Aspects of autonomic neurophysiology in diabetic polyneuropathy: a brief review.

The autonomic nervous system is a very diverse system, governing many organs according to endogenous and environmental demands. Consequently autonomic dysfunction in diabetic polyneuropathy is many faceted. Assessment of autonomic nerve function, by testing the reflex responses of autonomic effector organs, should preferably take this differentiation into account. Microneurography allows direct study of the normal and disturbed physiology of two subdivisions of the sympathetic nervous system: signals in muscle nerve fascicles involved in cardiovascular homeostasis, and impulses in skin nerve fascicles involved in body thermoregulation. Observations made with this research tool emphasize the functional differentiation of the autonomic nervous system, and the technique can be used to elucidate pathophysiological mechanisms in disorders such as diabetic polyneuropathy.