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Dell'Oro R, Quarti-Trevano F, Ciardullo S, Perseghin G, Mancia G, Grassi G. Reliability of heart rate in reflecting cardiac sympathetic overdrive in type 2 diabetes mellitus. Clin Auton Res 2024; 34:437-445. [PMID: 39037542 PMCID: PMC11362466 DOI: 10.1007/s10286-024-01054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024]
Abstract
PURPOSE Clinical trials have shown that in type 2 diabetes mellitus (T2D) resting office heart rate (HR) values > 70 beats/minute are associated with an increased cardiovascular risk, a worse prognosis and an unfavorable outcome. The present study was aimed at investigating whether the above mentioned treshold HR values reflect a sympathetic overdrive of marked degree. METHODS In 58 T2D patients (age range: 39-57 years) without signs of autonomic neuropathy and in 52 age-matched healthy controls, we assessed muscle sympathetic nerve activity (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC), subdividing the study population in different subgroups according to their clinic and 24-h HR values. RESULTS In T2D progressively greater clinic and 24-h HR values were accompanied by progressive increases in MSNA and NE. HR cutoff values indicated by clinical trials as associated with an increased cardiovascular risk (> 70 beats/minute) were accompanied by MSNA values significantly higher than those detected in patients with lower HR, this being the case also for NE. In T2D both MSNA and NE were significantly related to clinic (r = 0.93, P < 0.0001 and r = 0.87, P < 0.0001, respectively) and 24-h (r = 0.92, P < 0.0001 and r = 0.84, P < 0.0001, respectively) HR. The MSNA and NE behaviour observed in T2D was not detected in healthy controls. CONCLUSIONS In T2D clinic HR values allow to detect patients with a greater sympathetic overactivity. Considering the adverse clinical impact of the sympathetic overdrive on prognosis, our data emphasize the need of future studies investigating the potential usefulness of lifestyle and pharmacological interventions exerting sympathomodulatory effects.
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Affiliation(s)
- Raffaella Dell'Oro
- Department of Medicine, Clinica Medica, Surgery University Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Milan, Italy
| | - Fosca Quarti-Trevano
- Department of Medicine, Clinica Medica, Surgery University Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Milan, Italy
| | - Stefano Ciardullo
- Department of Medicine and Rehabilitation, Department of Medicine and Surgery, Policlinico Dii Monza, University Milano-Bicocca, Monza, Milan, Italy
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation, Department of Medicine and Surgery, Policlinico Dii Monza, University Milano-Bicocca, Monza, Milan, Italy
| | | | - Guido Grassi
- Department of Medicine, Clinica Medica, Surgery University Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Milan, Italy.
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2
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Patel M, Braun JA, Henderson LA, Dawood T, Macefield VG. The effects of electrical stimulation of ventromedial prefrontal cortex on skin sympathetic nerve activity. Cereb Cortex 2024; 34:bhae235. [PMID: 38839074 DOI: 10.1093/cercor/bhae235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/13/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024] Open
Abstract
Skin sympathetic nerve activity (SSNA) is primarily involved in thermoregulation and emotional expression; however, the brain regions involved in the generation of SSNA are not completely understood. In recent years, our laboratory has shown that blood-oxygen-level-dependent signal intensity in the ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are positively correlated with bursts of SSNA during emotional arousal and increases in signal intensity in the vmPFC occurring with increases in spontaneous bursts of SSNA even in the resting state. We have recently shown that unilateral transcranial alternating current stimulation (tACS) of the dlPFC causes modulation of SSNA but given that the current was delivered between electrodes over the dlPFC and the nasion, it is possible that the effects were due to current acting on the vmPFC. To test this, we delivered tACS to target the right vmPFC or dlPFC and nasion and recorded SSNA in 11 healthy participants by inserting a tungsten microelectrode into the right common peroneal nerve. The similarity in SSNA modulation between ipsilateral vmPFC and dlPFC suggests that the ipsilateral vmPFC, rather than the dlPFC, may be causing the modulation of SSNA during ipsilateral dlPFC stimulation.
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Affiliation(s)
- Mariya Patel
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Joe A Braun
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Department of Neuroscience, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia
| | - Luke A Henderson
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Sydney, NSW 2006, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC 3004, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
- Department of Neuroscience, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia
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Thrall SF, D'Souza AW, Abrahamson-Durant B, Vianna LC, Limberg JK, Macefield VG, Foster GE. A comparison of wavelet-based action potential detection from the NeuroAmp and the Iowa Bioengineering Nerve Traffic Analysis system. J Neurophysiol 2024; 131:1168-1174. [PMID: 38629146 PMCID: PMC11383387 DOI: 10.1152/jn.00448.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/25/2024] [Accepted: 04/12/2024] [Indexed: 06/01/2024] Open
Abstract
Microneurographic recordings of muscle sympathetic nerve activity (MSNA) reflect postganglionic sympathetic axonal activity directed toward the skeletal muscle vasculature. Recordings are typically evaluated for spontaneous bursts of MSNA; however, the filtering and integration of raw neurograms to obtain multiunit bursts conceals the underlying c-fiber discharge behavior. The continuous wavelet transform with matched mother wavelet has permitted the assessment of action potential discharge patterns, but this approach uses a mother wavelet optimized for an amplifier that is no longer commercially available (University of Iowa Bioengineering Nerve Traffic Analysis System; Iowa NTA). The aim of this project was to determine the morphology and action potential detection performance of mother wavelets created from the commercially available NeuroAmp (ADinstruments), from distinct laboratories, compared with a mother wavelet generated from the Iowa NTA. Four optimized mother wavelets were generated in a two-phase iterative process from independent datasets, collected by separate laboratories (one Iowa NTA, three NeuroAmp). Action potential extraction performance of each mother wavelet was compared for each of the NeuroAmp-based datasets. The total number of detected action potentials was not significantly different across wavelets. However, the predictive value of action potential detection was reduced when the Iowa NTA wavelet was used to detect action potentials in NeuroAmp data, but not different across NeuroAmp wavelets. To standardize approaches, we recommend a NeuroAmp-optimized mother wavelet be used for the evaluation of sympathetic action potential discharge behavior when microneurographic data are collected with this system.NEW & NOTEWORTHY The morphology of custom mother wavelets produced across laboratories using the NeuroAmp was highly similar, but distinct from the University of Iowa Bioengineering Nerve Traffic Analysis System. Although the number of action potentials detected was similar between collection systems and mother wavelets, the predictive value differed. Our data suggest action potential analysis using the continuous wavelet transform requires a mother wavelet optimized for the collection system.
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Affiliation(s)
- Scott F Thrall
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Andrew W D'Souza
- Division of Pulmonary Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Brendan Abrahamson-Durant
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
| | - Lauro C Vianna
- NeuroV̇ASQ̇ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasília, Brasília, Brazil
| | - Jacqueline K Limberg
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, United States
| | - Vaughan G Macefield
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Glen E Foster
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, Canada
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Wang H, Wang W, Gao X, Wu D, Lu Q, Li C, Zheng S, Wang H. Effects of Postural Resonance on Skin Sympathetic Nerve Activity and Blood Pressure: A Pilot Study Evaluating Vascular Tone Baroreflex Stimulation Through Biofeedback. Appl Psychophysiol Biofeedback 2024; 49:205-218. [PMID: 38159163 DOI: 10.1007/s10484-023-09614-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
Heart rate and vascular tension baroreflex exhibit resonance characteristics at approximately 0.1 and 0.03 Hz. In this study, we aimed to induce postural resonance (PR) through rhythmic postural adjustments. To assess the viability of this technique, we investigated the acute impacts of postural resonance on blood pressure, sympathetic nerve activity, and mood. Fifteen healthy study participants, consisting of 8 males and 7 females, were selected for this self-controlled study. Skin sympathetic nerve activity was continuously monitored during both the intervention and stress test on the experimental day. After PR intervention, the diastolic blood pressure and mean arterial pressure in the PR group exhibited significant reductions compared to the CON group (P = 0.032, CON = 71.67 ± 2.348, PR = 64.08 ± 2.35; P = 0.041, CON = 75.00 ± 2.17, PR = 81.67 ± 2.17). After PR intervention both left brachial ankle pulse wave velocity and right brachial ankle pulse wave velocity exhibited a significant reduction compared to pre-intervention levels (from 1115.86 ± 150.08 to 1048.43 ± 127.40 cm/s, p < 0.001; 1103.86 ± 144.35 to 1060.43 ± 121.35 cm/s, p = 0.018). PR intervention also led to a significant decrease in burst frequency and duration (P = 0.049; CON = 8.96 ± 1.17, PR = 5.51 ± 1.17) and a noteworthy decrease in burst amplitude and burst threshold during the cold-pressor test (P = 0.002; P = 0.002). Additionally, VAS scores exhibited a substantial increase following PR (P = 0.035, CON = 28.4 ± 4.49, PR = 42.17 ± 4.10). PR can induce resonance effects within the cardiovascular system, resulting in the effective reduction of blood pressure, skin sympathetic nerve activity and pulse wave velocity, and decreased burst amplitude and burst threshold of the sympathetic nerve during the cold-pressor test.
