Autonomic Neuroscience: Basic and Clinical

Stroke is one of the leading causes of death and disability globally. A significant proportion of stroke survivors are left with long term neurological deficits that have a detrimental effect on personal wellbeing and wider socioeconomic impacts. As such, there is an unmet need for novel therapies that improve neurological recovery after stroke. Invasive vagus nerve stimulation (VNS) paired with rehabilitation has been shown to improve upper limb motor function in chronic stroke. However, invasive VNS requires a surgical procedure and therefore may not be suitable for all stroke patients. Non-invasive, transcutaneous VNS (tVNS) via auricular vagus nerve stimulation in the ear (taVNS) and cervical vagus nerve stimulation in the neck (tcVNS) have been shown to activate similar vagal nerve projections in the central nervous system to invasive VNS. A number of pre-clinical studies indicate that tVNS delivered in acute middle cerebral artery occlusion reduces infarct size through anti-inflammatory effects, reduced excitotoxicity and increased blood-brain barrier integrity. Longer term effects of tVNS in stroke that may mediate neuroplasticity include microglial polarisation, angiogenesis and neurogenesis. Pilot clinical trials of taVNS indicate that taVNS paired with rehabilitation may improve upper limb motor and sensory function in patients with chronic stroke. In this review, we summarise and critically appraise the current pre-clinical and clinical evidence, outline the major ongoing clinical trials and detail the challenges and future directions regarding tVNS in acute and chronic stroke.

Sheharyar S Baig

Marharyta Kamarova

Ali Ali

Li Su

Jesse Dawson

Jessica N Redgrave

Arshad Majid

Autonomic neuroscience : basic & clinical

Auton Neurosci

Transcutaneous vagus nerve stimulation (tVNS) in stroke: the evidence, challenges and future directions.

经皮迷走神经刺激在卒中治疗中的证据、挑战与未来方向。

Cardiac sympathetic blockade is a therapeutic approach for arrhythmias and heart failure and may be a beneficial effect of high thoracic epidural anesthesia. These treatments require detailed knowledge of the spatial location and distribution of cardiac autonomic nerves, however, there are controversies on this subject in humans.To provide a systematic overview of current knowledge on human anatomy of the cardiac autonomic nervous system.In contrast to the often claimed assumption that human preganglionic sympathetic cardiac neurons originate mainly from thoracic spinal segments T1-T4 or T5, there is ample evidence indicating involvement of cervical spinal segment C8 and thoracic spinal segments below T5. Whether cervical ganglia besides the stellate ganglion play a role in transmission of cardiac sympathetic signals is unclear. Similarly, there is debate on the origin of cardiac nerves from different thoracic ganglia. Most human studies report thoracic cardiac nerves emerging from the first to fourth thoracic paravertebral ganglia; others report contributions from the fifth, sixth and even the seventh thoracic ganglia. There is no agreement on the precise composition of nerve plexuses at the cardiac level. After years of debate, it is generally accepted that the vagal nerve contributes to ventricular innervation. Vagal distribution appears higher in atria, whereas adrenergic fibers exceed the number of vagal fibers in the ventricles.Anatomy of the human cardiac autonomic nervous system is highly variable and likely extends beyond generally assumed boundaries. This information is relevant for thoracic epidural anesthesia and procedures targeting neuronal modulation of cardiac sympathetic innervation.

J. Wink

R. van Delft

R.G.E. Notenboom

P.F. Wouters

M.C. DeRuiter

J.W.M. Plevier

M.R.M. Jongbloed

Autonomic Neuroscience

Human adult cardiac autonomic innervation: Controversies in anatomical knowledge and relevance for cardiac neuromodulation

人类成年心脏自主神经支配：解剖学知识中的争议及其对心脏神经调节的相关性

The sympathetic innervation of the gastrointestinal (GI) tract regulates motility, secretion and blood flow by inhibiting the activity of the enteric nervous system (ENS) and direct vasoconstrictor innervation of the gut microvasculature. In addition to these well-established roles, there is evidence that the sympathetic nervous system (SNS) can modulate GI inflammation. Postganglionic sympathetic neurons innervate lymphoid tissues and immune cells within the GI tract. Furthermore, innate and adaptive immune cells express receptors for sympathetic neurotransmitters. Activation of these receptors can affect a variety of important immune cell functions, including cytokine release and differentiation of helper T lymphocyte subsets. This review will consider the neuroanatomical evidence of GI immune cell innervation by sympathetic axons, the effects of blocking or enhancing SNS activity on GI inflammation, and the converse modulation of sympathetic neuroanatomy and function by GI inflammation.

Andrea L Cervi

Mark K Lukewich

Alan E Lomax

Neural regulation of gastrointestinal inflammation: role of the sympathetic nervous system.

神经调节胃肠道炎症：交感神经系统的作用。

The sympathetic nervous system has an important role in generating pain. Various pathomechanisms are involved that respond well to the application of local anesthetics (LA), for example to the stellate ganglion block (SGB).We wanted to know more about the effects of SGB on cardiovascular parameters.We included 15 healthy volunteers; another 15 healthy volunteers as a control group (sham injection of LA). In order to produce a more precise SGB, we employed only a small volume of LA (3mL), a LA with a lower permeability (procaine 1%), and a modified injection technique. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and echocardiographic parameters were recorded before and after SGB. We also investigated whether there are side differences (left and right SBG).At baseline all parameters were within the normal range. After performing right and left SGB DBP significantly increased (on the right side from 68.73±8.61 to 73.53±11.10, p=0.015; on the left side from 70.66±13.01 to 77.93±10.40, p=0.003). In the control group no increase in DBP was observed. No side-specific differences were found, except a significant reduction in the maximum velocity of myocardial contraction during the systole with left-sided SGB.Even with our methods we could not prevent the simultaneous occurrence of a partial parasympatholytic effect. For this reason, the SGB has only minor hemodynamic effects, which is desirable as it enhances the safety of the SGB.

