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Features of individuals with Prader\u2013Willi syndrome (PWS) impacted by PWS molecular genetic classes suggest alterations in ANS function; however, these have been rarely studied and presented with conflicting results. The aim of this study was to investigate if the ANS function is altered in PWS. In this case-control study, we assessed ANS function in 20 subjects with PWS (6 males\/14 females; median age 10.5 years) and 27 body mass index (BMI) z-score-matched controls (19 males\/8 females; median age 12.8 years). Standardized non-invasive measures of cardiac baroreflex function, heart rate, blood pressure, heart rate variability, quantitative sudomotor axon reflex tests, and a symptom questionnaire were completed. The increase in heart rate in response to head-up tilt testing was blunted (p &lt; 0.01) in PWS compared to controls. Besides a lower heart rate ratio with Valsalva in PWS (p &lt; 0.01), no significant differences were observed in other measures of cardiac function or sweat production. Findings suggest possible altered sympathetic function in PWS.<\/jats:p>","DOI":"10.3390\/ijms24098013","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T10:51:52Z","timestamp":1682679112000},"page":"8013","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluation of Autonomic Nervous System Dysfunction in Childhood Obesity and Prader\u2013Willi Syndrome"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-8668","authenticated-orcid":false,"given":"Lawrence P.","family":"Richer","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9014-6246","authenticated-orcid":false,"given":"Qiming","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2911-0524","authenticated-orcid":false,"given":"Merlin G.","family":"Butler","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry & Behavioral Sciences and Pediatrics, Kansas University Medical Center, Kansas City, KS 66160, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1854-3364","authenticated-orcid":false,"given":"Hayford M.","family":"Avedzi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darren S.","family":"DeLorey","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-2305","authenticated-orcid":false,"given":"Ye","family":"Peng","sequence":"additional","affiliation":[{"name":"JC School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hein M.","family":"Tun","sequence":"additional","affiliation":[{"name":"JC School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arya M.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Ainsley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5989-0528","authenticated-orcid":false,"given":"Camila E.","family":"Orsso","sequence":"additional","affiliation":[{"name":"Department of Agricultural Food & Nutritional Science, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8089-2162","authenticated-orcid":false,"given":"Lucila","family":"Triador","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Freemark","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27705, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Haqq","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada"},{"name":"Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27705, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/s12933-020-01052-1","article-title":"Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity","volume":"19","author":"Bendor","year":"2020","journal-title":"Cardiovasc. 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