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Affiliation(s)
- Hao Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Wendi Wang
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Xiaolin Gao
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China.
| | - Dongzhe Wu
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China.
| | - Qiaopei Lu
- Sports Training Center, Institute of Sport Science, Beijing, China
| | - Chuangtao Li
- Sports Rehabilitation Research Center, China Institute of Sport Science, Beijing, China
| | - Sainan Zheng
- School of Sport Science, Beijing Sport University, Beijing, China
| | - Haoruo Wang
- School of Sport Science, Beijing Sport University, Beijing, China
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5
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D'Alesio G, Stumpp LI, Sciarrone P, Navari A, Gentile F, Borrelli C, Ballanti S, Degl'Innocenti E, Carrasco A, Costa AC, Andrade A, Mannini A, Macefield VG, Emdin M, Passino C, Mazzoni A, Giannoni A, Oddo CM. An open computational toolbox to analyze multi- and single-unit sympathetic nerve activity in microneurography. BIOPHYSICS REVIEWS 2024; 5:021401. [PMID: 38895135 PMCID: PMC11184970 DOI: 10.1063/5.0202385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/08/2024] [Indexed: 06/21/2024]
Abstract
Microelectrode recordings from human peripheral and cranial nerves provide a means to study both afferent and efferent axonal signals at different levels of detail, from multi- to single-unit activity. Their analysis can lead to advancements both in diagnostic and in the understanding of the genesis of neural disorders. However, most of the existing computational toolboxes for the analysis of microneurographic recordings are limited in scope or not open-source. Additionally, conventional burst-based metrics are not suited to analyze pathological conditions and are highly sensitive to distance of the microelectrode tip from the active axons. To address these challenges, we developed an open-source toolbox that offers advanced analysis capabilities for studying neuronal reflexes and physiological responses to peripheral nerve activity. Our toolbox leverages the observation of temporal sequences of action potentials within inherently cyclic signals, introducing innovative methods and indices to enhance analysis accuracy. Importantly, we have designed our computational toolbox to be accessible to novices in biomedical signal processing. This may include researchers and professionals in healthcare domains, such as clinical medicine, life sciences, and related fields. By prioritizing user-friendliness, our software application serves as a valuable resource for the scientific community, allowing to extract advanced metrics of neural activity in short time and evaluate their impact on other physiological variables in a consistent and standardized manner, with the final aim to widen the use of microneurography among researchers and clinicians.
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Affiliation(s)
- Giacomo D'Alesio
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | - Alessandro Navari
- Cardiovascular Medicine Department, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | | | - Chiara Borrelli
- Medical Research Center, University of Iowa, Iowa City, Iowa, USA
| | - Sara Ballanti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | - Alexandre Andrade
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal
| | - Andrea Mannini
- Artificial Intelligence for Rehabilitation Laboratory, Fondazione Don Carlo Gnocchi IRCCS, Florence, Italy
| | | | | | | | - Alberto Mazzoni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
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6
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Benarroch E. What Is the Role of the Sympathetic System in Skeletal Muscle? Neurology 2024; 102:e209488. [PMID: 38710007 DOI: 10.1212/wnl.0000000000209488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
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7
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Wu HF, Saito-Diaz K, Huang CW, McAlpine JL, Seo DE, Magruder DS, Ishan M, Bergeron HC, Delaney WH, Santori FR, Krishnaswamy S, Hart GW, Chen YW, Hogan RJ, Liu HX, Ivanova NB, Zeltner N. Parasympathetic neurons derived from human pluripotent stem cells model human diseases and development. Cell Stem Cell 2024; 31:734-753.e8. [PMID: 38608707 PMCID: PMC11069445 DOI: 10.1016/j.stem.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/16/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024]
Abstract
Autonomic parasympathetic neurons (parasymNs) control unconscious body responses, including "rest-and-digest." ParasymN innervation is important for organ development, and parasymN dysfunction is a hallmark of autonomic neuropathy. However, parasymN function and dysfunction in humans are vastly understudied due to the lack of a model system. Human pluripotent stem cell (hPSC)-derived neurons can fill this void as a versatile platform. Here, we developed a differentiation paradigm detailing the derivation of functional human parasymNs from Schwann cell progenitors. We employ these neurons (1) to assess human autonomic nervous system (ANS) development, (2) to model neuropathy in the genetic disorder familial dysautonomia (FD), (3) to show parasymN dysfunction during SARS-CoV-2 infection, (4) to model the autoimmune disease Sjögren's syndrome (SS), and (5) to show that parasymNs innervate white adipocytes (WATs) during development and promote WAT maturation. Our model system could become instrumental for future disease modeling and drug discovery studies, as well as for human developmental studies.
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Affiliation(s)
- Hsueh-Fu Wu
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA; Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA
| | - Kenyi Saito-Diaz
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA
| | - Chia-Wei Huang
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA; Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Jessica L McAlpine
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA; Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA
| | - Dong Eun Seo
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA; Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA
| | - D Sumner Magruder
- Department of Genetics, Department of Computer Science, Wu Tsai Institute, Program for Computational Biology and Bioinformatics, Yale University, New Haven, CT 06520, USA
| | - Mohamed Ishan
- Regenerative Bioscience Center, Department of Animal and Dairy Science College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Harrison C Bergeron
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - William H Delaney
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA
| | - Fabio R Santori
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA
| | - Smita Krishnaswamy
- Department of Genetics, Department of Computer Science, Wu Tsai Institute, Program for Computational Biology and Bioinformatics, Yale University, New Haven, CT 06520, USA
| | - Gerald W Hart
- Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA; Complex Carbohydrate Research Center, University of Georgia, Athens, GA 30602, USA
| | - Ya-Wen Chen
- Department of Otolaryngology, Department of Cell, Developmental, and Regenerative Biology, Institute for Airway Sciences, Institute for Regenerative Medicine, Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Robert J Hogan
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA; Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Hong-Xiang Liu
- Regenerative Bioscience Center, Department of Animal and Dairy Science College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA 30602, USA
| | - Natalia B Ivanova
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA; Department of Genetics, University of Georgia, Athens, GA 30602, USA
| | - Nadja Zeltner
- Center for Molecular Medicine, University of Georgia, Athens, GA 30602, USA; Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602, USA; Department of Cellular Biology, University of Georgia, Athens, GA 30602, USA.
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8
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Grassi G, Drager LF. Sympathetic overactivity, hypertension and cardiovascular disease: state of the art. Curr Med Res Opin 2024; 40:5-13. [PMID: 38597067 DOI: 10.1080/03007995.2024.2305248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 04/11/2024]
Abstract
Cardiovascular disease (CVD) remains the most prevalent cause of premature death worldwide. It had been suspected for decades that increased activity of the sympathetic nervous system (SNS) might play a pathogenetic role in the development and progression of hypertension, heart failure (HF) and CVD. The use of microneurographic techniques to directly assess the SNS has allowed this field to advance considerably in recent years. We now have compelling evidence for a key role of sympathetic overactivity in the pathogenesis and progression of hypertension and associated hypertension-mediated organ damage (such as endothelial dysfunction, arterial stiffness and left ventricular hypertrophy), HF (with or without reduced left ventricular ejection fraction). Sympathetic overactivity also drives increased cardiovascular risk in the settings of obesity, metabolic syndrome, chronic kidney disease and obstructive sleep apnoea, among other conditions. Thus, sympathetic overactivity is an important factor that drives patients through the CVD continuum, from the early appearance of cardiovascular risk factors, to impairments of the structure and function of components of the heart and arteries, to established CVD, and ultimately to a life-threatening cardiovascular event. A deeper understanding of the role of sympathetic overactivity in the pathogenesis of CVD and HF will support the optimization of therapeutic interventions for these conditions.
