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PloS One 2015Heart failure with preserved left ventricular ejection fraction (HFPEF) affects about half of all patients diagnosed with heart failure. The pathophysiological aspect of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Heart failure with preserved left ventricular ejection fraction (HFPEF) affects about half of all patients diagnosed with heart failure. The pathophysiological aspect of this complex disease state has been extensively explored, yet it is still not fully understood. Since the sympathetic nervous system is related to the development of systolic HF, we hypothesized that an increased sympathetic nerve activation (SNA) is also related to the development of HFPEF. This review summarizes the available literature regarding the relation between HFPEF and SNA.
METHODS AND RESULTS
Electronic databases and reference lists through April 2014 were searched resulting in 7722 unique articles. Three authors independently evaluated citation titles and abstracts, resulting in 77 articles reporting about the role of the sympathetic nervous system and HFPEF. Of these 77 articles, 15 were included for critical appraisal: 6 animal and 9 human studies. Based on the critical appraisal, we selected 9 articles (3 animal, 6 human) for further analysis. In all the animal studies, isoproterenol was administered to mimic an increased sympathetic activity. In human studies, different modalities for assessment of sympathetic activity were used. The studies selected for further evaluation reported a clear relation between HFPEF and SNA.
CONCLUSION
Current literature confirms a relation between increased SNA and HFPEF. However, current literature is not able to distinguish whether enhanced SNA results in HFPEF, or HFPEF results in enhanced SNA. The most likely setting is a vicious circle in which HFPEF and SNA sustain each other.
Topics: Animals; Databases, Factual; Echocardiography; Heart Failure; Humans; Sympathetic Nervous System; Ventricular Function, Left
PubMed: 25658630
DOI: 10.1371/journal.pone.0117332 -
International Journal of Molecular... Jul 2023The observation of neurogenic fever resulting from subarachnoid hemorrhage (SAH) in animal models is a useful tool for the interpretation of its pathophysiology in... (Review)
Review
The observation of neurogenic fever resulting from subarachnoid hemorrhage (SAH) in animal models is a useful tool for the interpretation of its pathophysiology in humans, which is still a major challenge in the management of neurocritical patients. This systematic review aims to identify the prognostic factors and pathophysiological elements that determine the onset of neurogenic fever and its severity in animal models. In addition, our study aims to analyze which pharmacological treatments are most effective. All the articles available in Pubmed, Embase, and the Biological Science Collection until August 2021 concerning in vivo experimental studies on SAH animal models, including full texts and abstracts written in English and Italian, were considered. The risk of bias was assessed with SYRCLE's Risk of Bias tool. In total, 81 records were retrieved; after excluding duplicates, 76 records were potentially relevant. A total of 64 articles was excluded after title and abstract screening. The remaining 12 studies were evaluated as full texts, and 6 other studies were excluded (SAH-induced animal studies without a body temperature assessment). In one study, body temperature was measured after SAH induction, but the authors did not report temperature recording. Therefore, only five studies met the search criteria. The high methodological heterogeneity (different animal species, different temperature measurement methods, and different methods of the induction of bleeding) prevented meta-analysis. Synthesis methodology without meta-analysis (SWiM) was used for data analysis. The total number of animals used as controls was 87 (23 rabbits, 32 mice, and 32 rats), while there were 130 animals used as interventions (54 rabbits, 44 mice, and 32 rats). The presence of blood in the subarachnoid space, particularly red blood cells, is responsible for neurogenic fever; the role of hemoglobin is unclear. The mechanism is apparently not mediated by prostaglandins. The autonomic nervous system innervating brown adipose tissue is undoubtedly implicated in the onset of neurogenic fever. The activation of the central adenosine-1 receptor is effective in controlling the temperature of animals with neurogenic fever (by inhibiting thermogenesis of brown adipose tissue).
Topics: Humans; Rats; Mice; Rabbits; Animals; Subarachnoid Hemorrhage; Autonomic Nervous System; Disease Models, Animal
PubMed: 37511267
DOI: 10.3390/ijms241411514 -
Clinical Autonomic Research : Official... Sep 2019Autonomic dysfunction is a hallmark feature of hereditary ATTR amyloidosis. The aim of this study was to summarize the characteristics and natural history of autonomic...
