Treating Disorders of the Peripheral and Autonomic Nervous System
BIDMC's Center for Autonomic and Peripheral Nerve Disorders is an international center for the research, investigation, testing and treatment of disorders of the peripheral and autonomic nervous system. This division of the nervous system controls automatic bodily functions, such as heart rate, blood pressure and sweating, as well as bowel, bladder and sexual function. At our Center, we focus on:
- Leading-edge discoveries of new autonomic disorders
- Developing biomarkers that improve the diagnosis of autonomic diseases
- Bringing new, more effective therapies for autonomic disorders to practice
We take a science-first approach to providing care for patients using the most up-to-date treatment options available. As a patient at our practice, you'll have access to a variety of clinical trials that can improve overall quality of life in relation to:
- Multiple system atrophy
- Parkinson's disease with dysautonomia
- Pure autonomic failure
- Lewy body dementia
- Diabetes, amyloidosis, small fiber neuropathy, and other peripheral and autonomic neuropathies
- Postural tachycardia syndrome
- Neurally-mediated syncope
- Orthostatic hypotension
To be seen at our Center, you must be referred by a physician. During your visit, you'll meet with a neurologist and may need to undergo autonomic testing which could include a biopsy.
View the Center's active research clinical trials here.
Our Services
Autonomic Testing
What Does Autonomic Testing Entail?
As part of the testing process, you’ll participate in a series of painless, non-invasive assessments to assist with diagnosis. We’ll measure your heart rate and blood pressure in response to a variety of stimuli, such as deep breathing and active/passive standing. We’ll also measure your sweat response to deep breathing and mild electrical stimuli.
Pre-Test Instructions
- Avoid ingesting alcohol and over-the-counter medications, like nasal decongestants.
- Avoid cardiovascular medications for one to three days prior to the test as permitted by your primary care doctor.
- Avoid caffeine and any other artificial stimulants for at least six hours before the study.
- Eat well about three hours prior to the study (but not within two hours) unless your doctor tells you otherwise. This is particularly important for patients with diabetes.
- Wear a short-sleeved, loose-fitting top.
- Please have your insurance information and a list of your current medications (including dosages) on hand. Upon your arrival, you’ll be asked to fill out a short questionnaire concerning your symptoms and medical history.
Skin Biopsy
If you require a biopsy, your clinician will take samples from three separate spots on one of your legs. This will be used to determine the number of small nerve fibers in your skin.
The biopsy procedure involves the following:
- You’ll receive an injection of local anesthetic to numb the area requiring the biopsy.
- A sharp device will be used to take biopsy samples from your skin. Each sample is 3 mm in size (about ¼ the size of a pencil eraser) which means stitches are not required.
- We’ll then examine the nerve fibers from your biopsy samples under a microscope. Samples are taken from the outside of the leg (just above the ankle), the area above the knee, and just below the hip.
Following your procedure, we’ll provide you with care instructions for the biopsy sites.
Meet Our Team
Roy L. Freeman, MD
Neurology
Christopher H. Gibbons, MD
Clinical Neurophysiology; Neurology