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Affiliation(s)
- Guido Grassi
- Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy
| | - Luciano F Drager
- Hypertension Unit, Renal Division, University of São Paulo Medical School, Sao Paulo, Brazil
- Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
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9
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Tahsin CT, Anselmo M, Lee E, Stokes W, Fonkoue IT, Vanden Noven ML, Carter JR, Keller-Ross ML. Sleep disturbance and sympathetic neural reactivity in postmenopausal females. Am J Physiol Heart Circ Physiol 2024; 326:H752-H759. [PMID: 38214902 PMCID: PMC11221801 DOI: 10.1152/ajpheart.00724.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/13/2024]
Abstract
Sleep disturbance, one of the most common menopausal symptoms, contributes to autonomic dysfunction and is linked to hypertension and cardiovascular risk. Longitudinal studies suggest that hyperreactivity of blood pressure (BP) to a stressor can predict the future development of hypertension. It remains unknown if postmenopausal females who experience sleep disturbance (SDG) demonstrate greater hemodynamic and sympathetic neural hyperreactivity to a stressor. We hypothesized that postmenopausal females with reported sleep disturbance would exhibit increased hemodynamic and sympathetic reactivity to a stressor compared with postmenopausal females without sleep disturbance (non-SDG). Fifty-five postmenopausal females (age, 62 ± 4 yr old; SDG, n = 36; non-SDG; n = 19) completed two study visits. The Menopause-Specific Quality of Life Questionnaire (MENQOL) was used to assess the presence of sleep disturbance (MENQOL sleep scale, ≥2 units). Beat-to-beat BP (finger plethysmography), heart rate (HR; electrocardiogram), and muscle sympathetic nerve activity (MSNA; microneurography; SDG, n = 25; non-SDG, n = 15) were continuously measured during a 10-min baseline and 2-min stressor (cold pressor test; CPT) in both groups. Menopause age and body mass index were similar between groups (P > 0.05). There were no differences between resting BP, HR, or MSNA (P > 0.05). HR and BP reactivity were not different between SDG and non-SDG (P > 0.05). In contrast, MSNA reactivity had a more rapid increase in the first 30 s of the CPT in the SDG (burst incidence, Δ10.2 ± 14.8 bursts/100 hb) compared with the non-SDG (burst incidence, Δ4.0 ± 14.8 bursts/100 hb, time × group, P = 0.011). Our results demonstrate a more rapid sympathetic neural reactivity to a CPT in postmenopausal females with perceived sleep disturbance, a finding that aligns with and advances recent evidence that sleep disturbance is associated with sympathetic neural hyperactivity in postmenopausal females.NEW & NOTEWORTHY This is the first study to demonstrate that muscle sympathetic nerve activity (MSNA) to a cold pressor test is augmented in postmenopausal females with perceived sleep disturbance. The more rapid increase in MSNA reactivity during the cold pressor test in the sleep disturbance group was present despite similar increases in the perceived pain levels between groups. Baseline MSNA burst incidence and burst frequency, as well as blood pressure and heart rate, were similar between the sleep disturbance and nonsleep disturbance groups.
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Affiliation(s)
- Chowdhury Tasnova Tahsin
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Miguel Anselmo
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - William Stokes
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ida T Fonkoue
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
| | - Marnie L Vanden Noven
- Department of Exercise Science, Belmont University, Nashville, Tennessee, United States
| | - Jason R Carter
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States
| | - Manda L Keller-Ross
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, United States
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10
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McCarthy B, Datta S, Sesa-Ashton G, Wong R, Dawood T, Macefield VG. Differential control of sympathetic outflow to muscle and skin during physical and cognitive stressors. Clin Auton Res 2024; 34:177-189. [PMID: 38308178 PMCID: PMC10944443 DOI: 10.1007/s10286-024-01015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/10/2024] [Indexed: 02/04/2024]
Abstract
PURPOSE Sympathetic nerve activity towards muscle (MSNA) and skin (SSNA) regulates various physiological parameters. MSNA primarily functions in blood pressure and flow, while SSNA operates in thermoregulation. Physical and cognitive stressors have been shown to have effects on both types of sympathetic activity, but there are inconsistencies as to what these effects are. This article aims to address the discrepancies in the literature and compare MSNA and SSNA responses. METHODS Microelectrode recordings were taken from the common peroneal nerve in 29 participants: MSNA (n = 21), SSNA (n = 16) and both MSNA and SSNA (n = 8). Participants were subjected to four different 2-min stressors: two physical (isometric handgrip task, cold pressor test) and two cognitive (mental arithmetic task, Stroop colour-word conflict test), the latter of which saw participants separated into responders and non-responders to the stressors. It was hypothesised that the physical stressors would have a greater effect on MSNA than SSNA, while the cognitive stressors would operate conversely. RESULTS Peristimulus time histogram (PSTH) analysis showed the mental arithmetic task to significantly increase both MSNA and SSNA; the isometric handgrip task and cold pressor test to increase MSNA, but not SSNA; and Stroop test to have no significant effects on changing MSNA or SSNA from baseline. Additionally, stress responses did not differ between MSNA and SSNA in participants who had both sets of data recorded. CONCLUSIONS This study has provided evidence to support the literature which claims cognitive stressors increase sympathetic activity, and provides much needed SSNA data in response to stressors.
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Affiliation(s)
- Brendan McCarthy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Sudipta Datta
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Rebecca Wong
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Baker Department of Cardiometabolic Health, The University of Melbourne, Melbourne, VIC, Australia.
- Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia.
- Department of Neuroscience, Central Clinical School, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia.
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11
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Jardine DL. What lies beneath: cyclical giant bursts of SNA during vasovagal syncope. Clin Auton Res 2024; 34:213-217. [PMID: 38308177 DOI: 10.1007/s10286-023-01009-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/09/2023] [Indexed: 02/04/2024]
Affiliation(s)
- D L Jardine
- Departments of Medicine and General Medicine, Christchurch Hospital, 2, Riccarton Ave, Christchurch, 4710, New Zealand.
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12
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Tai BWS, Dawood T, Macefield VG, Yiallourou SR. The association between sleep duration and muscle sympathetic nerve activity. Clin Auton Res 2023; 33:647-657. [PMID: 37543558 PMCID: PMC10751264 DOI: 10.1007/s10286-023-00965-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/07/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE Sleep duration is associated with risk of hypertension and cardiovascular diseases. It is thought that shorter sleep increases sympathetic activity. However, most studies are based on acute experimental sleep deprivation that have produced conflicting results. Furthermore, there are limited data available on habitual sleep duration and gold-standard measures of sympathetic activation. Hence, this study aimed to assess the association between habitual sleep duration and muscle sympathetic nerve activity. METHODS Twenty-four participants aged ≥ 18 years were included in the study. Sleep was assessed using at-home 7-day/night actigraphy (ActiGraph™ GT3X-BT) and sleep questionnaires (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale). Microelectrode recordings of muscle sympathetic nerve activity were obtained from the common peroneal nerve. Participants were categorised into shorter or longer sleep duration groups using a median split of self-report and actigraphy sleep measures. RESULTS Compared to longer sleepers, shorter sleepers averaged 99 ± 40 min and 82 ± 40 min less sleep per night as assessed by self-report and objective measures, respectively. There were no differences in age (38 ± 18 vs 39 ± 21 years), sex (5 male, 7 female vs 6 male, 6 female), or body mass index (23 ± 3 vs 22 ± 3 kg/m2) between shorter and longer sleepers. Expressed as burst frequency, muscle sympathetic nerve activity was higher in shorter versus longer sleepers for both self-report (39.4 ± 12.9 vs 28.4 ± 8.5 bursts/min, p = 0.019) and objective (37.9 ± 12.4 vs 28.1 ± 8.8 bursts/min, p = 0.036) sleep duration. CONCLUSIONS Shorter sleep duration assessed in a home setting was associated with higher muscle sympathetic nerve activity. Sympathetic overactivity may underlie the association between short sleep and hypertension.
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Affiliation(s)
- Bryan W S Tai
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Tye Dawood
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Vaughan G Macefield
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Stephanie R Yiallourou
- Human Autonomic Neurophysiology Lab, Baker Heart and Diabetes Institute, Melbourne, Australia.
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.
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Udhayakumar R, Rahman S, Buxi D, Macefield VG, Dawood T, Mellor N, Karmakar C. Measurement of stress-induced sympathetic nervous activity using multi-wavelength PPG. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221382. [PMID: 37650068 PMCID: PMC10465208 DOI: 10.1098/rsos.221382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 08/02/2023] [Indexed: 09/01/2023]
Abstract
The onset of stress triggers sympathetic arousal (SA), which causes detectable changes to physiological parameters such as heart rate, blood pressure, dilation of the pupils and sweat release. The objective quantification of SA has tremendous potential to prevent and manage psychological disorders. Photoplethysmography (PPG), a non-invasive method to measure skin blood flow changes, has been used to estimate SA indirectly. However, the impact of various wavelengths of the PPG signal has not been investigated for estimating SA. In this study, we explore the feasibility of using various statistical and nonlinear features derived from peak-to-peak (AC) values of PPG signals of different wavelengths (green, blue, infrared and red) to estimate stress-induced changes in SA and compare their performances. The impact of two physical stressors: and Hand Grip are studied on 32 healthy individuals. Linear (Mean, s.d.) and nonlinear (Katz, Petrosian, Higuchi, SampEn, TotalSampEn) features are extracted from the PPG signal's AC amplitudes to identify the onset, continuation and recovery phases of those stressors. The results show that the nonlinear features are the most promising in detecting stress-induced sympathetic activity. TotalSampEn feature was capable of detecting stress-induced changes in SA for all wavelengths, whereas other features (Petrosian, AvgSampEn) are significant (AUC ≥ 0.8) only for IR and Red wavelengths. The outcomes of this study can be used to make device design decisions as well as develop stress detection algorithms.
