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Current Psychiatry Reports Jun 2024In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors. (Review)
Review
PURPOSE OF REVIEW
In this narrative review we wanted to describe the relationship of autonomic nervous system activity with social environment and suicidal spectrum behaviors.
RECENT FINDINGS
Patients with suicidal ideation/suicide attempt have higher sympathetic nervous system (SNS) and lower parasympathetic nervous system (PNS) activity in resting conditions and during acute stress tasks compared with patients without suicidal ideation/suicide attempt. Death by suicide and violent suicide attempt also are related to SNS hyperactivation. Similarly, a SNS/PNS imbalance has been observed in people with childhood trauma, stressful life events or feelings of loneliness and isolation. Social support seems to increase PNS control and resilience. Due to the importance of the social context and stressful life events in suicidal behavior, SNS/PNS imbalance could act as a mediator in this relationship and be a source of relevant biomarkers. Childhood trauma and stressful life events may impair the autonomic nervous system response in suicidal patients. Loneliness, isolation and social support may act as moderators in acute stress situations.
Topics: Humans; Stress, Psychological; Social Isolation; Autonomic Nervous System; Suicidal Ideation; Suicide, Attempted; Autonomic Nervous System Diseases; Loneliness
PubMed: 38717659
DOI: 10.1007/s11920-024-01503-6 -
Life Sciences Nov 2023Abnormal cardiac metabolism or cardiac metabolic remodeling is reported before the onset of heart failure with reduced ejection fraction (HFrEF) and is known to trigger... (Review)
Review
Abnormal cardiac metabolism or cardiac metabolic remodeling is reported before the onset of heart failure with reduced ejection fraction (HFrEF) and is known to trigger and maintain the mechanical dysfunction and electrical, and structural abnormalities of the ventricle. A dysregulated cardiac autonomic tone characterized by sympathetic overdrive with blunted parasympathetic activation is another pathophysiological hallmark of HF. Emerging evidence suggests a link between autonomic nervous system activity and cardiac metabolism. Chronic β-adrenergic activation promotes maladaptive metabolic remodeling whereas cholinergic activation attenuates the metabolic aberrations through favorable modulation of key metabolic regulatory molecules. Restoration of sympathovagal balance by neuromodulation strategies is emerging as a novel nonpharmacological treatment strategy in HF. The current review attempts to evaluate the 'neuro-metabolic axis' in HFrEF and whether neuromodulation can mitigate the adverse metabolic remodeling in HFrEF.
Topics: Humans; Heart Failure; Stroke Volume; Heart; Autonomic Nervous System; Cholinergic Agents
PubMed: 37774940
DOI: 10.1016/j.lfs.2023.122122 -
Seminars in Pediatric Neurology Oct 2023THE CRITICAL ROLE OF THE CENTRAL AUTONOMIC NERVOUS SYSTEM IN FETAL-NEONATAL TRANSITION: Sarah B. Mulkey, Adre dú Plessis Seminars in Pediatric Neurology Volume 28,...
THE CRITICAL ROLE OF THE CENTRAL AUTONOMIC NERVOUS SYSTEM IN FETAL-NEONATAL TRANSITION: Sarah B. Mulkey, Adre dú Plessis Seminars in Pediatric Neurology Volume 28, December 2018, Pages 29-37 The objective of this article is to understand the complex role of the central autonomic nervous system in normal and complicated fetal-neonatal transition and how autonomic nervous system dysfunction can lead to brain injury. The central autonomic nervous system supports coordinated fetal transitional cardiovascular, respiratory, and endocrine responses to provide safe transition of the fetus at delivery. Fetal and maternal medical and environmental exposures can disrupt normal maturation of the autonomic nervous system in utero, cause dysfunction, and complicate fetal-neonatal transition. Brain injury may both be caused by autonomic nervous system failure and contribute directly to autonomic nervous system dysfunction in the fetus and newborn. The central autonomic nervous system has multiple roles in supporting transition of the fetus. Future studies should aim to improve real-time monitoring of fetal autonomic nervous system function and in supporting typical autonomic nervous system development even under complicated conditions.