Katia Puente de la Vega Costa

Miquel A. Gómez Perez

Cristina Roqueta

Lorenz Fischer

Effects on hemodynamic variables and echocardiographic parameters after a stellate ganglion block in 15 healthy volunteers

星状神经节阻滞对15名健康志愿者血流动力学变量和超声心动图参数的影响

Diabetic autonomic neuropathy affects the entire autonomic nervous system and can lead to dysfunction of the cardiovascular, gastrointestinal, and genitourinary organ systems. Genitourinary dysfunction associated with diabetic autonomic neuropathy includes diabetic bladder dysfunction, sexual dysfunction, and recurrent urinary tract infections. Urological complications in diabetes mellitus are very common; in fact, genitourinary complications are more common than diabetic neuropathy or nephropathy. While several studies have reported on genitourinary dysfunction in individuals with diabetes, UroEDIC, an ancillary study to the Diabetes Control and Complications Trial (DCCT) and its observational follow up, the Epidemiology of Diabetes Interventions and Complications study (EDIC), comprehensively characterized the association between urologic complications and cardiovascular autonomic neuropathy. UroEDIC demonstrated significant associations between autonomic neuropathy and urologic complications in type 1 diabetes, specifically erectile dysfunction, female sexual dysfunction, and lower urinary tract symptoms. In this narrative review, we review the current literature on urological complications in diabetes.

Nnenaya Agochukwu-Mmonu

Rodica Pop-Busui

Hunter Wessells

Aruna V. Sarma

Autonomic neuropathy and urologic complications in diabetes

糖尿病中的自主神经病变和泌尿系统并发症

Margherita Barbetti

Cristina Ottaviani

Julian F. Thayer

Andrea Sgoifo

Luca Carnevali

Sex differences in heart rate and heart rate variability responses to transcutaneous auricular vagal nerve stimulation in rats

大鼠经耳迷走神经刺激引起的心率和心率变异性反应的性别差异

Alaina C. Glasgow

Joon Young Kim

Metabolic targets in the Postural Orthostatic Tachycardia Syndrome: A short thematic review

直立性心动过速综合征的代谢靶点：一个简短的主题综述

An imbalance between cardiovascular parasympathetic and sympathetic activity towards sympathetic predominance has been implicated in the pathogenesis of treatment-resistant arterial hypertension and heart failure. Arterial baroreceptors control efferent cardiovascular autonomic activity and have, therefore, been recognized as potential treatment targets. Baroreflex activation therapy through electrical carotid sinus stimulation is a device-based approach to modulate cardiovascular autonomic activity. Electrical carotid sinus stimulation lowered blood pressure in various hypertensive animal models and improved cardiac remodeling and survival in preclinical models of heart failure. In human mechanistic profiling studies, electrical carotid sinus stimulation lowered blood pressure through sympathetic inhibition with substantial inter-individual variability. The first-generation device reduced blood pressure in controlled and uncontrolled clinical trials. Controlled clinical trials proving efficacy in blood pressure reduction in patients with hypertension do not exist for the currently available second-generation carotid sinus stimulator. Investigations in heart failure patients showed improved symptoms, quality of life, and natriuretic peptide biomarkers. Electrical carotid sinus stimulation is an interesting technology to modulate cardiovascular autonomic control. However, controlled trials with hard clinical endpoints are required.

Jens Jordan

Jens Tank

Karsten Heusser

Hannes Reuter

Baroreflex activation therapy through electrical carotid sinus stimulation

通过电刺激颈动脉窦的血压反射激活疗法

Luiz Fernando Veríssimo

Fernando Henrique Ferrari Alves

Viviane Batista Estrada

Leonardo Andre da Costa Marques

Karoliny Coelho Andrade

Amanda Monteiro Bonancea

Natália Tavares Okano

Fernando Morgan de Aguiar Corrêa

Gislaine Garcia Pelosi

Cardiovascular effects of early maternal separation and escitalopram treatment in rats with depressive-like behaviour

早期母婴分离及艾司西酞普兰治疗对抑郁样行为大鼠心血管效应的影响

Kohlton Bendowski

Yuanyuan Zhang

Ariege Bizanti

Duyen Nguyen

Adhithyaa Nair

Jichao Ma

Jin Chen

Zixi Jack Cheng

Distribution and morphology of CGRP-IR axons in flat-mounts of whole male and female mouse atria

雄性和雌性小鼠心房整体铺片的CGRP-IR轴突分布与形态

Abbreviation	Auton. Neurosci.
Journal Impact	3.39
Quartiles(Global)	NEUROSCIENCES(Q2)

ISSN	1566-0702, 1872-7484
h-index	93

Publication Information	Publisher: Elsevier B.V.，Publishing cycle: Monthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2000，Proportion of original research papers: 54.79%，Self Citation Rate:3.10%， Gold OA Rate: 18.36%
Average review cycle	网友分享经验：较慢,6-12周
Average recruitment ratio	网友分享经验：较易

Autonomic Neuroscience: Basic and Clinical

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