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Affiliation(s)
| | - Saifur Rahman
- School of Information Technology Deakin University, Geelong 3225, Australia
| | | | | | - Tye Dawood
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | | | - Chandan Karmakar
- School of Information Technology Deakin University, Geelong 3225, Australia
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14
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Wong R, Sesa-Ashton G, Datta S, McCarthy B, Henderson LA, Dawood T, Macefield VG. The role of the dorsolateral prefrontal cortex in control of skin sympathetic nerve activity in humans. Cereb Cortex 2023; 33:8265-8272. [PMID: 37143172 PMCID: PMC10558060 DOI: 10.1093/cercor/bhad112] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 05/06/2023] Open
Abstract
The dorsolateral prefrontal cortex (dlPFC) is primarily involved in higher order executive functions, with there being evidence of lateralization. Brain imaging studies have revealed its link to the generation of skin sympathetic nerve activity (SSNA), which is elevated in states of emotional arousal or anxiety. However, no studies have directly explored dlPFC influences on SSNA. Transcranial alternating current stimulation (-2 to 2 mA, 0.08 Hz, 100 cycles) was applied between the left or right dlPFC and nasion via surface electrodes. Spontaneous bursts of SSNA were recorded from the common peroneal nerve via a tungsten microelectrode in 21 healthy participants. The modulation index was calculated for each stimulation paradigm by constructing cross-correlation histograms between SSNA and the sinusoidal stimulus. Stimulation of the dlPFC caused significant modulation of SSNA, but there was no significant difference in the median modulation index across sides. Stimulation also caused cyclic modulation of skin blood flow and sweat release. We have shown for the first time that stimulation of the dlPFC causes modulation of SSNA, also reflected in the effector-organ responses. This supports a role for the dlPFC in the control of SSNA, which likely contributes to the ability of emotions to bring about cutaneous vasoconstriction and sweat release.
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Affiliation(s)
- Rebecca Wong
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, VIC, Australia
| | | | - Sudipta Datta
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, VIC, Australia
| | - Brendan McCarthy
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, VIC, Australia
| | - Luke A Henderson
- School of Medical Sciences (Neuroscience), Brain and Mind Centre, The University of Sydney, NSW, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, VIC, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Baker Department of Cardiometabolic Health, The University of Melbourne, VIC, Australia
- Department of Anatomy and Physiology, The University of Melbourne, VIC, Australia
- Department of Neuroscience, Central Clinical School, Monash University, VIC, Australia
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15
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Verma N, Knudsen B, Gholston A, Skubal A, Blanz S, Settell M, Frank J, Trevathan J, Ludwig K. Microneurography as a minimally invasive method to assess target engagement during neuromodulation. J Neural Eng 2023; 20:10.1088/1741-2552/acc35c. [PMID: 36898148 PMCID: PMC10587909 DOI: 10.1088/1741-2552/acc35c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Objective.Peripheral neural signals recorded during neuromodulation therapies provide insights into local neural target engagement and serve as a sensitive biomarker of physiological effect. Although these applications make peripheral recordings important for furthering neuromodulation therapies, the invasive nature of conventional nerve cuffs and longitudinal intrafascicular electrodes (LIFEs) limit their clinical utility. Furthermore, cuff electrodes typically record clear asynchronous neural activity in small animal models but not in large animal models. Microneurography, a minimally invasive technique, is already used routinely in humans to record asynchronous neural activity in the periphery. However, the relative performance of microneurography microelectrodes compared to cuff and LIFE electrodes in measuring neural signals relevant to neuromodulation therapies is not well understood.Approach.To address this gap, we recorded cervical vagus nerve electrically evoked compound action potentials (ECAPs) and spontaneous activity in a human-scaled large animal model-the pig. Additionally, we recorded sensory evoked activity and both invasively and non-invasively evoked CAPs from the great auricular nerve. In aggregate, this study assesses the potential of microneurography electrodes to measure neural activity during neuromodulation therapies with statistically powered and pre-registered outcomes (https://osf.io/y9k6j).Main results.The cuff recorded the largest ECAP signal (p< 0.01) and had the lowest noise floor amongst the evaluated electrodes. Despite the lower signal to noise ratio, microneurography electrodes were able to detect the threshold for neural activation with similar sensitivity to cuff and LIFE electrodes once a dose-response curve was constructed. Furthermore, the microneurography electrodes recorded distinct sensory evoked neural activity.Significance.The results show that microneurography electrodes can measure neural signals relevant to neuromodulation therapies. Microneurography could further neuromodulation therapies by providing a real-time biomarker to guide electrode placement and stimulation parameter selection to optimize local neural fiber engagement and study mechanisms of action.
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Affiliation(s)
- Nishant Verma
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Bruce Knudsen
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Aaron Gholston
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Aaron Skubal
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Stephan Blanz
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Megan Settell
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Jennifer Frank
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
| | - James Trevathan
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
| | - Kip Ludwig
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, United States of America
- Wisconsin Institute for Translational Neuroengineering (WITNe), Madison, WI, United States of America
- Department of Neurosurgery, University of Wisconsin-Madison, Madison, WI, United States of America
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16
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Metzler-Wilson K, Fang MM, Alibegovic K, Daggett JW, Narra SC, Dazé RP, Miller OG, Wilson TE. Effect of reflex and mechanical decreases in skin perfusion on thermal- and agonist-induced eccrine sweating in humans. Am J Physiol Regul Integr Comp Physiol 2023; 324:R271-R280. [PMID: 36622082 PMCID: PMC9970189 DOI: 10.1152/ajpregu.00066.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 12/07/2022] [Accepted: 01/02/2023] [Indexed: 01/10/2023]
Abstract
In humans, skin blood flux (SkBF) and eccrine sweating are tightly coupled, suggesting common neural control and regulation. This study was designed to separate these two sympathetic nervous system end-organ responses via nonadrenergic SkBF-decreasing mechanical perturbations during heightened sudomotor drive. We induced sweating physiologically via whole body heat stress using a high-density tube-lined suit (protocol 1; 2 women, 4 men), and pharmacologically via forearm intradermal microdialysis of two steady-state doses of a cholinergic agonist, pilocarpine (protocol 2; 4 women, 3 men). During sweating induction, we decreased SkBF via three mechanical perturbations: arm and leg dependency to engage the cutaneous venoarteriolar response (CVAR), limb venous occlusion to engage the CVAR and decrease perfusion pressure, and limb arterial occlusion to cause ischemia. In protocol 1, heat stress increased arm cutaneous vascular conductance and forearm sweat rate (capacitance hygrometry). During heat stress, despite decreases in SkBF during each of the acute (3 min) mechanical perturbations, eccrine sweat rate was unaffected. During heat stress with extended (10 min) ischemia, sweat rate decreased. In protocol 2, both pilocarpine doses (ED50 and EMAX) increased SkBF and sweat rate. Each mechanical perturbation resulted in decreased SkBF but minimal changes in eccrine sweat rate. Taken together, these data indicate that a wide range of acute decreases in SkBF do not appear to proportionally decrease either physiologically- or pharmacologically induced eccrine sweating in peripheral skin. This preservation of evaporative cooling despite acutely decreased SkBF could have consequential impacts for heat storage and balance during changes in body posture, limb position, or blood flow restrictive conditions.
