Karissa N. Arca, M.D., is interested in the cross-section between autonomic disorders and headache. This includes further understanding the characteristics of postural and orthostatic headache in patients with cerebrospinal fluid leaks, postural tachycardia syndrome and orthostatic hypotension. Additionally, Dr. Arca studies the patterns of autonomic dysfunction in patients with pectus excavatum.
Dr. Arca is working on further characterizing respiratory patterns in patients with autonomic disorders. Specifically, she has studied breathing patterns in patients with concussion, postural tachycardia and Sjogren's disease.
In addition to her clinical and scientific endeavors, Dr. Arca has been involved in educational research studying the outcomes of advocacy education in headache fellows. Another project involved evaluating the efficacy of online learning for the medical student neuroscience curriculum during the COVID-19 pandemic.
Exploring the use of neuromodulation for the treatment of postural tachycardia is a future research interest. Dr. Arca also is looking at investigating coexisting conditions including headache and intestinal dysmotility.
- Autonomic dysfunction in pectus excavatum. Thought to be a sporadic disorder, pectus excavatum is associated with connective tissue disorders as well. Its symptoms, which include palpitations, exertional intolerance, syncope and postural lightheadedness, can mimic autonomic dysfunction.
- Postural orthostatic tachycardia syndrome. This common autonomic disorder requires a thoughtful diagnostic evaluation to rule out secondary causes or mimics.
Autonomic testing. From 2019 to 2022 at Mayo Clinic in Arizona, patients diagnosed with pectus excavatum, who described significant positional lightheadedness, were evaluated with autonomic testing. This was in addition to cardiac evaluations for presurgical planning.
Those patients with atypical autonomic testing results were further evaluated in the autonomic neurology clinic. Dr. Arca and her colleagues are currently analyzing the results of autonomic testing in patients with pectus excavatum to determine the potential association between pectus excavatum and postural tachycardia, or other autonomic dysfunction.
Significance to patient care
Dr. Arca's research is directly inspired by her patients. She seeks to define clinical phenotypes of headache and autonomic disorders to better understand pathophysiologic mechanisms and ultimately obtain improved treatment options for patients.