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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 -
Anatomical Record (Hoboken, N.J. : 2007) Sep 2023The first information on the structure and function of the autonomic nervous system dates back to the time of Galen (second century), while the beginning of the study of... (Review)
Review
The first information on the structure and function of the autonomic nervous system dates back to the time of Galen (second century), while the beginning of the study of the autonomic nervous system in Russia can be traced back to the mid-19th century. This review is devoted to the professional achievements of Russian researchers in the 19th and 20th centuries who were active in the field of the autonomic nervous system at different stages of the development of neuromorphology and neurophysiology. In addition, recent achievements of modern Russian researchers active in this domain are also highlighted. This review is mainly devoted to research on the autonomic nervous system in Russia, but it would be unfair not to mention the scientists who made a significant contribution to this field of science and worked in the republics of the former USSR. Russian morphology and physiology developed under the significant influence of well-known western scientific schools. I sincerely hope that cooperation between Russian and foreign colleagues will continue and will be fruitful for global science.
Topics: History, 20th Century; History, 19th Century; Neurophysiology; Russia; Autonomic Nervous System
PubMed: 35633506
DOI: 10.1002/ar.24944 -
Journal of Anatomy Dec 2023Vagal afferent neuronal somas are in the nodose and jugular ganglia. In this study, we identified extraganglionic neurons in whole-mount preparations of the vagus nerves...
Vagal afferent neuronal somas are in the nodose and jugular ganglia. In this study, we identified extraganglionic neurons in whole-mount preparations of the vagus nerves from Phox2b-Cre-ZsGreen transgenic mice. These neurons are typically arranged in small clusters and monolayers along the cervical vagus nerve. Although infrequent, these neurons were sometimes observed along the thoracic and esophageal vagus. We performed RNAscope in situ hybridization and confirmed that the extraganglionic neurons detected in this transgenic mouse strain expressed vagal afferent markers (i.e., Phox2b and Slc17a6) as well as markers that identify them as potential gastrointestinal mechanoreceptors (i.e., Tmc3 and Glp1r). We also identified extraganglionic neurons in the vagus nerves of wild-type mice that were injected intraperitoneally with Fluoro-Gold, thereby ruling out possible anatomical discrepancies specific for transgenic mice. In wild-type mice, extraganglionic cells were positive for peripherin, confirming their neuronal nature. Taken together, our findings revealed a previously undiscovered population of extraganglionic neurons associated with the vagus nerve. Going forward, it is important to consider the possible existence of extraganglionic mechanoreceptors that transmit signals from the abdominal viscera in future studies related to vagal structure and function.
Topics: Mice; Animals; Vagus Nerve; Mechanoreceptors; Neurons, Afferent; Neurons; Mice, Transgenic
PubMed: 37403978
DOI: 10.1111/joa.13925 -
Stress (Amsterdam, Netherlands) Jan 2024The purpose of this study was to determine the relationship between fetal exposure to maternal prenatal stressors and infant parasympathetic (PNS) and sympathetic (SNS)...
OBJECTIVES
The purpose of this study was to determine the relationship between fetal exposure to maternal prenatal stressors and infant parasympathetic (PNS) and sympathetic (SNS) nervous function at 3 timepoints across the first year of life.
BACKGROUND
Autonomic nervous system impairments may mediate associations between gestational exposure to stressors and later infant health problems. Heart rate variability (HRV) provides a sensitive index of PNS and SNS function. However, no studies have assessed longitudinal associations between prenatal stressors and infant HRV measures of both PNS and SNS over the first year of life.
METHODS
During the third trimester of pregnancy, 233 women completed measures of life stressors and depression. At 1, 6 and 12 months of age, a stressor protocol was administered while infant electrocardiographic (ECG) data were collected from a baseline through a post-stressor period. HRV measures of PNS and SNS activity (HF, LF, LF/HF ratio) were generated from ECG data. We used multilevel regression to examine the aims, adjusting for maternal depression and neonatal morbidity.
RESULTS
There were no associations between prenatal stressors and any baseline or reactivity HRV metric over the infant's first year of life. However, exposure to more stressors was associated with lower post-stressor LF HRV at both 6 (β = -.44, = .001) and 12 (β = -.37, = .005) months of age.
CONCLUSIONS
Findings suggest potential alterations in development of the vagally mediated baroreflex function as a result of exposure to prenatal stressors, with implications for the infants' ability to generate a resilient recovery in response to stressors.
Topics: Infant; Infant, Newborn; Pregnancy; Humans; Female; Stress, Psychological; Autonomic Nervous System; Electrocardiography; Family; Heart Rate
PubMed: 38497496
DOI: 10.1080/10253890.2024.2327328 -
Archives of Disease in Childhood May 2024Paediatric asthma is an increasing global healthcare problem for which current treatments are not always effective. This review explores how abnormal triggering of the... (Review)
Review
Paediatric asthma is an increasing global healthcare problem for which current treatments are not always effective. This review explores how abnormal triggering of the autonomic diving reflex might be important in explaining research findings and the real-world experience of asthma. It hypothesises that the way in which stress during pregnancy is associated with childhood asthma could be through effects on the developing nervous system. This results in increased parasympathetic responsiveness and specifically, excessive triggering of the diving reflex in response to wetting and cooling of the face and nose as occurs with upper airway infections and allergic rhinitis. In aquatic mammals the reflex importantly includes the contraction of airway smooth muscle to minimise lung volume and prevent nitrogen narcosis from diving at depth. Misfiring of this reflex in humans could result in the pathological airway narrowing that occurs in asthma. The diving reflex, and possibly also smooth muscle, is a vestigial remnant of our aquatic past. The hypothesis further suggests that classically conditioned reflex responses to neutral cues and contexts that were present at the same time as the stimuli that initially caused symptoms, become of themselves ongoing triggers of recurrent wheeze. Symptoms occurring in this way, irrespective of the presence of allergens and ongoing airway sensitisation, explain why allergen avoidance is poorly effective in alleviating wheeze and why asthma is made worse by stress. Interventions to suppress the diving reflex and to prevent reflex conditioned wheezing could result in more effective asthma management.
Topics: Humans; Asthma; Respiratory Sounds; Child; Autonomic Nervous System; Female; Diving Reflex; Pregnancy; Stress, Psychological
PubMed: 37648401
DOI: 10.1136/archdischild-2023-325441 -
The Journal of Manual & Manipulative... Feb 2024Spinal manipulation (SM) has been hypothesized to influence the autonomic nervous system (ANS). Further, it has been proposed that the effects may vary depending on the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Spinal manipulation (SM) has been hypothesized to influence the autonomic nervous system (ANS). Further, it has been proposed that the effects may vary depending on the segment manipulated. The aim of this systematic review was to synthesize the current level of evidence for SM in influencing the ANS in healthy and/or symptomatic population.
METHODS
Various databases ( = 8) were searched (inception till May 2023) and 14 trials ( = 618 participants) were included in the review. Two authors independently screened, extracted and assessed the risk of bias in included studies. The data were synthesized using standard mean differences and meta-analysis for the primary outcome measures. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used for assessing the quality of the body of evidence for each outcome of interest.
RESULTS
Overall, there was low quality evidence that SM did not influence any measure of ANS including heart rate variability (HRV), oxy-hemoglobin, blood pressure, epinephrine and nor-epinephrine. However, there was low quality evidence that cervical spine manipulation may influence high frequency parameter of HRV, indicating its influence on the parasympathetic nervous system.
CONCLUSION
When compared with control or sham interventions, SM did not alter the ANS. Due to invalid methodologies and the low quality of included studies, findings must be interpreted with great caution. Future studies are needed which employ rigorous data collection processes to verify the true physiological implications of SM on ANS.
Topics: Humans; Autonomic Nervous System; Epinephrine; Heart Rate; Manipulation, Spinal; Parasympathetic Nervous System
PubMed: 38044657
DOI: 10.1080/10669817.2023.2285196 -
Applied Psychophysiology and Biofeedback Dec 2023To determine whether heart rate variability biofeedback (HRV-BF) training, compared to a psychoeducation control condition can strengthen the integration of the central... (Randomized Controlled Trial)
Randomized Controlled Trial
To determine whether heart rate variability biofeedback (HRV-BF) training, compared to a psychoeducation control condition can strengthen the integration of the central and autonomic nervous systems as measured by neuropsychological measures in patients with mild traumatic brain injury (mTBI). Participants were recruited from two university hospitals in Taipei, Taiwan. A total of 49 participants with mTBI were recruited for this study. Forty-one participants completed the study, 21 in the psychoeducation group and 20 in the HRV-BF group. Randomized controlled study. The Taiwanese Frontal Assessment Battery, the Semantic Association of Verbal Fluency Test, the Taiwanese version of the Word Sequence Learning Test, the Paced Auditory Serial Addition Test-Revised, and the Trail Making Test were used as performance-based neuropsychological functioning measures. The Checklist of Post-concussion Symptoms, the Taiwanese version of the Dysexecutive Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, and the National Taiwan University Irritability Scale were used as self-report neuropsychological functioning measures. Furthermore, heart rate variability pre- vs. post-training was used to measure autonomic nervous system functioning. Executive, information processing, verbal memory, emotional neuropsychological functioning, and heart rate variability (HRV) were improved significantly in the HRV-BF group at the posttest whereas the psychoeducation group showed no change. HRV biofeedback is a feasible technique following mild TBI that can improve neuropsychological and autonomic nervous system functioning. HRV-BF may be clinically feasible for the rehabilitation of patients with mTBI.
Topics: Humans; Brain Concussion; Heart Rate; Autonomic Nervous System; Cognition; Biofeedback, Psychology
PubMed: 37335413
DOI: 10.1007/s10484-023-09592-4 -
Anatomical Record (Hoboken, N.J. : 2007) Sep 2023The sympathetic nervous system inhibits gut motility, secretion, and blood flow in the gut microvasculature and can modulate gastrointestinal inflammation. Sympathetic... (Review)
Review
The sympathetic nervous system inhibits gut motility, secretion, and blood flow in the gut microvasculature and can modulate gastrointestinal inflammation. Sympathetic neurons signal via catecholamines, neuropeptides, and gas mediators. In the current review, we summarize the current understanding of the mature sympathetic innervation of the gastrointestinal tract with a focus mainly on the prevertebral sympathetic ganglia as the main output to the gut. We also highlight recent work regarding the developmental processes of sympathetic innervation. The anatomy, neurochemistry, and connections of the sympathetic prevertebral ganglia with different parts of the gut are considered in adult organisms during prenatal and postnatal development and aging. The processes and mechanisms that control the development of sympathetic neurons, including their migratory pathways, neuronal differentiation, and aging, are reviewed.
Topics: Gastrointestinal Tract; Sympathetic Nervous System; Ganglia, Sympathetic; Neurons
PubMed: 35762574
DOI: 10.1002/ar.25015 -
Anatomical Record (Hoboken, N.J. : 2007) Sep 2023The present contribution comprises both an introductory comment and an overview of the contributions within this special issue on historical and current research on the...
The autonomic nervous system from a morphofunctional perspective: Historical overview and current concepts over the last two centuries highlighting contributions from Eastern Europe.
The present contribution comprises both an introductory comment and an overview of the contributions within this special issue on historical and current research on the autonomic nervous system from Eastern European colleagues, particularly focusing on the autonomic innervation of the gastrointestinal tract and of the cardiovascular system. It also gives a selected overview of interesting and seminal papers on these topics that appeared in The Anatomical Record since its foundation in 1906.
Topics: Autonomic Nervous System; Gastrointestinal Tract; Europe, Eastern
PubMed: 36733228
DOI: 10.1002/ar.25169 -
Pain Medicine (Malden, Mass.) Jul 2023Stellate ganglion block (SGB) is performed to relieve head, face, neck, or upper limb pain, and several non-pain indications for performing this block have emerged over... (Review)
Review
INTRODUCTION
Stellate ganglion block (SGB) is performed to relieve head, face, neck, or upper limb pain, and several non-pain indications for performing this block have emerged over the years. To date, there has been no attempt to synthesize evidence on SGB for treating non-pain indications. This scoping review presents a summary of the efficacy and adverse effects of SGB when performed for 6 non-pain indications.
METHODS
This scoping review was accomplished through the use of Arksey and O'Malley framework. A literature search was conducted for relevant articles in medical databases to identify publications on SGB and specified study types. Two reviewers independently assessed the risk of bias for randomized controlled trials, nonrandomized comparative studies, and case series. Results were summarized and recommendations were made on the basis of the strength of the available evidence according to the US Preventative Services Task Force grading system.
RESULTS
Twenty-four studies (19 randomized controlled trials and 5 nonrandomized studies) were included in this review. On the basis of the evidence, SGB is recommended for obtunding cardiovascular sympathetic stimulation, improving perfusion in limbs, and alleviating menopausal symptoms with a Grade B or C recommendation and a moderate-to-low level of certainty. There was insufficient evidence to recommend SGB for the other indications.
CONCLUSIONS
SGB can be considered for obtunding cardiovascular sympathetic stimulation and stress response, reducing vascular tone to improve vascular insufficiency in the limbs and perioperative hemodynamic stability, and alleviating hot flashes in menopause, in conditions refractory to conventional medical management.
Topics: Female; Humans; Stellate Ganglion; Autonomic Nerve Block; Pain; Research Design
PubMed: 36727500
DOI: 10.1093/pm/pnad011