Prevalence of Dysautonomic Symptoms in <scp>CHARGE</scp> Syndrome: A Pilot Study of 25 Individuals With <scp>CHARGE</scp> Syndrome

CHARGE syndrome is a heterogeneous genetic disorder with an evolving phenotype, particularly in adults. This study examined whether dysautonomic symptoms are common in adolescents and adults with CHARGE syndrome. Adolescents and adults with CHARGE syndrome completed a CHARGE-specific checklist and modified items from COMPASS-31 with the cardiovascular items from the ASP to assess dysautonomic symptoms. Participants were 25 individuals (20 female, 5 male), aged 12-33 years (mean = 21.3 years), with clinically confirmed diagnoses, 16 of whom had a CHD7 mutation. Dysautonomic symptoms were common: 50%-60% reported fatigue, heat intolerance, constipation, nausea, and headaches; 40%-50% reported postural tachycardia, tachycardia, dyspnea, weakness, exercise intolerance, and anxiety. These rates appear at a high frequency. A detailed case study of one participant is included in the supplemental material. Findings suggest dysautonomia may be prevalent in individuals with CHARGE syndrome and highlight the need for greater awareness of symptoms and triggers. Interventions such as vagal nerve stimulation may help restore autonomic balance and improve quality of life.