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Affiliation(s)
- Kristen Metzler-Wilson
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, Indiana
- Department of Anatomy, Cell Biology, and Physiology, Indiana University School of Medicine, Indianapolis, Indiana
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Milie M Fang
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Kenan Alibegovic
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - James W Daggett
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Seetharam C Narra
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Robert P Dazé
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
| | - Olivia G Miller
- Department of Physical Therapy, Indiana University School of Health and Human Sciences, Indianapolis, Indiana
| | - Thad E Wilson
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana
- Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky
- Saha Cardiovascular Research Center, University of Kentucky College of Medicine, Lexington, Kentucky
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17
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Hissen SL, Takeda R, Yoo JK, Badrov MB, Stickford ASL, Best SA, Okada Y, Jarvis SS, Nelson DB, Fu Q. Posture-related changes in sympathetic baroreflex sensitivity during normal pregnancy. Clin Auton Res 2022; 32:485-495. [PMID: 36394777 DOI: 10.1007/s10286-022-00903-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/12/2022] [Indexed: 11/18/2022]
Abstract
Normal pregnancy is associated with vast adjustments in cardiovascular autonomic control. Sympathetic baroreflex sensitivity has been reported to be attenuated during pregnancy in animal models, but most studies in humans are cross-sectional and findings from longitudinal case studies are inconclusive. It remains unclear how sympathetic baroreflex sensitivity is altered longitudinally during pregnancy within an individual in different body postures. Therefore, this study examined the impact of posture on sympathetic baroreflex sensitivity in 24 normal-weight normotensive pregnant women. Spontaneous sympathetic baroreflex sensitivity was assessed during early (6-11 weeks) and late (32-36 weeks) pregnancy and 6-10 weeks postpartum in the supine posture and graded head-up tilt (30° and 60°). In addition, data from the postpartum period were compared with (and no different to) 18 age-matched non-pregnant women to confirm that the postpartum period was reflective of a non-pregnant condition (online supplement). When compared with postpartum (-3.8 ± 0.4 bursts/100 heartbeats/mmHg), supine sympathetic baroreflex sensitivity was augmented during early pregnancy (-5.9 ± 0.4 bursts/100 heartbeats/mmHg, P < 0.001). However, sympathetic baroreflex sensitivity at 30° or 60° head-up tilt was not different between any phase of gestation (P > 0.05). When compared to supine, sympathetic baroreflex sensitivity at 60° head-up tilt was significantly blunted during early (Δ2.0 ± 0.7 bursts/100 heartbeats/mmHg, P = 0.024) and late (Δ1.5 ± 0.6 bursts/100 heartbeats/mmHg, P = 0.049) pregnancy but did not change postpartum (Δ0.4 ± 0.6 bursts/100 heartbeats/mmHg, P = 1.0). These data show that time-course changes in sympathetic baroreflex sensitivity are dependent on the posture it is examined in and provides a foundation of normal blood pressure regulation during pregnancy for future studies in women at risk for adverse pregnancy outcomes.
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Affiliation(s)
- Sarah L Hissen
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ryosuke Takeda
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jeung-Ki Yoo
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Mark B Badrov
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- University Health Network, Toronto, ON, Canada
| | - Abigail S L Stickford
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- Medtronic Plc, Minneapolis, MN, USA
| | - Stuart A Best
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- University of Kentucky, Lexington, KY, USA
| | - Yoshiyuki Okada
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- Hiroshima University, Hiroshima, Japan
| | - Sara S Jarvis
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA
- Northern Arizona University, Flagstaff, AZ, USA
| | - David B Nelson
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, 7232 Greenville Avenue, Dallas, TX, 75231, USA.
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.
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18
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Mavroudis I, Balmus IM, Ciobica A, Luca AC, Chowdhury R, Iordache AC, Gorgan DL, Radu I. Mini-Review on the Harlequin Syndrome-A Rare Dysautonomic Manifestation Requiring Attention. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070938. [PMID: 35888657 PMCID: PMC9324885 DOI: 10.3390/medicina58070938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
Harlequin syndrome (HS) is a rare autonomic disorder. The causes and risk factors of the disease are not fully understood. Some cases of HS are associated with traumatic injuries, tumors, or vascular impairments of the head. Symptoms of HS can also occur in some autoimmune disorders, ophthalmic disorders, sleep disorders, and with certain organic lesions. In this context, a thorough review of the pathophysiology of HS in relation to neurological, ophthalmological, and dermatological conditions is necessary. In this mini-review, we aim to review the pathophysiological changes and underlying mechanisms in primary and secondary HS. Additionally, we discuss possible management approaches for patients with HS in light of the discussed pathological mechanisms. The main symptoms of HS that are correlated with autonomic nervous system impairments include sudden unilateral flushing of the face, neck, chest, and rarely arm, with concurrent contralateral anhidrosis. Despite reported co-occurring syndromes (such as cluster headaches), several studies have shown that HS could frequently overlap with other syndromes that are disruptive to the idiopathic nerve pathways. HS usually does not require any medical treatment. In some severe cases, symptomatic treatments could be needed. However, total symptomatic relief may not be achieved in many cases of HS. We therefore suggest an approach to comprehensive management of HS, which may lead to better long-term control of HS.
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Affiliation(s)
- Ioannis Mavroudis
- Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds LS2 9JT, UK; (I.M.); (R.C.)
| | - Ioana-Miruna Balmus
- Department of Exact Sciences and Natural Sciences, Institute of Interdisciplinary Research, “Alexandru Ioan Cuza” University of Iasi, Alexandru Lapusneanu Street, No. 26, 700057 Iasi, Romania;
| | - Alin Ciobica
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University of Iasi, 700506 Iasi, Romania; (A.C.); (D.L.G.)
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, Sector 5, 050094 Bucuresti, Romania
- Center of Biomedical Research, Romanian Academy, B dul Carol I, No 8, 700505 Iasi, Romania
| | - Alina-Costina Luca
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- Correspondence: (A.-C.L.); (A.-C.I.)
| | - Rumana Chowdhury
- Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds LS2 9JT, UK; (I.M.); (R.C.)
| | - Alin-Constantin Iordache
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- Correspondence: (A.-C.L.); (A.-C.I.)
| | - Dragos Lucian Gorgan
- Department of Biology, Faculty of Biology, “Alexandru Ioan Cuza” University of Iasi, 700506 Iasi, Romania; (A.C.); (D.L.G.)
| | - Iulian Radu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
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19
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Patros M, Ottaviani MM, Wright L, Dawood T, Macefield VG. Quantification of cardiac and respiratory modulation of axonal activity in the human vagus nerve. J Physiol 2022; 600:3113-3126. [PMID: 35524982 DOI: 10.1113/jp282994] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/28/2022] [Indexed: 01/05/2023] Open
Abstract
We recently documented the first microelectrode recordings from the cervical vagus nerve in awake humans. Here we aimed to quantify cardiac and respiratory modulation of vagal activity to assess the feasibility of targeting axons supplying the heart and airways. Multi-unit activity was recorded from 43 sites in 19 healthy participants in the left (n = 10) and right (n = 9) vagus nerves with ECG, continuous non-invasive blood pressure and respiration. Cross-correlation histograms were constructed between axonal spikes and the R-waves or the peaks of inspiration. The latencies for the peak in cardiac modulation showed a bimodal distribution: while the majority of sites (72%) had peak latencies that preceded the R-wave by up to 550 ms (mean ± SD, -300 ± 178 ms), 12 sites had latencies of up to 250 ms following the R-wave (64 ± 87 ms). Interestingly, the majority of sites with negative latencies (68%) were found in the left nerve whereas most of those with positive latencies (75%) were found in the right. Conversely, on average the peak of respiratory modulation straddled the peak of inspiration. Sites showing respiratory modulation were more prevalent and showed stronger modulation than those with cardiac modulation: calculated for sites with modulation indices ≥15%, the median cardiac and respiratory modulation indices were 23.4% (n = 17) and 44.5% (n = 35), respectively. We conclude that, despite the fact that much of the vagus nerve supplies the gut, cardiac and respiratory modulation of vagal nerve activity can be identified through invasive recordings in awake humans. KEY POINTS: Intraneural recordings from the cervical vagus were obtained in awake humans via tungsten microelectrodes inserted into the nerve through ultrasound guidance. Cross-correlation analysis of multi-unit vagal activity revealed cardiac and respiratory modulation, from which the amplitude and latency of the peaks could be computed. The magnitude of the cardiac modulation (23%) was weaker than that of the respiratory modulation (45%). The latencies for the peak in cardiac modulation showed a bimodal distribution: the majority of sites (72%) had peak latencies that preceded the R-wave, while the remainder had latencies that followed the R-wave. The majority of sites with negative latencies (68%) were found in the left nerve whereas most of those with positive latencies (75%) were found in the right. On average the peak of respiratory modulation coincided with the peak of inspiration.
