Insular damage causing transient baroreflex dysfunction in a teenager with Allgrove syndrome

This is a preview of subscription content, access via your institution.

Fig. 1


  1. 1.

    Allgrove J, Clayden GS, Grant DB, Macaulay JC (1978) Familial glucocorticoid deficiency with achalasia of the cardia and deficient tear production. Lancet 1:1284–1286

    CAS  Article  Google Scholar 

  2. 2.

    Houlden H, Smith S, De Carvalho M, Blake J, Mathias C, Wood NW, Reilly MM (2002) Clinical and genetic characterization of families with triple A (Allgrove) syndrome. Brain 125:2681–2690

    Article  Google Scholar 

  3. 3.

    Gibbons CH, Schmidt P, Biaggioni I, Frazier-Mills C, Freeman R, Isaacson S, Karabin B, Kuritzky L, Lew M, Low P, Mehdirad A, Raj SR, Vernino S, Kaufmann H (2017) The recommendations of a consensus panel for the screening, diagnosis, and treatment of neurogenic orthostatic hypotension and associated supine hypertension. J Neurol 264:1567–1582

    Article  Google Scholar 

  4. 4.

    Abd-Allah NM, Hassan FH, Esmat AY, Hammad SA (2004) Age dependence of the levels of plasma norepinephrine, aldosterone, renin activity and urinary vanillylmandelic acid in normal and essential hypertensives. Biol Res 37:95–106

    CAS  Article  Google Scholar 

  5. 5.

    Benarroch EE (1993) The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc 68:988–1001

    CAS  Article  Google Scholar 

  6. 6.

    Kaufmann H, Norcliffe-Kaufmann L, Palma JA (2020) Baroreflex dysfunction. N Engl J Med 382:163–178

    CAS  Article  Google Scholar 

  7. 7.

    Sykora M, Diedler J, Rupp A, Turcani P, Steiner T (2009) Impaired baroreceptor reflex sensitivity in acute stroke is associated with insular involvement, but not with carotid atherosclerosis. Stroke 40:737–742

    Article  Google Scholar 

  8. 8.

    Oppenheimer SM, Gelb A, Girvin JP, Hachinski VC (1992) Cardiovascular effects ofhuman insular cortex stimulation. Neurology 42:1727–1732

    CAS  Article  Google Scholar 

  9. 9.

    Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, Grassi G, Hilz MJ, Kaufmann H, Lahrmann H, Mancia G, Mayer G, Norcliffe-Kaufmann L, Pavy-Le Traon A, Raj SR, Robertson D, Rocha I, Struhal W, Thijs R, Tsioufis KP, van Dijk JG, Wenning GK (2018) Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS): endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res 28:355–362

    Article  Google Scholar 

  10. 10.

    Oppenheimer S (2006) Cerebrogenic cardiac arrhythmias: cortical lateralization and clinical significance. Clin Auton Res 16:6–11

    Article  Google Scholar 

  11. 11.

    Almairac F, Duffau H, Herbet G (2018) Contralesional macrostructural plasticity of the insular cortex in patients with glioma: a VBM study. Neurology 91:e1902–e1908

    Article  Google Scholar 

Download references



Author information




Study concept and design: KD, AF and MH. Acquisition of data: KD, NK, IJ, BR, IA, AF and MH. Analysis and interpretation of data: NK, IJ, BR, IA, AF and MH. Drafting of the manuscript: BR and IA. Critical revision of the manuscript for important intellectual content: KD, NK, IJ, BR, IA, AF and MH. Administrative, technical, and material support: KD, NK, IJ, BR, IA, AF and MH.

Corresponding author

Correspondence to Mario Habek.

Ethics declarations

Conflict of interest

None of the authors have relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties. No writing assistance was utilized in the production of this manuscript.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dumić, K., Krnić, N., Jovanović, I. et al. Insular damage causing transient baroreflex dysfunction in a teenager with Allgrove syndrome. Clin Auton Res (2021).

Download citation


  • Allgrove syndrome
  • Autonomic nervous system
  • Baroreflex dysfunction
  • Supine hypertension