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autonomic Nervous Function in Vasovagal Syncope of Children and Adolescents

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Neuroscience Bulletin 2019年第5期35卷 937-940页

作者： Chunyan Tao Chaoshu Tang Selena Chen Hongfang Jin Junbao Du Department of Pediatrics Peking University First Hospital Beijing 100034 China Department of Physiology and Pathophysiology Peking University Health Sciences Centre Beijing 100191 China Division of Biological Sciences University of California San Diego CA 92093 USA Key Laboratory of Molecular Cardiovascular Sciences Ministry of Education of China Beijing 100191 China

Syncope is defined as a transient loss of consciousness due to global cerebral hypoperfusion, accompanied by loss of muscle tone and failure to maintain an active position. Vasovagal syncope (VVS) is the most common presentation of syncope, and its diagnostic criteria include:(1) absence of any other evident etiology for syncope or presyncope,(2) positive response to head-up tilt test with evident vasovagal reaction (hypotension and/or bradycardia), and (3) no concomitant chronic or acute disease [1, 2]. The onset of VVS peaks initially in childhood and adolescence, and accounts for 60%–70% of all syncopal cases. Clinicians pay great attention to syncope among children and adolescents, due to its high prevalence and its impact on patients’ quality of life. Affected individuals often experience mental stress, economic burdens, and accidental bodily injuries related to syncope [2]. While the pathogenesis of VVS is not fully understood, autonomic nervous dysfunction has been identified as a contributing mechanism. The examination of autonomic nervous function can provide important information about patients with syncope.

关键词： autonomic Nervous Function Vasovagal Syncope Children Adolescents

autonomic nervous system network and liver regeneration

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World Journal of Gastroenterology 2018年第15期24卷 1616-1621页

作者： Kenya Kamimura Ryosuke Inoue Takuro Nagoya Norihiro Sakai Ryo Goto Masayoshi Ko Yusuke Niwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

To date, various signal transducers, cytokines, growth factors, and hormones have been reported to play an important role in homeostasis of various organs. Various cells and organs are involved in the hepatic regeneration process, which proceeds as a result of the coordination of many factors. While these factors are well known to be involved in the liver regeneration after the liver injury, however, as the details of such mechanisms have not been sufficiently elucidated, the practical applicability of hepatic regeneration based on the action of these and cytokines growth factors is still unclear. In terms of the involvement of the autonomic nervous system in hepatic regeneration, cell proliferation resulting from direct signal transduction to the liver has also been reported and recent studies focusing on the inter-organ communication via neural network opened a novel aspect of this field for therapeutic applicability. Therefore, the appropriate understanding of the relationship between autonomic neural network and liver regeneration through various organs including brain, afferent nerve, efferent nerve, etc. is essential. This mini-review explains the principle of neural system involved in the inter-organ communication and its contribution on the liver regeneration upon the liver injury reviewing recent progress in this field.

关键词： autonomic nerve Neural network Liver regeneration Hormone

autonomic Regulation of the Cardiovascular System: Diseases,Treatments, and Novel Approaches

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Neuroscience Bulletin 2019年第1期35卷 1-3页

作者： Zixi Jack Cheng Renjun Wang Qing-Hui Chen Burnett School of Biomedical Sciences College of MedicineUniversity of Central FloridaOrlandoFL 32816USA Department of Biotechnology School of Life ScienceJilin Normal UniversitySiping 136000China Department of Kinesiology and Integrative Physiology Michigan Technological UniversityHoughtonMI 49931-1200USA

The autonomic nervous system(ANS)integrates the involuntary physiological activities of visceral organs that are vital for survival.In particular,the ANS controls heart rate,blood pressure,breathing,gastrointestinal contraction and secretion,and electrolyte and fluid homeostasis.Many studies have focused on understanding the neural mechanisms of autonomic dysfunction or neuropathy in pathophysiological states including hypertension,heart failure.

关键词： In ANS autonomic Regulation of the Cardiovascular System Diseases,Treatments

autonomic functions and gastric motility in children with functional abdominal pain disorders

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World Journal of Gastroenterology 2019年第1期25卷 95-106页

作者： Amaranath Karunanayake Shaman Rajindrajith Hitanadura Asita de Silva Sampath Gunawardena Niranga Manjuri Devanarayana Department of Physiology Faculty of Medicine University of Ruhuna Department of Paediatrics Faculty of Medicine University of Kelaniya Department of Pharmacology Faculty of Medicine University of Kelaniya Department of Physiology Faculty of Medicine University of Kelaniya

BACKGROUND Abdominal pain-predominant functional gastrointestinal disorders(AP-FGIDs)are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood.AIM To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs.METHODS One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques.RESULTS The main gastric motility parameters assessed(gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4],and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs(P autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities(P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone(maladaptive parasympathetic tone)(Pautonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.