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Affiliation(s)
- Mikaela Patros
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
| | - Matteo M Ottaviani
- Department of Neurosurgery, Università Politecnica delle Marche, Ancona, Italy
| | - Leah Wright
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Tye Dawood
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Vaughan G Macefield
- Baker Heart and Diabetes Institute, Melbourne, Australia.,Department of Anatomy and Physiology, University of Melbourne, Melbourne, Australia
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20
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Watso JC, Belval LN, Cimino FA, Orth BD, Hendrix JM, Huang M, Johnson E, Foster J, Hinojosa-Laborde C, Crandall CG. Low-dose morphine reduces tolerance to central hypovolemia in healthy adults without affecting muscle sympathetic outflow. Am J Physiol Heart Circ Physiol 2022; 323:H89-H99. [PMID: 35452317 PMCID: PMC9190738 DOI: 10.1152/ajpheart.00091.2022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/22/2022]
Abstract
Hemorrhage is a leading cause of preventable battlefield and civilian trauma deaths. Low-dose (i.e., an analgesic dose) morphine is recommended for use in the prehospital (i.e., field) setting. Morphine administration reduces hemorrhagic tolerance in rodents. However, it is unknown whether morphine impairs autonomic cardiovascular regulation and consequently reduces hemorrhagic tolerance in humans. Thus, the purpose of this study was to test the hypothesis that low-dose morphine reduces hemorrhagic tolerance in conscious humans. Thirty adults (15 women/15 men; 29 ± 6 yr; 26 ± 4 kg·m-2, means ± SD) completed this randomized, crossover, double-blinded, placebo-controlled trial. One minute after intravenous administration of morphine (5 mg) or placebo (saline), we used a presyncopal limited progressive lower-body negative pressure (LBNP) protocol to determine hemorrhagic tolerance. Hemorrhagic tolerance was quantified as a cumulative stress index (mmHg·min), which was compared between trials using a Wilcoxon matched-pairs signed-rank test. We also compared muscle sympathetic nerve activity (MSNA; microneurography) and beat-to-beat blood pressure (photoplethysmography) during the LBNP test using mixed-effects analyses [time (LBNP stage) × trial]. Median LBNP tolerance was lower during morphine trials (placebo: 692 [473-997] vs. morphine: 385 [251-728] mmHg·min, P < 0.001, CI: -394 to -128). Systolic blood pressure was 8 mmHg lower during moderate central hypovolemia during morphine trials (post hoc P = 0.02; time: P < 0.001, trial: P = 0.13, interaction: P = 0.006). MSNA burst frequency responses were not different between trials (time: P < 0.001, trial: P = 0.80, interaction: P = 0.51). These data demonstrate that low-dose morphine reduces hemorrhagic tolerance in conscious humans. Thus, morphine is not an ideal analgesic for a hemorrhaging individual in the prehospital setting.NEW & NOTEWORTHY In this randomized, crossover, placebo-controlled trial, we found that tolerance to simulated hemorrhage was lower after low-dose morphine administration. Such reductions in hemorrhagic tolerance were observed without differences in MSNA burst frequency responses between morphine and placebo trials. These data, the first to be obtained in conscious humans, demonstrate that low-dose morphine reduces hemorrhagic tolerance. Thus, morphine is not an ideal analgesic for a hemorrhaging individual in the prehospital setting.
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Affiliation(s)
- Joseph C Watso
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Luke N Belval
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Frank A Cimino
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Bonnie D Orth
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Joseph M Hendrix
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mu Huang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elias Johnson
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Josh Foster
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carmen Hinojosa-Laborde
- United States Army Institute of Surgical Research, Joint Base San Antonio Fort Sam Houston, Houston, Texas
| | - Craig G Crandall
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
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21
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Watso JC, Belval LN, Cimino Iii FA, Orth BD, Hendrix JM, Huang M, Johnson E, Foster J, Hinojosa-Laborde C, Crandall CG. Low-Dose Morphine Reduces Pain Perception and Blood Pressure, but Not Muscle Sympathetic Outflow, Responses During the Cold Pressor Test. Am J Physiol Heart Circ Physiol 2022; 323:H223-H234. [PMID: 35714174 PMCID: PMC9273278 DOI: 10.1152/ajpheart.00092.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Our knowledge about how low-dose (analgesic) morphine affects autonomic cardiovascular regulation is primarily limited to animal experiments. Notably, it is unknown if low-dose morphine affects human autonomic cardiovascular responses during painful stimuli in conscious humans. Therefore, we tested the hypothesis that low-dose morphine reduces perceived pain and subsequent sympathetic and cardiovascular responses in humans during an experimental noxious stimulus. Twenty-nine participants (14F/15M; 29±6 y; 26±4 kg•m-2, mean ± SD) completed this randomized, crossover, placebo-controlled trial during two laboratory visits. During each visit, participants completed a cold pressor test (CPT; hand in ~0.4 °C ice bath for two minutes) before and ~35 minutes after drug/placebo administration (5 mg IV morphine or saline). We compared pain perception (100 mm visual analog scale), muscle sympathetic nerve activity (MSNA; microneurography; 14 paired recordings), and beat-to-beat blood pressure (BP; photoplethysmography) between trials (at both pre- and post-drug/placebo time points) using paired, two-tailed t-tests. Before drug/placebo infusion, perceived pain (p=0.92), Δ MSNA burst frequency (n=14, p=0.21), and Δ mean BP (p=0.39) during the CPT were not different between trials. After the drug/placebo infusion, morphine versus placebo attenuated perceived pain (morphine: 43±20 vs. placebo: 57±24 mm,p<0.001) and Δ mean BP (morphine: 10±7 vs. placebo: 13±8 mmHg,p=0.003), but not Δ MSNA burst frequency (morphine: 10±11 vs. placebo: 13±11 bursts/minute,p=0.12), during the CPT. Reductions in pain perception and Δ mean BP were only weakly related (r=0.34,p=0.07; post-morphine CPT minus post-placebo CPT). These data provide valuable information regarding how low-dose morphine affects autonomic cardiovascular responses during an experimental painful stimulus.
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Affiliation(s)
- Joseph C Watso
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Luke N Belval
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Frank A Cimino Iii
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
| | - Bonnie D Orth
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
| | - Joseph M Hendrix
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Mu Huang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Elias Johnson
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States
| | - Josh Foster
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | | | - Craig G Crandall
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, United States.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States.,Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX, United States
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22
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Jenkins ZM, Castle DJ, Eikelis N, Phillipou A, Lambert GW, Lambert EA. Autonomic nervous system function in women with anorexia nervosa. Clin Auton Res 2022; 32:29-42. [PMID: 34762216 DOI: 10.1007/s10286-021-00836-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/28/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE Abnormalities in autonomic function have been observed in people with anorexia nervosa. However, the majority of investigations have utilised heart rate variability as the sole assessment of autonomic activity. The current study utilised a variety of methodologies to assess autonomic nervous system function in women with a current diagnosis of anorexia, a past diagnosis of anorexia who were weight-restored, and healthy controls. METHODS The sample included 37 participants: 10 participants with anorexia, 17 weight-restored participants (minimum body mass index > 18.5 for minimum of 12 months) and 10 controls. Assessments of autonomic function included muscle sympathetic nerve activity (MSNA) using microneurography, heart rate variability, baroreflex sensitivity, blood pressure variability, head-up tilt table test, sudomotor function and assessment of plasma catecholamines. RESULTS MSNA (bursts/min) was significantly decreased in both anorexia (10.22 ± 6.24) and weight-restored (17.58 ± 1.68) groups, as compared to controls (23.62 ± 1.01, p < 0.001 and p = 0.033, respectively). Participants with anorexia had a significantly lower standard deviation in heart rate, lower blood pressure variability and decreased sudomotor function as compared to controls. Weight-restored participants demonstrated decreased baroreflex sensitivity in response to head-up tilt as compared to controls. CONCLUSION Women with a current or previous diagnosis of anorexia have significantly decreased sympathetic activity, which may reflect a physiological response to decreased energy intake. During the state of starvation, women with anorexia also displayed decreased sudomotor function. The consequences of a sustained decrease in MSNA are unknown, and future studies should investigate autonomic function in long-term weight-restored participants to determine whether activity returns to normal.
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Affiliation(s)
- Zoe M Jenkins
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia. .,Department of Mental Health, St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, VIC, 3065, Australia. .,Department of Psychiatry, University of Melbourne, Melbourne, Australia.
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, VIC, 3065, Australia.,Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Nina Eikelis
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Andrea Phillipou
- Department of Mental Health, St Vincent's Hospital Melbourne, PO Box 2900, Fitzroy, VIC, 3065, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Centre for Mental Health and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.,Department of Mental Health, Austin Health, Melbourne, Australia
| | - Gavin W Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth A Lambert
- Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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23
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Watso JC, Huang M, Belval LN, Cimino FA, Jarrard CP, Hendrix JM, Hinojosa-Laborde C, Crandall CG. Low-dose fentanyl reduces pain perception, muscle sympathetic nerve activity responses, and blood pressure responses during the cold pressor test. Am J Physiol Regul Integr Comp Physiol 2022; 322:R64-R76. [PMID: 34851729 PMCID: PMC8742733 DOI: 10.1152/ajpregu.00218.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Our knowledge about how low-dose (analgesic) fentanyl affects autonomic cardiovascular regulation is primarily limited to animal experiments. Notably, it is unknown if low-dose fentanyl influences human autonomic cardiovascular responses during painful stimuli in humans. Therefore, we tested the hypothesis that low-dose fentanyl reduces perceived pain and subsequent sympathetic and cardiovascular responses in humans during an experimental noxious stimulus. Twenty-three adults (10 females/13 males; 27 ± 7 yr; 26 ± 3 kg·m-2, means ± SD) completed this randomized, crossover, placebo-controlled trial during two laboratory visits. During each visit, participants completed a cold pressor test (CPT; hand in ∼0.4°C ice bath for 2 min) before and 5 min after drug/placebo administration (75 μg fentanyl or saline). We compared pain perception (100-mm visual analog scale), muscle sympathetic nerve activity (MSNA; microneurography, 11 paired recordings), and beat-to-beat blood pressure (BP; photoplethysmography) between trials (at both pre- and postdrug/placebo timepoints) using paired, two-tailed t tests. Before drug/placebo administration, perceived pain (P = 0.8287), ΔMSNA burst frequency (P = 0.7587), and Δmean BP (P = 0.8649) during the CPT were not different between trials. After the drug/placebo administration, fentanyl attenuated perceived pain (36 vs. 66 mm, P < 0.0001), ΔMSNA burst frequency (9 vs. 17 bursts/min, P = 0.0054), and Δmean BP (7 vs. 13 mmHg, P = 0.0174) during the CPT compared with placebo. Fentanyl-induced reductions in pain perception and Δmean BP were moderately related (r = 0.40, P = 0.0641). These data provide valuable information regarding how low-dose fentanyl reduces autonomic cardiovascular responses during an experimental painful stimulus.
