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Paediatric Anaesthesia May 2022Approximately one in every 700 babies in the United States is born with Down syndrome, or 0.14%. Children with Down syndrome have cognitive impairment and congenital... (Review)
Review
Approximately one in every 700 babies in the United States is born with Down syndrome, or 0.14%. Children with Down syndrome have cognitive impairment and congenital malformations necessitating frequent occurrences of general anesthesia and surgery. The thoughtful perioperative care of children with Down syndrome is relevant and acutely complex for the pediatric anesthesiologist. Behavior, sedation, hypotonia, upper airway obstruction, venous access, and bradycardia are omnipresent concerns apart from the surgical pathology. Down syndrome is also associated with autonomic nervous system dysfunction, a comorbidity that is overlooked in discussions of perioperative care and is described thus far in adults. Autonomic nervous system function or dysfunction may explain the phenotypical features of the perioperative challenges listed above. For this reason, understanding the development and measurement of autonomic nervous system function is important for the pediatric anesthesiologist. Definition and quantification of sympathetic and parasympathetic function will be reviewed.
Topics: Adult; Anesthesia, General; Anesthesiologists; Autonomic Nervous System; Bradycardia; Child; Down Syndrome; Humans; Sympathetic Nervous System
PubMed: 35156260
DOI: 10.1111/pan.14416 -
Folia Medica Cracoviensia Oct 2023Eating disorders are a heterogeneous group of diseases affecting mainly young people in developed countries. Among them, anorexia nervosa (AN) is the one with the... (Review)
Review
Eating disorders are a heterogeneous group of diseases affecting mainly young people in developed countries. Among them, anorexia nervosa (AN) is the one with the highest mortality, up to five times higher compared to healthy individuals. The etiology of this medical condition is complex and still un- certain. However, disturbances of the autonomic nervous system (ANS) and increased lipolysis resulting in a decrease of the adipose tissue volume are common findings among AN patients. Since ANS is directly connected to adipocyte tissue, thus significantly affecting the body's metabolic homeostasis, we suspect that this relationship may be a potential pathophysiological underpinning for the development of AN. In this narrative review, we have analyzed scientific reports on ANS activity in AN considering different phases of the disease in humans as well as animal models. Due to the different effects of the disease itself on the ANS as well as specific variations within animal models, the common feature seems to be dysregulation of its function without the identification of one universal pattern. Nonetheless, higher norepinephrine concentrations have been reported in adipocyte tissue, suggesting local dominance of the sym- pathetic nervous system. Further studies should explore in depth the modulation of sympathetic in adipose tissue factor and help answer key questions that arise during this brief narrative review.
Topics: Animals; Humans; Adolescent; Anorexia Nervosa; Autonomic Nervous System; Adipose Tissue; Norepinephrine; Heart Rate
PubMed: 38310530
DOI: 10.24425/fmc.2023.147215 -
Clinical Autonomic Research : Official... Jun 2015Despite decades of study, a clear understanding of autonomic nervous system activity in space remains elusive. Differential interpretation of fundamental data has driven... (Review)
Review
INTRODUCTION
Despite decades of study, a clear understanding of autonomic nervous system activity in space remains elusive. Differential interpretation of fundamental data has driven divergent theories of sympathetic activation and vasorelaxation.
METHODS
This paper will review the available in-flight autonomic and hemodynamic data in an effort to resolve these discrepancies. The NASA NEUROLAB mission, the most comprehensive assessment of autonomic function in microgravity to date, will be highlighted. The mechanisms responsible for altered autonomic activity during spaceflight, which include the effects of hypovolemia, cardiovascular deconditioning, and altered central processing, will be presented.
RESULTS
The NEUROLAB experiments demonstrated increased sympathetic activity and impairment of vagal baroreflex function during short-duration spaceflight. Subsequent non-invasive studies of autonomic function during spaceflight have largely reinforced these findings, and provide strong evidence that sympathetic activity is increased in space relative to the supine position on Earth. Others have suggested that microgravity induces a state of relative vasorelaxation and increased vagal activity when compared to upright posture on Earth. These ostensibly disparate theories are not mutually exclusive, but rather directly reflect different pre-flight postural controls.