Topics: Infant, Newborn; Child; Humans; Autonomic Nervous System; Fetus; Brain Injuries
PubMed: 37919029
DOI: 10.1016/j.spen.2023.101081 -
Cephalalgia : An International Journal... Aug 2023The management of cluster headache is similar to that of other primary headache disorders and can be broadly divided into acute and preventive treatments. Acute... (Review)
Review
BACKGROUND
The management of cluster headache is similar to that of other primary headache disorders and can be broadly divided into acute and preventive treatments. Acute treatments for cluster headache are primarily delivered via rapid, non-oral routes (such as inhalation, nasal, or subcutaneous) while preventives include a variety of unrelated treatments such as corticosteroids, verapamil, and galcanezumab. Neuromodulation is becoming an increasingly popular option, both non-invasively such as vagus nerve stimulation when medical treatment is contraindicated or side effects are intolerable, and invasively such as occipital nerve stimulation when medical treatment is ineffective. Clinically, this collection of treatment types provides a range of options for the informed clinician. Scientifically, this collection provides important insights into disease mechanisms.
METHODS
Two authors performed independent narrative reviews of the literature on guideline recommendations, clinical trials, real-world data, and mechanistic studies.
RESULTS
Cluster headache is treated with acute treatments, bridge treatments, and preventive treatments. Common first-line treatments include subcutaneous sumatriptan and high-flow oxygen as acute treatments, corticosteroids (oral or suboccipital injections) as bridge treatments, and verapamil as a preventive treatment. Some newer acute (non-invasive vagus nerve stimulation) and preventive (galcanezumab) treatments have excellent clinical trial data for episodic cluster headache, while other newer treatments (occipital nerve stimulation) have been specifically tested in treatment-refractory chronic cluster headache. Most treatments are suspected to act on the trigeminovascular system, the autonomic system, or the hypothalamus.
CONCLUSIONS
The first-line treatments have not changed in recent years, but new treatments have provided additional options for patients.
Topics: Humans; Cluster Headache; Oxygen; Sumatriptan; Autonomic Nervous System; Drug-Related Side Effects and Adverse Reactions
PubMed: 37652457
DOI: 10.1177/03331024231196808 -
International Journal of... Oct 2023Evidence suggests affective disorders such as depression and bipolar disorder are characterised by dysregulated autonomic nervous system (ANS) activity. These findings... (Review)
Review
Evidence suggests affective disorders such as depression and bipolar disorder are characterised by dysregulated autonomic nervous system (ANS) activity. These findings suggest ANS dysregulation may be involved in the pathogenesis of affective disorders. Different affective states are characterised by different ANS activity patterns (i.e., an increase or decrease in sympathetic or parasympathetic activity). To understand how ANS abnormalities are involved in the development of affective disorders, it is important to understand how affective states correlate with ANS activity before their onset. Using heart rate variability (HRV) as a tool to measure ANS activity, this review aimed to look at associations between affective states and HRV in non-clinical populations (i.e., in those without medical and psychiatric disorders). Searches on PubMed and Google Scholar were completed using the following search terms: heart rate variability, autonomic nervous system, sympathetic nervous system, parasympathetic nervous system, affective state, mood and emotion in all possible combinations. All but one of the studies examined (N = 13), demonstrated significant associations between affect and HRV. Findings suggest negative affect, encompassing both diffused longer-term experiences (i.e., mood) as well as more focused short-term experiences (i.e., emotions), may be associated with a reduction in parasympathetic activity as measured through HRV parameters known to quantify parasympathetic activity (e.g., high frequency (HF)-HRV). HRV measures typically linked to reduction in parasympathetic activity appear to be linked to negative affective states in non-clinical populations. However, given the complex and possibly non-linear relationship between HRV and parasympathetic activity, further studies need to clarify specificity of these findings. Future studies should investigate the potential utility of HRV measures as biomarkers for monitoring changes in affective states and for early detection of onset and relapse of depression in patients with affective disorders.