BACKGROUND
Autonomic dysfunction is a hallmark feature of hereditary ATTR amyloidosis. The aim of this study was to summarize the characteristics and natural history of autonomic dysfunction in patients with hereditary ATTR amyloidosis.
METHODS
A systematic review of the natural history and clinical trials of patients with ATTR amyloidosis was performed. Alternative surrogate markers of autonomic function were analyzed to understand the prevalence and outcome of autonomic dysfunction.
RESULTS
Patients with early-onset disease displayed autonomic dysfunction more distinctively than those with late-onset disease. The nutritional status and some autonomic items in the quality-of-life questionnaires were used to assess the indirect progression of autonomic dysfunction in most studies. Gastrointestinal symptoms and orthostatic hypotension were resent earlier than urogenital complications. Once symptoms were present, their evolution was equivalent to the progression of the motor and sensory neuropathy impairment.
CONCLUSION
The development of autonomic dysfunction impacts morbidity, disease progression, and mortality in patients with hereditary ATTR amyloidosis.
Topics: Amyloid Neuropathies, Familial; Autonomic Nervous System Diseases; Humans
PubMed: 31473866
DOI: 10.1007/s10286-019-00630-y -
Advanced Biomedical Research 2023Physical therapies such as electroconvulsive therapy (ECT) may result in higher response and recovery rates, especially in patients who have treatment-resistant... (Review)
Review
Physical therapies such as electroconvulsive therapy (ECT) may result in higher response and recovery rates, especially in patients who have treatment-resistant depression. Various studies have reported different changes in heart rate variability (HRV) parameters before and after depression treatment with ECT. Therefore, the present study reviews systematically the evidence describing changes in HRV parameters and the cardiac autonomic nervous system associated with ECT. Scopus, Web of Science, PubMed, and Embase electronic databases were searched for papers published up to September 8, 2022, without any restriction on the year and language of the study. A total of 895 articles were reviewed by two independent groups and nine articles that met the inclusion criteria were selected. Time-domain and frequency-domain HRV parameters were assessed. In conclusion, the results of our systematic review provided limited evidence for the influence of ECT on HRV parameters. Despite studies suggesting depression results in a decrease in parasympathetic activity and ECT results in an increase in cardiac vagal activity, ECT seems to have no consistent effect on HRV parameters.
PubMed: 38073723
DOI: 10.4103/abr.abr_95_23 -
Seizure Feb 2018To estimate the incidence of pre-ictal heart rate (HR) manifestations and to identify clinical and study-related factors modulating the estimate. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To estimate the incidence of pre-ictal heart rate (HR) manifestations and to identify clinical and study-related factors modulating the estimate.
METHODS
We searched articles recording concurrent pre-ictal EEG and HR in adults and children with epilepsy. Pre-ictal HR changes were classified as HR reduction (HRR) or increase (HRI). Studies reporting the total number of seizures and the number of seizures with pre-ictal HR changes were included in a random-effects meta-analysis. A random-effects meta-regression was used to identify variables affecting study heterogeneity.
RESULTS
Thirty studies, including 1110 participants and 2957 seizures, were included. The meta-analysis showed a pooled incidence of pre-ictal HRI of 36/100 seizures (95% CI 22-50). The pre-ictal HRI incidence was 44/100 seizures (95% CI 33-55) in studies including temporal lobe epilepsy, 55/100 seizures (95% CI 41-68) in studies enrolling adults and 35/100 seizures (95% CI 16-58) when patients on antiepileptic drugs were included. The meta-regression showed that the age group, the length of the pre-ictal period, the incidence of ictal tachycardia and the time of onset of the pre-ictal HRI had a significant impact on estimates variability. The pooled incidence of pre-ictal HRR was 0/100 seizures (95% CI 0-1).
CONCLUSION
Review of bias evaluation and methods assessment disclosed several major limitations in the evidence-base. HR monitoring could be valuable to identify seizures prior to their apparent onset, opening the possibility to early interventions. Additional effort is necessary to delineate the target population who might benefit from its use and the mechanisms sustaining the pre-ictal cardiac changes.
Topics: Adult; Anticonvulsants; Child; Epilepsy, Temporal Lobe; Heart Rate; Humans; Seizures
PubMed: 29367145
DOI: 10.1016/j.seizure.2018.01.003 -
Journal of Diabetes and Its... Nov 2021To estimate the prevalence of neuropathy in adolescents with type 1 diabetes. (Review)
Review
AIMS
To estimate the prevalence of neuropathy in adolescents with type 1 diabetes.