CONCLUSION
When these results are taken together, they demonstrate that the effectual autonomic challenge of spaceflight is small, and represents an orthostatic stress less than that of upright posture on Earth. In-flight countermeasures, including aerobic and resistance exercise, as well short-arm centrifugation, have been successfully deployed to counteract these mechanisms. Despite subtle changes in autonomic activity during spaceflight, underlying neurohumoral mechanisms of the autonomic nervous system remain intact and cardiovascular function remains stable during long-duration flight.
Topics: Autonomic Nervous System; Baroreflex; Hemodynamics; Humans; Space Flight; Sympathetic Nervous System; Weightlessness; Weightlessness Countermeasures
PubMed: 25820827
DOI: 10.1007/s10286-015-0285-y -
Experimental & Molecular Medicine Apr 2022Neurons in the central nervous system (CNS) communicate with peripheral organs largely via the autonomic nervous system (ANS). Through such communications, the... (Review)
Review
Neurons in the central nervous system (CNS) communicate with peripheral organs largely via the autonomic nervous system (ANS). Through such communications, the sympathetic and parasympathetic efferent divisions of the ANS may affect thermogenesis and blood glucose levels. In contrast, peripheral organs send feedback to the CNS via hormones and autonomic afferent nerves. These humoral and neural feedbacks, as well as neural commands from higher brain centers directly or indirectly shape the metabolic function of autonomic neurons. Notably, recent developments in mouse genetics have enabled more detailed studies of ANS neurons and circuits, which have helped elucidate autonomic control of metabolism. Here, we will summarize the functional organization of the ANS and discuss recent updates on the roles of neural and humoral factors in the regulation of energy balance and glucose homeostasis by the ANS.
Topics: Animals; Autonomic Nervous System; Autonomic Pathways; Central Nervous System; Glucose; Homeostasis; Mice
PubMed: 35474336
DOI: 10.1038/s12276-021-00705-9 -
Developmental Medicine and Child... Jul 2017
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Cerebral Palsy; Humans
PubMed: 28599358
DOI: 10.1111/dmcn.13440 -
Osteoarthritis and Cartilage Apr 2022
Topics: Arthritis, Rheumatoid; Autonomic Nervous System; Heart Rate; Humans; Osteoarthritis
PubMed: 35017059
DOI: 10.1016/j.joca.2021.12.009 -
Folia Medica Cracoviensia 2018Autonomic nervous system of the pelvis is still poorly understood. Every year more and more pelvic procedures are carried out on patients suffering from different pelvic... (Review)
Review
Autonomic nervous system of the pelvis is still poorly understood. Every year more and more pelvic procedures are carried out on patients suffering from different pelvic disorders what leads to numerous pelvic dysfunctions. Authors tried to review, starting from historical and clinical background, the most important reports on anatomy of the pelvic autonomic plexuses. We also pay attention to complete lack of knowledge of students of medicine on the autonomic nervous structures in the area studied. We present anatomical description of the pelvic plexuses including their visceral branches and anatomy of surrounding pelvic tissues which still remains unclear. More and more attention is paid to the topography of the plexuses specially because of new pain releasing techniques - neurolysies.
Topics: Autonomic Nervous System; Education, Medical; Humans; Pelvis; Peripheral Nerve Injuries; Students, Medical
PubMed: 30467432
DOI: 10.24425/fmc.2018.124656 -
Cardiology in Review 2020Cardiovascular disorders, such as orthostatic hypotension and supine hypertension, are common in patients with neurodegenerative synucleinopathies such as Parkinson... (Review)
Review
Cardiovascular disorders, such as orthostatic hypotension and supine hypertension, are common in patients with neurodegenerative synucleinopathies such as Parkinson disease (PD), and may also occur in other conditions, such as peripheral neuropathies, that result in autonomic nervous system (ANS) dysfunction. Dysfunction and degeneration of the ANS are implicated in the development of orthostatic and postprandial hypotension and impaired thermoregulation. Neurogenic orthostatic hypotension (nOH) results from sympathetic failure and is a common autonomic disorder in PD. Supine hypertension may also occur as a result of both sympathetic and parasympathetic dysfunction in conjunction with nOH in the majority of patients with PD. Management of supine hypertension in the setting of nOH can be counterintuitive and challenging. Additionally, the presence of other noncardiovascular comorbidities, such as diabetes mellitus and peripheral edema, may further contribute to the burden of disease. ANS dysfunction thus presents major healthcare implications and challenges for neurology and cardiovascular practices, necessitating an integrated neurology and cardiology management approach.