关键词： Abdominal pain Functional gastrointestinal disorders autonomic function Gastric motility

autonomic laterality in caloric vestibular stimulation

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World Journal of Cardiology 2020年第4期12卷 144-154页

作者： Mohammadreza Aghababaei Ziarati Mohammad Hosein Taziki Seyed Mehran Hosseini Department of Internal Medicine Medical FacultyGolestan University of Medical SciencesGorgan ***GolestanIran Department of Otolaryngology Medical FacultyGolestan University of Medical SciencesGorgan ***GolestanIran Department of Physiology Medical FacultyGolestan University of Medical SciencesGorgan ***GolestanIran Neuroscience Research Center Faculty of MedicineGolestan University of Medical SciencesGorgan ***GolestanIran

BACKGROUND Caloric stimulation of the vestibular system is associated with autonomic response.The lateralization in the nervous system activities also involves the autonomic nervous system.AIM To compare the effect of the right and left ear caloric test on the cardiac sympathovagal tone in healthy persons.METHODS This self-control study was conducted on 12 healthy male volunteers.The minimal ice water caloric test was applied for vestibular stimulation.This was done by irrigating 1 milliliter of 4±2°C ice water into the external ear canal in 1 s.In each experiment,only one ear was stimulated.For each ear,the pessimum position was considered as sham control and the optimum position was set as caloric vestibular stimulation of horizontal semicircular channel.The order of right or left caloric vestibular stimulation and the sequence of optimum or pessimum head position in each set were random.The recovery time between each calorie test was 5 min.The short-term heart rate variability(HRV)was used for cardiac sympathovagal tone metrics.All variables were compared using the analysis of variance.RESULTS After caloric vestibular stimulation,the short-term time-domain and frequencydomain HRV indices as well as,the systolic and the diastolic arterial blood pressure,the respiratory rate and the respiratory amplitude,had no significant changes.These negative results were similar in the right and the left sides.Nystagmus duration of left caloric vestibular stimulations in the optimum and the pessimum positions had significant differences(e.g.,72.14±39.06 vs 45.35±35.65,P<0.01).Nystagmus duration of right caloric vestibular stimulations in the optimum and the pessimum positions had also significant differences(e.g.,86.42±67.20 vs 50.71±29.73,P<0.01).The time of the start of the nystagmus following caloric vestibular stimulation had no differences in both sides and both positions.CONCLUSION Minimal ice water caloric stimulation of the right and left vestibular system did not affect the cardiac sympathovagal balance according to

关键词： Caloric stimulation Heart rate variability Vestibular system autonomic Laterality

Cell-Type Identification in the autonomic Nervous System

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Neuroscience Bulletin 2019年第1期35卷 145-155页

作者： Di-Shi Liu Tian-Le Xu Department of Anatomy and Physiology Shanghai Jiao Tong University School of Medicine

The autonomic nervous system controls various internal organs and executes crucial functions through sophisticated neural connectivity and circuits. Its dysfunction causes an imbalance of homeostasis and numerous human disorders. In the past decades, great efforts have been made to study the structure and functions of this system, but so far, our understanding of the classification of autonomic neuronal subpopulations remains limited and a precise map of their connectivity has not been achieved.One of the major challenges that hinder rapid progress in these areas is the complexity and heterogeneity of autonomic neurons. To facilitate the identification of neuronal subgroups in the autonomic nervous system, here we review the well-established and cutting-edge technologies that are frequently used in peripheral neuronal tracing and profiling, and discuss their operating mechanisms, advantages, and targeted applications.

关键词： autonomic nervous system Neuronal tracing Genetic marker Molecular profiling Cell-type diversity

Next-Generation Tools to Study autonomic Regulation In Vivo

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Neuroscience Bulletin 2019年第1期35卷 113-123页

作者： Snigdha Mukerjee Eric Lazartigues Department of Pharmacology and Experimental Therapeutics Louisiana State University Health Sciences Center Neuroscience and Cardiovascular Centers of Excellence Louisiana State University Health Sciences Center Southeast Louisiana Veterans Health Care System

The recent development of tools to decipher the intricacies of neural networks has improved our understanding of brain function. Optogenetics allows one to assess the direct outcome of activating a geneticallydistinct population of neurons. Neurons are tagged with light-sensitive channels followed by photo-activation with an appropriate wavelength of light to functionally activate or silence them, resulting in quantifiable changes in the periphery. Capturing and manipulating activated neuron ensembles, is a recently-designed technique to permanently label activated neurons responsible for a physiological function and manipulate them. On the other hand, neurons can be transfected with genetically-encoded Ca2^+ indicators to capture the interplay between them that modulates autonomic end-points or somatic behavior. These techniques work with millisecond temporal precision. In addition, neurons can be manipulated chronically to simulate physiological aberrations by transfecting designer G-protein-coupled receptors exclusively activated by designer drugs. In this review, we elaborate on the fundamental concepts and applications of these techniques in research.

