Autonomic Neuroscience: Basic and Clinical

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

Autonomic Neuroscience

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

The pathophysiology of vasovagal syncope (VVS) is reviewed, focusing on hemodynamic aspects. Much more is known about orthostatic than about emotional VVS, probably because the former can be studied using a tilt table test (TTT). Recent advances made it possible to quantify the relative contributions of the three factors that control blood pressure: heart rate (HR), stroke volume (SV) and total peripheral resistance (TPR). Orthostatic VVS starts with venous pooling, reflected in a decrease of SV. This is followed by cardioinhibition (CI), which is a decrease of HR that accelerates the ongoing decrease of BP, making the start of CI a literal as well as fundamental turning point. The role of hormonal and other humoral factors, respiration and of psychological influences is reviewed in short, leading to the conclusion that a multidisciplinary approach to the study of the pathophysiology of VVS may yield new insights.

J. Gert van Dijk

Ineke A. van Rossum

Roland D. Thijs

The pathophysiology of vasovagal syncope: Novel insights

血管迷走性晕厥的病理生理学：新见解

It is well known that the autonomic nervous system (ANS) is a major contributor in etiopathogenesis of vasovagal syncope (VVS). Catheter based neuromodulation (CNA) of the intrinsic cardiac ANS has evolved rapidly from being an experimental unproven procedure to its current status as an increasingly performed ablation procedure in many major hospitals worldwide. The present review aims to bring the anatomical elements of intrinsic cardiac ANS and clinical application of intrinsic cardiac neuromodulation together, by reviewing anatomical terminologies and clinical data, in order to provide a practical assistance to the electrophysiology community.

Tolga Aksu

Andre Davila

Dhiraj Gupta

The “heart brain” and neuromodulation for vasovagal syncope

“心脏大脑”与血管迷走性晕厥的神经调节

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

Auton Neurosci

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

Emily K. Woolf

Nicole Wells

Jeff Moore

Sarah Northway

Michael J. Buono

Intrinsic versus extrinsic contribution to intraindividual sweat rate variability of individual eccrine glands

个体汗腺的个体间汗液分泌率变异性的内在与外在贡献

Plasma levels of the catecholamine norepinephrine (NE) has emerged as a useful tool to help differentiate pre- and post-ganglionic disorders in patients with cardiovascular autonomic failure (AF). However, data on intrasubject reliability in individuals with these conditions are limited. We evaluated the intrasubject reproducibility of supine plasma NE levels drawn across two consecutive time points under controlled conditions during head-up table testing in a large cohort of patients with alpha-synucleinopathies and both pre- and post-ganglionic cardiovascular AF.

Giannicola Carrozzo

Mitchell G Miglis

Manuela Contin

Ilaria Cani

Pietro Cortelli

Pietro Guaraldi

Giovanna Calandra-Buonaura

Intrasubject reproducibility of supine norepinephrine plasma concentrations in patients with cardiovascular sympathetic failure

心血管交感神经功能衰竭患者仰卧位去甲肾上腺素血浆浓度的受试者内重复性

Significant volume is pooled in veins in humans and the amount is dramatically altered by various physiological stresses and diseases. Several animal and human studies demonstrated that limb venous distension evoked significant increases in blood pressure and sympathetic nerve activity (venous distension reflex, VDR). VDR has attracted much attention because of its potential to explain the still unknown mechanism of autonomic dysfunction in several diseases, which would lead to a new treatment approach. This mini review discusses accumulated evidence of VDR at this point and what should be investigated in the future to apply the current understanding of VDR in clinical practice.

Takuto Hamaoka

Lawrence I Sinoway

Jian Cui

The role of peripheral venous distension reflex in regulating hemodynamics: mini review

外周静脉扩张反射在调节血流动力学中的作用：小综述

Interoception entails perceiving or being aware of the internal state of the body, playing a pivotal role in regulating processes such as heartbeat, digestion, glucose metabolism, and respiration. The carotid body (CB) serves as an interoceptive organ, transmitting information to the brain via its sensitive nerve, the carotid sinus nerve, to maintain homeostasis. While traditionally known for sensing oxygen, carbon dioxide, and pH levels, the CB is now recognized to possess additional interoceptive properties, detecting various mediators involved in blood pressure regulation, inflammation, and glucose homeostasis, among other physiological functions. Furthermore, in the last decades CB dysfunction has been linked to diseases like sleep apnea, essential hypertension, and diabetes. In this review manuscript, we make a concise overview of the traditional interoceptive functions of the CB, acting as a sensor for oxygen levels, carbon dioxide levels, and pH, and introduce the novel interoceptive properties of the CB related to vascular, glucose and energy regulation. Additionally, we revise the contribution of the CB to the onset and progression of metabolic diseases, delving into the potential dysfunction of its interoceptive metabolic functions as a contributing factor to pathophysiology. Finally, we postulate the use of therapeutic interventions targeting the metabolic interoceptive properties of the CB as a potential avenue for addressing metabolic diseases.

短名	Auton. Neurosci.
Journal Impact	3.39
国际分区	NEUROSCIENCES(Q2)
期刊索引	SCI Q3中科院 4 区

ISSN	1566-0702, 1872-7484
h-index	93
国内分区	医学(4区)医学神经科学(4区)

涉及主题	医学生物内科学内分泌学心理学神经科学化学放射科遗传学血压生物化学麻醉心脏病学心率精神科病理受体解剖外科
出版信息	出版商: Elsevier B.V.，出版周期: Monthly，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2000，原创研究文献占比: 54.79%，自引率:3.10%， Gold OA占比: 18.36%
平均审稿周期	网友分享经验：较慢,6-12周
平均录用比例	网友分享经验：较易

Autonomic Neuroscience: Basic and Clinical

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

Autonomic neuropathy and urologic complications in diabetes

The pathophysiology of vasovagal syncope: Novel insights

The “heart brain” and neuromodulation for vasovagal syncope

Baroreflex activation therapy through electrical carotid sinus stimulation

Baroreflex activation therapy through electrical carotid sinus stimulation

Intrinsic versus extrinsic contribution to intraindividual sweat rate variability of individual eccrine glands

Intrasubject reproducibility of supine norepinephrine plasma concentrations in patients with cardiovascular sympathetic failure

The role of peripheral venous distension reflex in regulating hemodynamics: mini review

Carotid body interoception in health and disease