Topics: Autonomic Nervous System; Cardiovascular Diseases; Humans; Hypotension, Orthostatic; Parkinson Disease
PubMed: 31764015
DOI: 10.1097/CRD.0000000000000280 -
GeroScience Dec 2022Aging of the cardiovascular regulatory function manifests as an imbalance between the sympathetic and parasympathetic (vagal) components of the autonomic nervous system... (Review)
Review
Aging of the cardiovascular regulatory function manifests as an imbalance between the sympathetic and parasympathetic (vagal) components of the autonomic nervous system (ANS). The most characteristic change is sympathetic overdrive, which is manifested by an increase in the muscle sympathetic nerve activity (MSNA) burst frequency with age. Age-related changes that occur in vagal nerve activity is less clear. The resting tonic parasympathetic activity can be estimated noninvasively by measuring the increase in heart rate occurring in response to muscarinic cholinergic receptor blockade; animal study models have shown this to diminish with age. Humoral, cellular, and neural mechanisms work together to prevent non-resolving inflammation. This review focuses on the mechanisms underlying age-related alternations in the ANS and how an imbalance in the ANS, evaluated by MSNA and heart rate variability (HRV), potentially facilitates inflammation when the homeostatic mechanisms between reflex neural circuits and the immune system are compromised, particularly the dysfunction of the cholinergic anti-inflammatory reflex. Physiologically, the efferent arm of this reflex acts via the [Formula: see text] 7 nicotinic acetylcholine receptors expressed in macrophages, monocytes, dendritic cells, T cells, and endothelial cells to curb the release of inflammatory cytokines, in which inhibition of NF‑κB nuclear translocation and activation of a JAK/STAT-mediated signaling cascade in macrophages and other immune cells are implicated. This reflex is likely to become less adequate with advanced age. Consequently, a pro-inflammatory state induced by reduced vagus output with age is associated with endothelial dysfunction and may significantly contribute to the development and propagation of atherosclerosis, heart failure, and hypertension. The aim of this review is to summarize the relationship between ANS dysfunction, inflammation, and endothelial dysfunction in the context of aging. Meanwhile, this review also attempts to describe the role of HRV measures as a predictor of the level of inflammation and endothelial dysfunction in the aged population and explore the possible therapeutical effects of vagus nerve stimulation.
Topics: Animals; Endothelial Cells; Inflammation; Autonomic Nervous System; Sympathetic Nervous System; Immune System; Vascular Diseases
PubMed: 35773441
DOI: 10.1007/s11357-022-00616-1 -
Autonomic Neuroscience : Basic &... Dec 2017In this review we describe a series of major concepts introduced during the past 150years that have contributed to our current understanding about how physiological... (Review)
Review
In this review we describe a series of major concepts introduced during the past 150years that have contributed to our current understanding about how physiological processes required for well-being and survival are regulated. One can theorize that hierarchical networks involving input-output relationships continuously orchestrate and learn adaptive patterns of observable behaviors, cognition, memory, mood, and autonomic systems. Taken together, these networks function as "good regulators" determining levels of internal variables and act as if there were homeostatic comparators ("homeostats"). The consequences of models with vs. without homeostats remain the same in terms of allostatic load and the eventual switch from stabilizing negative feedback loops to destabilizing, pathogenic positive feedback loops. Understanding this switch seems important for comprehending senescence-related, neurodegenerative disorders that involve the autonomic nervous system. Our general proposal is that disintegration of homeostatic systems causes disorders of regulation in degenerative diseases and that medical cybernetics can inspire and rationalize new approaches to treatment and prevention.
Topics: Animals; Autonomic Nervous System; Cybernetics; Homeostasis; Humans
PubMed: 28918243
DOI: 10.1016/j.autneu.2017.09.001