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Affiliation(s)
- Joseph C. Watso
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,2Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Mu Huang
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,3Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Luke N. Belval
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,2Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Frank A. Cimino
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Caitlin P. Jarrard
- 3Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph M. Hendrix
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,4Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carmen Hinojosa-Laborde
- 5United States Army Institute of Surgical Research, Joint
Base San Antonio, San Antonio, Texas
| | - Craig G. Crandall
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,2Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas,3Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
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24
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Huang M, Watso JC, Belval LN, Cimino FA, Fischer M, Jarrard CP, Hendrix JM, Laborde CH, Crandall CG. Low-dose fentanyl does not alter muscle sympathetic nerve activity, blood pressure, or tolerance during progressive central hypovolemia. Am J Physiol Regul Integr Comp Physiol 2022; 322:R55-R63. [PMID: 34851734 PMCID: PMC8742719 DOI: 10.1152/ajpregu.00217.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Hemorrhage is a leading cause of battlefield and civilian trauma deaths. Several pain medications, including fentanyl, are recommended for use in the prehospital (i.e., field setting) for a hemorrhaging solider. However, it is unknown whether fentanyl impairs arterial blood pressure (BP) regulation, which would compromise hemorrhagic tolerance. Thus, the purpose of this study was to test the hypothesis that an analgesic dose of fentanyl impairs hemorrhagic tolerance in conscious humans. Twenty-eight volunteers (13 females) participated in this double-blinded, randomized, placebo-controlled trial. We conducted a presyncopal limited progressive lower body negative pressure test (LBNP; a validated model to simulate hemorrhage) following intravenous administration of fentanyl (75 µg) or placebo (saline). We quantified tolerance as a cumulative stress index (mmHg·min), which was compared between trials using a paired, two-tailed t test. We also compared muscle sympathetic nerve activity (MSNA; microneurography) and beat-to-beat BP (photoplethysmography) during the LBNP test using a mixed effects model [time (LBNP stage) × trial]. LBNP tolerance was not different between trials (fentanyl: 647 ± 386 vs. placebo: 676 ± 295 mmHg·min, P = 0.61, Cohen's d = 0.08). Increases in MSNA burst frequency (time: P < 0.01, trial: P = 0.29, interaction: P = 0.94) and reductions in mean BP (time: P < 0.01, trial: P = 0.50, interaction: P = 0.16) during LBNP were not different between trials. These data, the first to be obtained in conscious humans, demonstrate that administration of an analgesic dose of fentanyl does not alter MSNA or BP during profound central hypovolemia, nor does it impair tolerance to this simulated hemorrhagic insult.
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Affiliation(s)
- Mu Huang
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,2Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph C. Watso
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,3Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Luke N. Belval
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,3Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Frank A. Cimino
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Mads Fischer
- 2Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas,4Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Caitlin P. Jarrard
- 2Department of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joseph M. Hendrix
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,5Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Carmen Hinojosa Laborde
- 6United States Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas
| | - Craig G. Crandall
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas,3Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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25
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Verma N, Graham RD, Mudge J, Trevathan JK, Franke M, Shoffstall AJ, Williams J, Dalrymple AN, Fisher LE, Weber DJ, Lempka SF, Ludwig KA. Augmented Transcutaneous Stimulation Using an Injectable Electrode: A Computational Study. Front Bioeng Biotechnol 2021; 9:796042. [PMID: 34988068 PMCID: PMC8722711 DOI: 10.3389/fbioe.2021.796042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Minimally invasive neuromodulation technologies seek to marry the neural selectivity of implantable devices with the low-cost and non-invasive nature of transcutaneous electrical stimulation (TES). The Injectrode® is a needle-delivered electrode that is injected onto neural structures under image guidance. Power is then transcutaneously delivered to the Injectrode using surface electrodes. The Injectrode serves as a low-impedance conduit to guide current to the deep on-target nerve, reducing activation thresholds by an order of magnitude compared to using only surface stimulation electrodes. To minimize off-target recruitment of cutaneous fibers, the energy transfer efficiency from the surface electrodes to the Injectrode must be optimized. TES energy is transferred to the Injectrode through both capacitive and resistive mechanisms. Electrostatic finite element models generally used in TES research consider only the resistive means of energy transfer by defining tissue conductivities. Here, we present an electroquasistatic model, taking into consideration both the conductivity and permittivity of tissue, to understand transcutaneous power delivery to the Injectrode. The model was validated with measurements taken from (n = 4) swine cadavers. We used the validated model to investigate system and anatomic parameters that influence the coupling efficiency of the Injectrode energy delivery system. Our work suggests the relevance of electroquasistatic models to account for capacitive charge transfer mechanisms when studying TES, particularly when high-frequency voltage components are present, such as those used for voltage-controlled pulses and sinusoidal nerve blocks.
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Affiliation(s)
- Nishant Verma
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe)–Madison, Madison, WI, United States
| | - Robert D. Graham
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - Jonah Mudge
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe)–Madison, Madison, WI, United States
| | - James K. Trevathan
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe)–Madison, Madison, WI, United States
| | | | - Andrew J Shoffstall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Justin Williams
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe)–Madison, Madison, WI, United States
| | - Ashley N. Dalrymple
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
- Rehab Neural Engineering Labs (RNEL), Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lee E. Fisher
- Rehab Neural Engineering Labs (RNEL), Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
| | - Douglas J. Weber
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
- Rehab Neural Engineering Labs (RNEL), Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States
| | - Scott F. Lempka
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Kip A. Ludwig
- Department of Biomedical Engineering, University of Wisconsin–Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe)–Madison, Madison, WI, United States
- Department of Neurosurgery, University of Wisconsin–Madison, Madison, WI, United States
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26
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Nardone M, Incognito AV, Kathia MM, Omazic LJ, Lee JB, Teixeira AL, Xie S, Vianna LC, Millar PJ. Signal-averaged resting sympathetic transduction of blood pressure: is it time to account for prevailing muscle sympathetic burst frequency? Am J Physiol Regul Integr Comp Physiol 2021; 321:R484-R494. [PMID: 34287075 DOI: 10.1152/ajpregu.00131.2021] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Calculating the blood pressure (BP) response to a burst of muscle sympathetic nerve activity (MSNA), termed sympathetic transduction, may be influenced by an individual's resting burst frequency. We examined the relationships between sympathetic transduction and MSNA in 107 healthy males and females and developed a normalized sympathetic transduction metric to incorporate resting MSNA. Burst-triggered signal-averaging was used to calculate the peak diastolic BP response following each MSNA burst (sympathetic transduction of BP) and following incorporation of MSNA burst cluster patterns and amplitudes (sympathetic transduction slope). MSNA burst frequency was negatively correlated with sympathetic transduction of BP (r=-0.42; P<0.01) and the sympathetic transduction slope (r=-0.66; P<0.01), independent of sex. MSNA burst amplitude was unrelated to sympathetic transduction of BP in males (r=0.04; P=0.78), but positively correlated in females (r=0.44; P<0.01) and with the sympathetic transduction slope in all participants (r=0.42; P<0.01). To control for MSNA, the linear regression slope of the log-log relationship between sympathetic transduction and MSNA burst frequency was used as a correction exponent. In sub-analysis of males (38±10 vs. 14±4bursts/min) and females (28±5 vs. 12±4bursts/min) with high vs. low MSNA, sympathetic transduction of BP and sympathetic transduction slope were lower in participants with high MSNA (all P<0.05). In contrast, normalized sympathetic transduction of BP and normalized sympathetic transduction slope were similar in males and females with high vs. low MSNA (all P>0.22). We propose that incorporating MSNA burst frequency into the calculation of sympathetic transduction will allow comparisons between participants with varying levels of resting MSNA.