关键词： autonomic regulation Optogenetics Calcium sensors DREADD

Quantitative autonomic function test in differentiation of multiple system atrophy from idiopathic Parkinson disease

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Chinese Medical Journal 2019年第16期132卷 1919-1924页

作者： Ji-Yun Park Dongseok Yang Hei-Jun Yang Hyun Ah Kim Saeromi Kim Deokhyun Heo Jeong-Ho Park Eek-Sung Lee Tae-Kyeong Lee Department of Neurology Ulsan University HospitalUniversity of Ulsan College of MedicineUlsan 44033Korea Department of Physical Medicine and Rehabilitation Ulsan University HospitalUniversity of Ulsan College of MedicineUlsan 44033Korea Department of Neurology Keimyu叩 University School of MedicineDaegu 42601Korea Department of Neurology College of MedicineSoonchunhyang UniversitySoonchunhyang University Bucheon HospitalBucheon 14584Korea

Background:Differential diagnosis of idiopathic Parkinson disease (IPD) and multiple system atrophy-Parkinson type (MSA-P) is challenging since they share clinical features with parkinsonism and autonomic dysfunction.To distinguish MSA-P from IPD when the symptoms are relatively mild,we investigated the usefulness of the quantitative fractionalized autonomic indexes and evaluated the correlations of autonomic test indexes and functional status.Methods:Thirty-six patients with parkinsonism (22 with IPD and 14 with MSA-P) in Soonchunhyang University Bucheon Hospital from February 2014 to June 2015 were prospectively enrolled in the study.We compared fractionalized autonomic indexes and composite autonomic scoring scale between patients with IPD and MSA-P with Hoehn and Yahr (H&Y) score ≤3.Parasympathetic indexes included expiratory/inspiratory ratio during deep breathing,Valsalva ratio (VR),and regression slope of systolic blood pressure (BP) in early phase Ⅱ (vagal baroreflex sensitivity) during Valsalva maneuver.Sympathetic adrenergic indexes were pressure recovery time (PRT) and adrenergic baroreflex sensitivity (BRSa) (BP decrement associated with phase 3 divided by the PRT),sympathetic index 1,sympathetic index 3,early phase Ⅱ mean BP drop,and pulse pressure reduction rate.Additionally,we compared the unified multiple system atrophy rating scale (UMSARS) and H&Y scores and the autonomic indexes in all patients.Results:PRT was significantly different between the IPD and MSA-P groups (P =0.004) despite the similar BP drop during tilt.Cutoff value of PRT was 5.5 s (sensitivity,71.4%;specificity,72.7%).VR (r =-0.455,P =0.009) and BRSa (r =-0.356,P =0.036) demonstrated a significant correlation with UMSARS and H&Y scores.Conclusions:Among the cardiovascular autonomic indexes,PRT can be a useful parameter in differentiating the early stage of MSA-P from that of IPD.Moreover,VR,and BRSa may be the optimal indexes in determining functional symptom severity.

关键词： Parkinson disease Multiple system atrophy autonomic dysfunction Cardiovascular autonomic indexes

Treatment of prolonged clonidine-induced autonomic instability with midodrine:a case report about a new approach or a cautionary tale?

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Emergency and Critical Care Medicine 2023年第4期3卷 194-197页

作者： Saada Malouf Catherine Henry Lara Pemberton Joe-Anthony Rotella Department of Emergency Medicine Northern HealthEppingAustralia SPECTRE(Substance Use PsychiatryEnvenomationClinical Toxicologistand REcreational substances)UnitNorthern HealthEppingAustralia Melbourne Medical School University of MelbourneParkvilleAustralia

Background:Clonidine is a centrally acting a2 adrenergic and imidazoline-1 receptor agonist that can cause somnolence,bradycardia,and hypotension within several hours of ingestion.Less well-described but observed by us locally is the observation that patients presenting after large overdoses including clonidine can have prolonged autonomic instability.As a result,they may require many days in hospital before recovery.We have previously used midodrine as an indirect antagonist with good effect;however,there are no previous reports of its use for this indication.Case presentation:We present the case of a young female patient who developed prolonged autonomic instability following a large overdose of clonidine(coingested with smaller doses of escitalopram+lisdexamfetamine)that was treated with midodrine but complicated by a type 2 non-ST segment elevated myocardial infarction.Conclusion:Midodrine seems to ameliorate this protracted instability and may provide a means to decrease hospital length of stay in appropriate individuals.

关键词： autonomic Case report Clonidine Instability Midodrine Overdose