METHODS
Systematic collection of published studies exploring the prevalence of large fibre neuropathy (LFN), small fibre neuropathy (SFN), and autonomic neuropathy in adolescents with type 1 diabetes. Following prospective registration (Prospero CRD42020206093), PubMed, EMBASE, and Cochrane Library were searched for studies from 2000 to 2020. PICO framework was used in the selection process (Population: adolescents aged 10-19 years with type 1 diabetes; Intervention: diagnostic methods for neuropathy; Comparison: reference data; Outcome: data on prevalence or comparison). Data were extracted concerning study quality based on available data and established methods for determining and diagnosing various neuropathy types.
RESULTS
From 2,017 initial citations, 27 studies (7589 participants) fulfilled eligibility criteria. The study population (47% males) had a diabetes duration between 4.0 and 10.6 years, and HbA1c level between 7.3 and 10.8%, 56-95 mmol/mol. The prevalence of LFN, based on nerve conduction studies, was 10-57%. Based on other tests for neuropathy, the prevalence of LFN and SFN was 12-62%, and that of cardiac autonomic neuropathy was 12-75%.
CONCLUSION
The described prevalence of neuropathy in adolescents with type 1 diabetes varied, which can be methodological due to different screening methods and classifications of neuropathy.
Topics: Adolescent; Diabetes Mellitus, Type 1; Diabetic Neuropathies; Female; Humans; Male; Peripheral Nervous System Diseases; Prevalence; Prospective Studies
PubMed: 34429229
DOI: 10.1016/j.jdiacomp.2021.108027 -
Journal of Neurology Dec 2023Autonomic dysfunctions are prevalent in several cerebellar disorders, but they have not been systematically investigated in spinocerebellar ataxias (SCAs). Studies... (Review)
Review
BACKGROUND
Autonomic dysfunctions are prevalent in several cerebellar disorders, but they have not been systematically investigated in spinocerebellar ataxias (SCAs). Studies investigating autonomic deficits in SCAs are fragmented, with each one focusing on different autonomic dysfunctions and different SCA subtypes.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic review of the literature to assess the presence of autonomic dysfunctions in various SCAs. PubMed served as the primary database, and the Rayyan web application was employed for study screening.
RESULTS
We identified 46 articles investigating at least one autonomic function in patients with SCA. The results were analyzed and categorized based on the genetic subtype of SCA, thereby characterizing the specific autonomic deficits associated with each subtype.
CONCLUSION
This review confirms the presence of autonomic dysfunctions in various genetic subtypes of SCA, underscoring the cerebellum's role in the autonomic nervous system (ANS). It also emphasizes the importance of investigating these functions in clinical practice.
Topics: Humans; Spinocerebellar Ataxias; Cerebellum; Primary Dysautonomias; Autonomic Nervous System
PubMed: 37749264
DOI: 10.1007/s00415-023-11993-8 -
Frontiers in Immunology 2024Recent evidence supports the contribution of gut microbiota dysbiosis to the pathophysiology of rheumatic diseases, neuropathic pain, and neurodegenerative disorders.... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Recent evidence supports the contribution of gut microbiota dysbiosis to the pathophysiology of rheumatic diseases, neuropathic pain, and neurodegenerative disorders. The bidirectional gut-brain communication network and the occurrence of chronic pain both involve contributions of the autonomic nervous system and the hypothalamic pituitary adrenal axis. Nevertheless, the current understanding of the association between gut microbiota and chronic pain is still not clear. Therefore, the aim of this study is to systematically evaluate the existing knowledge about gut microbiota alterations in chronic pain conditions.
METHODS
Four databases were consulted for this systematic literature review: PubMed, Web of Science, Scopus, and Embase. The Newcastle-Ottawa Scale was used to assess the risk of bias. The study protocol was prospectively registered at the International prospective register of systematic reviews (PROSPERO, CRD42023430115). Alpha-diversity, β-diversity, and relative abundance at different taxonomic levels were summarized qualitatively, and quantitatively if possible.