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Affiliation(s)
- Massimo Nardone
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Anthony V Incognito
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | | | - Lucas Joseph Omazic
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jordan B Lee
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - André L Teixeira
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Shengkun Xie
- Global Management Studies, Ted Rogers School of Management, Ryerson University, Toronto, Ontario, Canada
| | - Lauro C Vianna
- NeuroVASQ - Integrative Physiology Laboratory, Faculty of Physical Education, University of Brasilia, Brazil
| | - Philip J Millar
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada.,Toronto General Research Institute, Toronto General Hospital, Toronto, Ontario, Canada
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27
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Goudman L, De Smedt A, Louis F, Stalmans V, Linderoth B, Rigoard P, Moens M. The Link Between Spinal Cord Stimulation and the Parasympathetic Nervous System in Patients With Failed Back Surgery Syndrome. Neuromodulation 2021; 25:128-136. [PMID: 33987891 DOI: 10.1111/ner.13400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In patients with chronic pain, a relative lower parasympathetic activity is suggested based on heart rate variability measurements. It is hypothesized that spinal cord stimulation (SCS) is able to influence the autonomic nervous system. The aim of this study is to further explore the influence of SCS on the autonomic nervous system by evaluating whether SCS is able to influence skin conductance, blood volume pulse, heart rate, and respiration rate. MATERIALS AND METHODS Twenty-eight patients with Failed Back Surgery Syndrome (FBSS), who are treated with SCS, took part in this multicenter study. Skin conductance and cardiorespiratory parameters (blood volume pulse, heart rate, and respiration rate) were measured during on and off states of SCS. Paired statistics were performed on a 5-min recording segment for all parameters. RESULTS SCS significantly decreased back and leg pain intensity scores in patients with FBSS. Skin conductance level and blood volume pulse were not altered between on and off states of SCS. Heart rate and respiration rate significantly decreased when SCS was activated. CONCLUSIONS Parameters that are regulated by the sympathetic nervous system were not significantly different between SCS on and off states, leading to the hypothesis that SCS is capable of restoring the dysregulation of the autonomic nervous system by primarily increasing the activity of the parasympathetic system, in patients with FBSS.
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Affiliation(s)
- Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium.,Pain in Motion International Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium.,STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Ann De Smedt
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium.,STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Jette, Belgium.,Department of Physical Medicine and Rehabilitation, Universitair Ziekenhuis Brussel, Jette, Belgium
| | - Frédéric Louis
- Clinique de la douleur, Clinique Sainte-Elisabeth-CHC, Verviers, Belgium
| | - Virginie Stalmans
- Clinique de la douleur, Clinique Sainte-Elisabeth-CHC, Verviers, Belgium
| | - Bengt Linderoth
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Philippe Rigoard
- Department of Spine, Neuromodulation and Rehabilitation, Poitiers University Hospital, Poitiers, France.,Institut Pprime UPR 3346, CNRS, ISAE-ENSMA, University of Poitiers, Poitiers, France.,PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Jette, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel, Jette, Belgium.,Pain in Motion International Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Jette, Belgium.,STIMULUS Consortium (reSearch and TeachIng neuroModULation Uz bruSsel), Universitair Ziekenhuis Brussel, Jette, Belgium.,Department of Radiology, Universitair Ziekenhuis Brussel, Jette, Belgium
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Di Natale MR, Stebbing MJ, Furness JB. Autonomic neuromuscular junctions. Auton Neurosci 2021; 234:102816. [PMID: 33991756 DOI: 10.1016/j.autneu.2021.102816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 01/25/2023]
Abstract
This review traces the history of the discovery and subsequent understanding of smooth muscle cells and their motor innervation. Smooth muscle tissue is made up of thousands of very small, individual, electrically connected, muscle cells. Each axon that enters a smooth muscle tissue branches extensively to form a terminal arbour that comes close to hundreds of smooth muscle cells. The branches of the terminal arbour are varicose, and each varicosity, of which there can be thousands, contains numerous transmitter storage vesicles. However, the probability of an individual varicosity releasing transmitter onto the adjacent muscle cells when an action potential passes is low. Many axons influence each muscle cell, some because they release transmitter close to the cell, and some because the events that they cause in other cells are electrically coupled to the cell under investigation. In tissues where this has been assessed, 20 or more axons can influence a single smooth muscle cell. We present a model of the innervation and influence of neurons on smooth muscle.
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Affiliation(s)
- Madeleine R Di Natale
- Department of Anatomy & Physiology, University of Melbourne, Parkville, VIC 3010, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3010, Australia
| | - Martin J Stebbing
- Department of Anatomy & Physiology, University of Melbourne, Parkville, VIC 3010, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3010, Australia
| | - John B Furness
- Department of Anatomy & Physiology, University of Melbourne, Parkville, VIC 3010, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3010, Australia.
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29
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Critchley HD, Botan V, Ward J. Absence of reliable physiological signature of illusory body ownership revealed by fine-grained autonomic measurement during the rubber hand illusion. PLoS One 2021; 16:e0237282. [PMID: 33793569 PMCID: PMC8016256 DOI: 10.1371/journal.pone.0237282] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 03/10/2021] [Indexed: 01/15/2023] Open
Abstract
The neural representation of a 'biological self' is linked theoretically to the control of bodily physiology. In an influential model, selfhood relates to internal agency and higher-order interoceptive representation, inferred from the predicted impact of efferent autonomic nervous activity on afferent viscerosensory feedback. Here we tested if an altered representation of physical self (illusory embodiment of an artificial hand) is accompanied by sustained shifts in autonomic activity. Participants (N = 37) underwent procedures for induction of the rubber hand illusion (synchronous stroking of own unseen hand and observed stroking of artificial hand) and a control condition (asychronous stroking). We recorded electrocardiography, electrodermal activity, and a non-invasive measure of multiunit skin sympathetic nerve activity (SKNA) from the chest. We compared these autonomic indices between task conditions, and between individuals who did and did not experience the illusion. Bayes factors quantified the strength of evidence for and against null hypotheses. Observed proprioceptive drift and subjective reports confirmed the efficacy of the synchronous (vs asynchronous) condition in inducing illusory hand ownership. Stringent discriminant analysis classified 24/37 individuals as experiencing the rubber hand illusion. Surprisingly, heart rate, heart rate variability, electrodermal activity, and SKNA measures revealed no autonomic differences between synchronous vs asynchronous conditions, nor between individuals who did or did not experience the rubber hand illusion. Bayes factors indicated substantial evidence for no physiological differences. In contrast to earlier reports, our autonomic data show the absence of a reliable change in physiological state during the rubber hand illusion. More encompassing perturbations of self-experience, for example in full body illusions, may nevertheless be coupled to, or facilitated by, changes in efferent autonomic activity and afferent viscerosensory feedback. Our findings suggest that such changes in bodily physiology are not sustained as an obligatory component of the rubber hand illusion.
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Affiliation(s)
- Hugo D. Critchley
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
- Brighton and Sussex Medical School, University of Sussex and University of Brighton, Brighton, United Kingdom
| | - Vanessa Botan
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Jamie Ward
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
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30
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Young BE, Greaney JL, Keller DM, Fadel PJ. Sympathetic transduction in humans: recent advances and methodological considerations. Am J Physiol Heart Circ Physiol 2021; 320:H942-H953. [PMID: 33416453 DOI: 10.1152/ajpheart.00926.2020] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ever since their origin more than one half-century ago, microneurographic recordings of sympathetic nerve activity have significantly advanced our understanding of the generation and regulation of central sympathetic outflow in human health and disease. For example, it is now appreciated that a myriad of disease states exhibit chronic sympathetic overactivity, a significant predictor of cardiovascular morbidity and mortality. Although microneurographic recordings allow for the direct quantification of sympathetic outflow, they alone do not provide information with respect to the ensuing sympathetically mediated vasoconstriction and blood pressure (BP) response. Therefore, the study of vascular and/or BP responses to sympathetic outflow (i.e., sympathetic transduction) has now emerged as an area of growing interest within the field of neural cardiovascular control in human health and disease. To date, studies have primarily examined sympathetic transduction under two distinct paradigms: when reflexively evoking sympatho-excitation through the induction of a laboratory stressor (i.e., sympathetic transduction during stress) and/or following spontaneous bursts of sympathetic outflow occurring under resting conditions (i.e., sympathetic transduction at rest). The purpose of this brief review is to highlight how our physiological understanding of sympathetic transduction has been advanced by these studies and to evaluate the primary analytical techniques developed to study sympathetic transduction in humans. We also discuss the framework by which the assessment of sympathetic transduction during stress reflects a fundamentally different process relative to sympathetic transduction at rest and why findings from investigations using these different techniques should be interpreted as such and not necessarily be considered one and the same.
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Affiliation(s)
- Benjamin E Young
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Jody L Greaney
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - David M Keller
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
| | - Paul J Fadel
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas
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31
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Watso JC, Huang M, Moralez G, Cramer MN, Hendrix JM, