-
Annals of Neurology Apr 1977A 9-year-old boy presented with symptoms and signs of marked postganglionic cholinergic autonomic dysfunction manifested by bilateral internal ophthalmoplegia, impaired...
A 9-year-old boy presented with symptoms and signs of marked postganglionic cholinergic autonomic dysfunction manifested by bilateral internal ophthalmoplegia, impaired secretion of tears and saliva, lack of gastrointestinal motility, atony of the bladder, generalized absence of sweating, and hypertension. Clinical and pharmacological studies confirmed that the abnormalities were restricted mainly to the postganglionic cholinergic autonomic system and showed evidence of postdenervation supersensitivity to parasympathomimetic drugs. The patient was treated in the early phase of his illness by the administration of carbachol, and eventually he made a slow and partial spontaneous recovery. Histoimmunofluorescent studies on a skin biopsy specimen suggested an autoimmune origin for his disease, with IgG antibodies being produced against postganglionic cholinergic autonomic fibers.
Topics: Autoimmune Diseases; Autonomic Fibers, Postganglionic; Child; Cholinergic Fibers; Fluorescent Antibody Technique; Hemodynamics; Humans; Male; Nervous System Diseases; Parasympathetic Nervous System; Reflex, Pupillary
PubMed: 363043
DOI: 10.1002/ana.410010411 -
Brain Research. Brain Research Reviews Jul 1995The motor outflow of the autonomic nervous system (ANS) is differentiated into two major divisions, parasympathetic (PSNS) and sympathetic (SNS). Both are organized... (Review)
Review
The motor outflow of the autonomic nervous system (ANS) is differentiated into two major divisions, parasympathetic (PSNS) and sympathetic (SNS). Both are organized hierarchically into pre- and postganglionic levels, but classically the two divisions have been assumed to differ in their ratios of pre- to postganglionic neurons. The PSNS been characterized as having lower ('one-to-few') ratios, whereas the SNS has been described as possessing higher ('one-to-many') ratios. These patterns have been assumed to measure differing divergences of the outflows. In this review, a ratio of pre- to postganglionic neurons is called a ratio index, and the idea that the PSNS and SNS have characteristically different ratio indexes and divergences is called the ratio rule. The putative differences in the ratio indexes of the two divisions - as well as Fulton's influential proposal that they form one of the bases of contrasting functional capacities of the PSNS and SNS - have been widely accepted for nearly for nearly three quarters of a century. A survey of the original observations yielding the concept of the ratio rule as well as the more recent estimates of pre- and postganglionic numbers, however, challenges both the generality and the adequacy of the ratio rule and indexes. The originally formulated differences between the PSNS and SNS represent an overgeneralization since they were based on observations of only two ganglia, the ciliary ganglion in the PSNS and the superior cervical ganglion in the SNS. Furthermore, these original estimates were based on limited samples and were subject to a number of counting artifacts. A survey of the literature suggests that ratio indexes vary much more within each ANS division than they do between the two divisions. When ganglia other than the ciliary and superior cervical are examined, the two divisions of the ANS have broad, largely overlapping ranges of ratio indexes. Additionally, other PSNS-SNS pairs can be found in which the relative sizes of their respective indexes are completely contrary to the ratio rule. For a given ganglion, there are substantial differences in the ratio index between species, between individuals of the same species, and between stages of development in the same species. Furthermore, both divisions of the ANS have wide and largely overlapping ranges of physiological effects varying from specific to diffuse, from local to widespread. Finally, the ratio index measure ignores the degree of convergence found in different ganglia, and it is insensitive to the fact that many ganglia have multiple functionally distinct motor neuron pools, each with separate inputs varying in their degrees of divergence and/or convergence. Thus ratio indexes do not differentiate the PSNS from the SNS, and conclusions based on such putative distinctions are questionable.
Topics: Animals; Autonomic Fibers, Postganglionic; Autonomic Nervous System; Humans; Neurons
PubMed: 8547955
DOI: 10.1016/0165-0173(95)00006-o -
American Journal of Physiology. Cell... Jan 2014
Molecular mechanisms of dysautonomia during heart failure. Focus on "Heart failure-induced changes of voltage-gated Ca2+ channels and cell excitability in rat cardiac postganglionic neurons".
Topics: Action Potentials; Animals; Autonomic Fibers, Postganglionic; Calcium Channels, N-Type; Heart Failure; Male; Stellate Ganglion
PubMed: 24108866
DOI: 10.1152/ajpcell.00311.2013 -
Annals of Neurology Sep 1985We describe the cases of eight patients with chronic idiopathic anhidrosis. These patients were heat intolerant and became hot, flushed, dizzy, dyspneic, and weak but...
We describe the cases of eight patients with chronic idiopathic anhidrosis. These patients were heat intolerant and became hot, flushed, dizzy, dyspneic, and weak but did not sweat when the ambient temperature was high or when they exercised. Four patients had preganglionic sudomotor lesions and in the remaining 4 the lesion appeared to be postganglionic. The patients did not have orthostatic hypotension, other evidence of generalized autonomic failure, or symptomatic somatic neuropathy. One patient regained thermoregulatory sweat function and no patient's condition progressed to generalized autonomic failure. Chronic idiopathic anhidrosis appears to be distinctly different from other autonomic neuropathies that tend to carry much poorer prognoses.