RESULTS
The initial database search identified a total of 3544 unique studies, of which 21 studies were eventually included in the systematic review and 11 in the meta-analysis. Decreases in alpha-diversity were revealed in chronic pain patients compared to controls for several metrics: observed species (SMD= -0.201, 95% CI from -0.04 to -0.36, p=0.01), Shannon index (SMD= -0.27, 95% CI from -0.11 to -0.43, p<0.001), and faith phylogenetic diversity (SMD -0.35, 95% CI from -0.08 to -0.61, p=0.01). Inconsistent results were revealed for beta-diversity. A decrease in the relative abundance of the Lachnospiraceae family, genus and , and species of and , as well as an increase in spp., was revealed in chronic pain patients compared to controls.
DISCUSSION
Indications for gut microbiota dysbiosis were revealed in chronic pain patients, with non-specific disease alterations of microbes.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42023430115.
Topics: Humans; Chronic Pain; Dysbiosis; Hypothalamo-Hypophyseal System; Phylogeny; Pituitary-Adrenal System; Clostridiales
PubMed: 38352865
DOI: 10.3389/fimmu.2024.1342833 -
Neuroscience and Biobehavioral Reviews Jan 2020Although arousal mechanisms have frequently been found to be atypical in ADHD, these findings usually emerged from indirect behavioural measures which give only a...
Although arousal mechanisms have frequently been found to be atypical in ADHD, these findings usually emerged from indirect behavioural measures which give only a limited understanding of arousal dysregulation in this condition. To assess the hypothesis that functioning of the autonomic nervous system (ANS), one component of arousal, is atypical in ADHD, we carried out a systematic review of the literature on 55 studies investigating electro-dermal, heart rate and pupillometry measures under different experimental conditions (resting-state, cognitive tasks and in response to reinforcers or socio-emotional stimuli). Our literature review identified ANS dysfunction in individuals with ADHD, more often in the direction of hypo-arousal than hyper-arousal, particularly at rest and during tasks requiring response regulation and sustained attention. Almost half of the reported findings were null. Stimulant medications increased ANS activity and, in some studies, reinforcers and rewards produced a similar effect, suggesting that ANS function can be modified in ADHD. Further research is needed to assess the influence of comorbid symptoms and to explore methodological parameters that may influence findings.
Topics: Attention Deficit Disorder with Hyperactivity; Autonomic Nervous System; Central Nervous System Stimulants; Galvanic Skin Response; Heart Rate; Humans; Reward
PubMed: 31722229
DOI: 10.1016/j.neubiorev.2019.11.001 -
Neurology International Sep 2023The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and... (Review)
Review
The aim of this systematic review with meta-analysis was to determine differences in cardiovascular autonomic parameters between patients with myasthenia gravis (MG) and healthy controls (HCs). Two reviewers searched four electronic databases, namely PubMed, Web of Science, EMBASE, and SCOPUS, from database inception to 7 July 2023 for studies investigating cardiovascular autonomic parameters in MG vs. HCs. A random-effects meta-analysis was performed to compute Hedges' g ± 95% confidence intervals (CI). Out of a total of 2200 records, 8 observational studies with a sample size of 301 patients with MG and 454 HCs were included in the systematic review. Meta-analysis revealed lower values of expiration/inspiration ratio (g = -0.45, I = 74.7), baroreflex sensitivity (g = -0.56, 95%CI -0.80, -0.33; I = 0.3), percentage of adjacent NN intervals differing by more than 50 ms (g = -1.2, I = 82.8), square root of the mean of squared differences between successive beat intervals (g = -1.94, I = 95.1), mean of the standard deviations of all NN intervals (g = -0.83, 95%CI -1.37, -0.28; I = 55.5), and high frequency of HRV during tilt (g = -0.75, 95%CI -0.11, -0.39; I = 0). MG patients vs. HCs had higher systolic blood pressure (g = 0.39; I = 56.1), sympathovagal balance at rest/during tilt (LF/HF-RRI, g = 0.44; I = 0; LF/HF-RRI, g = 0.86; I = 0; LF/HF, g = 0.40; I = 0). As a group, MG patients have altered cardiac autonomic function, including decreased parasympathetic function, lower baroreflex sensitivity, and higher sympathovagal balance at rest and during orthostatic challenges.
PubMed: 37755362
DOI: 10.3390/neurolint15030071