Autonomic Disorders section evaluates patients with known or suspected autonomic diagnoses, including:
- Autoimmune Autonomic Ganglionopathy
- Autonomic Neuropathies (Diabetes, Amyloidosis)
- Inherited autonomic disorders
- Multiple System Atrophy
- Orthostatic Hypotension
- Parkinson's disease with orthostatic hypotension
- Pure Autonomic Failure
- Postural Tachycardia Syndrome (POTS)
- Syncope
Primary Services
The Autonomic Disorders section offers a variety of diagnostic and therapeutic services, including clinical autonomic testing, pupillometry, skin biopsy, serological testing, neurological exams, and exercise programs.
Collaborative Services
We collaborate with Physical Therapy and Physiatry to improve the mobility and function of our patients. Since the autonomic system interacts with the entire body, we collaborate often with Cardiology, Urology, Gastroenterology, Allergy, Rheumatology, Palliative Care and others to coordinate multidisciplinary care for our patients.
Specialty Programs
- UT Southwestern Autonomic Disorders Clinic
- UT Southwestern Multidisciplinary Multiple System Atrophy Clinic
- Clinical Autonomic Testing Laboratory
Faculty
Research Lab - Vernino Lab
Dr. Vernino has a long interest in autoimmune neurological disorders, especially those associated with antibodies against cell membrane ion channels and receptors. His laboratory works on evaluating the role of novel autoantibodies, specifically in disorders of the autonomic nervous system. Dr. Vernino is also involved in clinical trials evaluating immune therapies for autonomic disorders and autoimmune encephalitis.