Topics: Humans; Heart Rate; Autonomic Nervous System; Parasympathetic Nervous System; Sympathetic Nervous System; Affect
PubMed: 37543289
DOI: 10.1016/j.ijpsycho.2023.08.001 -
Parkinsonism & Related Disorders May 2024We recently proposed a new disease model of Parkinson's disease - the a-Synuclein Origin site and Connectome model. The model posits that the initial pathology starts... (Review)
Review
We recently proposed a new disease model of Parkinson's disease - the a-Synuclein Origin site and Connectome model. The model posits that the initial pathology starts either in the olfactory bulb or amygdala leading to a brain-first subtype, or in the enteric nervous system leading to a body-first subtype. These subtypes should be distinguishable early in the disease course on a range of imaging, clinical, and neuropathological markers. Here, we review recent original human studies, which tested the predictions of the model. Molecular imaging studies were generally in agreement with the model, whereas structural imaging studies, such as MRI volumetry, showed conflicting findings. Most large-scale clinical studies were supportive, reporting clustering of relevant markers of the body-first subtype, including REM-sleep behavior disorder, constipation, autonomic dysfunction, neuropsychiatric symptoms, and cognitive impairment. Finally, studies of a-synuclein deposition in antemortem and postmortem tissues revealed distribution of pathology, which generally supports the model.
Topics: Humans; Parkinson Disease; alpha-Synuclein; Brain; Connectome; Enteric Nervous System
PubMed: 38519273
DOI: 10.1016/j.parkreldis.2024.106101 -
Brain and Nerve = Shinkei Kenkyu No... Nov 2023This paper reviews patterns of heart rate variability and mechanisms of allostasis. The paper focuses on traditional autonomic nervous system and brain-heart axis... (Review)
Review
This paper reviews patterns of heart rate variability and mechanisms of allostasis. The paper focuses on traditional autonomic nervous system and brain-heart axis research, recent biological measurements, and ambulatory electrocardiogram (ECG) big data analysis. The importance of biological measurement of daily activities and the results of data-driven research that analyzes ECG big data will provide new insights into the use of bio-signals.
Topics: Humans; Heart Rate; Allostasis; Autonomic Nervous System; Brain
PubMed: 37936429
DOI: 10.11477/mf.1416202510 -
JACC. Clinical Electrophysiology Sep 2023Although the autonomic reaction such as bradycardia is observed frequently during pulsed-field ablation (PFA)-guided pulmonary vein isolation (PVI), its mechanism and...
BACKGROUND
Although the autonomic reaction such as bradycardia is observed frequently during pulsed-field ablation (PFA)-guided pulmonary vein isolation (PVI), its mechanism and effect on the adjacent intrinsic cardiac autonomic nervous system (ICANS) are unclear.
OBJECTIVES
This study aimed to reveal the clinical impact of PFA on ICANS by investigating the serum S100 increase (ΔS100), a well-known denervation relevant biomarker.
METHODS
Pre- and postprocedural serum S100 analyses were systematically conducted in patients undergoing PVI using either the pentaspline PFA or cryoballoon ablation (CBA) system. ΔS100 release kinetics were compared between both technologies. Cerebral magnetic resonance imaging was conducted to eliminate the effect of central nervous system release.
RESULTS
A total of 97 patients (PFA: n = 54 and CBA: n = 43) were enrolled. Overall S100 increased in both groups with a lower amount in PFA (0.035 μg/L; IQR: 0.02-0.063 μg/L) compared with CBA (0.12 μg/L; IQR: 0.09-0.17 μg/L; P < 0.0001). In cerebral magnetic resonance imaging, silent emboli were detected in 10 patients (18.5%) in PFA and 7 patients (16.3%) in CBA (P = 0.773). Even after excluding patients with cerebral emboli, ΔS100 was lower in PFA. During PFA PVI, 30 patients (56%) demonstrated transient bradycardia in 70 of 210 PVs (35%). ΔS100 was similar between patients with or without transient bradycardia.
CONCLUSIONS
We report a significantly lower S100 release following PFA PVI vs CBA PVI even if silent cerebral emboli were excluded. Notably, vagal response during PFA was not associated with S100 release. These observations are in line with lower nervous tissue destruction of PFA compared with CBA.