Topics: Adult; Autonomic Fibers, Postganglionic; Autonomic Fibers, Preganglionic; Autonomic Nervous System; Blood Pressure; Body Temperature Regulation; Chronic Disease; Female; Heart Rate; Humans; Hypohidrosis; Male; Middle Aged; Prognosis; Reflex, Pupillary; Sweating
PubMed: 4051460
DOI: 10.1002/ana.410180312 -
Autonomic Neuroscience : Basic &... Jul 2011The use of microneurography to measure muscle sympathetic nerve activity has provided important insights in human physiology. However, placing microelectrodes into... (Review)
Review
The use of microneurography to measure muscle sympathetic nerve activity has provided important insights in human physiology. However, placing microelectrodes into nerves can be challenging, particularly in certain patient populations. In this paper, we describe the use of real-time ultrasound guidance to assist with microneurography, including advantages, disadvantages, and proper training.
Topics: Autonomic Fibers, Postganglionic; Computer Systems; Humans; Microelectrodes; Peroneal Nerve; Radial Nerve; Sympathetic Nervous System; Ultrasonography
PubMed: 21514900
DOI: 10.1016/j.autneu.2011.03.007 -
Physiological Reviews Jan 1971
Review
Topics: Adrenal Glands; Adrenal Medulla; Autonomic Fibers, Postganglionic; Axonal Transport; Axons; Centrifugation, Density Gradient; Cytoplasmic Granules
PubMed: 4100392
DOI: 10.1152/physrev.1971.51.1.98 -
Archives of Neurology Apr 2011To evaluate postganglionic autonomic and somatic nerve fiber involvement in a patient with chronic autoimmune autonomic ganglionopathy.
OBJECTIVE
To evaluate postganglionic autonomic and somatic nerve fiber involvement in a patient with chronic autoimmune autonomic ganglionopathy.
DESIGN
Case report.
SETTING
Department of Neurological Sciences, University Federico II of Naples.
PATIENT
A patient with a 16-year history of severe autonomic failure and a high nicotinic acetylcholine receptor antibody titer underwent an extensive laboratory evaluation.
MAIN OUTCOME MEASURES
Evaluation of sympathetic and parasympathetic functions and sural nerve and skin biopsies.
RESULTS
Clinical and laboratory evaluations showed the involvement of cardiovascular, pupillary, sudomotor, gastrointestinal, and bladder functions. Sudomotor function study and skin biopsy findings revealed postganglionic autonomic damage. Moreover, sural nerve and skin biopsy specimens provided clear evidence of somatic nerve fiber involvement.
CONCLUSIONS
We demonstrated postganglionic autonomic damage that could be related to a prolonged and severe impaired synaptic transmission and we report, for the first time to our knowledge, a somatic nerve fiber involvement in autoimmune autonomic ganglionopathy.
Topics: Autoimmune Diseases; Ganglia, Autonomic; Humans; Male; Middle Aged; Polyneuropathies; Sympathetic Fibers, Postganglionic
PubMed: 21482929
DOI: 10.1001/archneurol.2011.60 -
British Journal of Anaesthesia Feb 1982
Review
Topics: Acetylcholine; Animals; Autonomic Fibers, Postganglionic; Cholinesterase Inhibitors; Ganglia, Autonomic; Heart; Hemodynamics; Histamine Release; Humans; Muscle Spindles; Neuromuscular Blocking Agents; Norepinephrine; Receptors, Muscarinic; Receptors, Nicotinic; Vagus Nerve
PubMed: 6174134
DOI: 10.1093/bja/54.2.147 -
Neurology Jun 2014To evaluate postganglionic autonomic involvement in multiple system atrophy (MSA).
OBJECTIVE
To evaluate postganglionic autonomic involvement in multiple system atrophy (MSA).
METHODS
We quantified sudomotor innervation in skin biopsy of 29 patients with MSA (19 male and 10 female; age 60.0 ± 7.7 years) and 29 age- and sex-matched healthy subjects. Samples were obtained from thigh and leg and, in 20 out of the 29 cases, also from fingertip. Dysautonomic complaints were evaluated by SCOPA-AUT, a self-administered questionnaire. Sudomotor function was evaluated in a subgroup of patients by the silastic imprint test. Skin samples were processed by indirect immunofluorescence using pan-neuronal and selective cholinergic markers. Total length of sudomotor nerves was measured on digital confocal images using a semiautomated morphometric approach.
RESULTS
Measurements of sudomotor nerve density (total length of nerve per volume of glandular tissue) favorably correlated to values obtained using a stereologic unbiased method. Sudomotor nerve density was lower in patients compared to controls in all the examined sites (0.9 ± 0.2 vs 1.9 ± 0.4 nm/μm(3), p < 0.001, in fingertip; 0.7 ± 0.2 vs 1.9 ± 0.5 nm/µm(3), p < 0.001, in thigh; 0.6 ± 0.2 vs 1.8 ± 0.4 nm/µm(3), p < 0.001, in leg).
CONCLUSIONS
Our data support the hypothesis that postganglionic impairment occurs in MSA and may contribute with the coexisting degeneration of central structures to the development of dysautonomic disorders in this condition.
Topics: Aged; Autonomic Denervation; Autonomic Fibers, Postganglionic; Autonomic Nervous System Diseases; Case-Control Studies; Female; Humans; Male; Middle Aged; Multiple System Atrophy; Skin; Surveys and Questionnaires
PubMed: 24838791
DOI: 10.1212/WNL.0000000000000518 -
Cold Spring Harbor Symposia on... 1976
Review
Topics: Adenylyl Cyclases; Animals; Autonomic Fibers, Postganglionic; Cattle; Cyclic AMP; Cyclic GMP; Dopamine; Ganglia; Ganglia, Autonomic; Lysergic Acid Diethylamide; Membrane Potentials; Microtubules; Neurotransmitter Agents; Phosphoproteins; Protein Kinases; Serotonin; Synapses; Synaptic Transmission; Tyrosine 3-Monooxygenase
PubMed: 7379
DOI: 10.1101/sqb.1976.040.01.017