Bruce H. Knox
Independent Scholar, Auckland, New Zealand
Publications
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Research Article
Multifactorial Secondary Autonomic Dysfunction (MSAD): A Cumulative-Injury and Autonomic-Reserve Framework for Complex Secondary Dysautonomia
Author(s): Bruce H. Knox*
Background: Autonomic disorders frequently affect cardiovascular, gastrointestinal, thermoregulatory, genitourinary, sleep, cognitive, and exercise domains. In some patients, no single cause adequately explains the onset, severity, fluctuation, and partial recovery of multisystem dysfunction. Multifactorial Secondary Autonomic Dysfunction (MSAD) has been proposed to describe a secondary dysautonomic phenotype in which cumulative physiological insults interact with limited autonomic reserve. Objective: To refine MSAD into a journal-ready, falsifiable clinical framework that distinguishes hypotheses from established evidence and can be tested against recognised primary autonomic and neurodegenerative disorders. Approach: This conceptual review integrates the previously published MSAD framework and first-person longit.. Read More»