Topics: Humans; Bradycardia; Pulmonary Veins; Intracranial Embolism; Heart; Autonomic Nervous System
PubMed: 37480870
DOI: 10.1016/j.jacep.2023.05.035 -
CNS Neuroscience & Therapeutics Feb 2024Autonomic dysfunction with central autonomic network (CAN) damage occurs frequently after intracerebral hemorrhage (ICH) and contributes to a series of adverse outcomes.... (Review)
Review
AIMS
Autonomic dysfunction with central autonomic network (CAN) damage occurs frequently after intracerebral hemorrhage (ICH) and contributes to a series of adverse outcomes. This review aims to provide insight and convenience for future clinical practice and research on autonomic dysfunction in ICH patients.
DISCUSSION
We summarize the autonomic dysfunction in ICH from the aspects of potential mechanisms, clinical significance, assessment, and treatment strategies. The CAN structures mainly include insular cortex, anterior cingulate cortex, amygdala, hypothalamus, nucleus of the solitary tract, ventrolateral medulla, dorsal motor nucleus of the vagus, nucleus ambiguus, parabrachial nucleus, and periaqueductal gray. Autonomic dysfunction after ICH is closely associated with neurological functional outcomes, cardiac complications, blood pressure fluctuation, immunosuppression and infection, thermoregulatory dysfunction, hyperglycemia, digestive dysfunction, and urogenital disturbances. Heart rate variability, baroreflex sensitivity, skin sympathetic nerve activity, sympathetic skin response, and plasma catecholamine concentration can be used to assess the autonomic functional activities after ICH. Risk stratification of patients according to autonomic functional activities, and development of intervention approaches based on the restoration of sympathetic-parasympathetic balance, would potentially improve clinical outcomes in ICH patients.
CONCLUSION
The review systematically summarizes the evidence of autonomic dysfunction and its association with clinical outcomes in ICH patients, proposing that targeting autonomic dysfunction could be potentially investigated to improve the clinical outcomes.
Topics: Humans; Autonomic Nervous System; Sympathetic Nervous System; Autonomic Nervous System Diseases; Vagus Nerve; Cerebral Hemorrhage; Heart Rate
PubMed: 38372446
DOI: 10.1111/cns.14544 -
Clinical Autonomic Research : Official... Dec 2023Pediatric patients with autonomic dysfunction and orthostatic intolerance (OI) often present with co-existing symptoms and signs that might or might not directly relate... (Review)
Review
PURPOSE
Pediatric patients with autonomic dysfunction and orthostatic intolerance (OI) often present with co-existing symptoms and signs that might or might not directly relate to the autonomic nervous system. Our objective was to identify validated screening instruments to characterize these comorbidities and their impact on youth functioning.
METHODS
The Pediatric Assembly of the American Autonomic Society reviewed the current state of practice for identifying symptom comorbidities in youth with OI. The assembly includes physicians, physician-scientists, scientists, advanced practice providers, psychologists, and a statistician with expertise in pediatric disorders of OI. A total of 26 representatives from the various specialties engaged in iterative meetings to: (1) identify and then develop consensus on the symptoms to be assessed, (2) establish committees to review the literature for screening measures by member expertise, and (3) delineate the specific criteria for systematically evaluating the measures and for making measure recommendations by symptom domains.
RESULTS
We review the measures evaluated and recommend one measure per system/concern so that assessment results from unrelated clinical centers are comparable. We have created a repository to apprise investigators of validated, vetted assessment tools to enhance comparisons across cohorts of youth with autonomic dysfunction and OI.
CONCLUSION
This effort can facilitate collaboration among clinical settings to advance the science and clinical treatment of these youth. This effort is essential to improving management of these vulnerable patients as well as to comparing research findings from different centers.
Topics: Adolescent; Humans; Child; Autonomic Nervous System Diseases; Orthostatic Intolerance; Autonomic Nervous System
PubMed: 37733160
DOI: 10.1007/s10286-023-00984-4