The cerebellum seems not a ‘little brain’ for the autonomic nervous system

Neurogenic postural hypotension is a debilitating condition in patients with Parkinson's disease, multiple system atrophy (MSA), autoimmune autonomic ganglionopathy, and advanced diabetic neuropathy (Palma and Kaufmann, 2017). Pathology for this condition are mostly peripheral (periarterial nerves innervating alpha 1B receptors on the vessel wall), and in MSA, spinal intermediolateral nucleus and medullary A1,2/C1,2 neurons are the responsible sites. In pure autonomic failure (lesion overlaps that of Parkinson's disease), cingulate and medial frontal pathology is contributing to postural hypotension (Hirano et al, 2009).

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