Symptoms can be devastating when our innate system fails

Our body's autonomic system is responsible for unconscious control of functions like breathing, digestion, heart rate and blood pressure. When it fails, as it does in between two and five per cent of the population, the results can be devastating.

The most significant impact of autonomic failure on an individual’s quality of life is the body’s inability to regulate blood pressure. When people with the condition stand, they experience a rapid fall in blood pressure. As a result, they can suffer from nausea, blurred vision, light-headedness or even faint.

Autonomic failure can appear on its own or alongside conditions like Type 2 diabetes and Parkinson’s disease. Physicians know it can’t be cured, so treatments are geared towards relieving symptoms.

Dr. Jacquie Baker, PhD, a postdoctoral fellow under the supervision of Dr. Satish Raj, MD, and Dr. Richard Wilson, PhD, is on a mission to improve the lives of individuals suffering from autonomic failure by looking into ways to help regulate their blood pressure. She recently received a prestigious Canadian Institutes of Health Research (CIHR) postdoctoral fellowship award to help her pursue her research goals in this area.

“Throughout my PhD work, and now in my postdoctoral fellowship, I have been interested in people who have autonomic failure,” says Baker. “For some individuals, their blood pressure can be extremely high when they are lying down and then it will suddenly drop when they stand up.”

In her PhD work at Western University, completed in 2019, Baker examined brain activity in individuals suffering from autonomic failure. Her postdoctoral work focuses on investigating a new tool to measure autonomic activity in the brain, assessing a novel technique to improve blood-pressure regulation and compare autonomic reactivity that may put women at increased cardiovascular risk.

Optical Coherence Tomography (OCT) is a non-invasive imaging technology similar to ultrasound that is used by eye doctors to look at the retina that is like ultrasound technology. It takes high-resolution, cross-sectional images of the retina and has traditionally been used to detect retinal diseases and conditions.

Wilson and his team have developed a way to use this technology to measure the tiny blood vessels in the eyes to reveal the structural and functional changes in the brain. Baker will use this technology to measure brain blood flow when blood pressure is dropping.

Baker is also investigating the potential development of a new portable device that could theoretically increase the amount of carbon dioxide breathed by individuals, which has been shown to boost blood pressure.

“Managing blood pressure will allow these people to get up and get back to their lives,” says Baker, noting symptoms vary by individual.

Wilson says Baker’s work is important.

“I am thrilled to be working with (Baker),” he says. “She is applying cutting-edge technology to chart the fascinating and largely unmapped interface between brain and body. We know this interface holds the key to many chronic, serious and prevalent diseases, but it will require brilliant and courageous minds like Jacquie's to fully explore it.”

Baker grew up in Ontario and completed all three levels of her post-secondary training at Western. She originally thought she would pursue a career in medicine, but changed her mind while working in an autonomic clinic after completing her master’s.

“Seeing what people go through when their autonomic system fails was a game-changer,” says Baker. “Seeing someone’s blood pressure drop over 100 points and knowing there is little to offer these patients completely changed my career trajectory. The knowledge (to help) just isn’t there, and I just knew my path was to do a doctorate focusing on clinical autonomic research.”

Baker’s passion now lies in clinical research and her career goal is to establish her own collaborative autonomic research lab.

She says she also wants to raise awareness about autonomic disorders: "My goal is to raise awareness in the public and entice the next generation of researchers to consider this area of research.” 

Raj says because Baker’s work is at the junction of basic and clinical science, it is ideally suited to translate into cutting-edge clinical care.

“Baker is the future of research in Canada that is going to help us understand the basis of autonomic disorders and help treat future generations of patients,” he says. “We are lucky to have her in Calgary.”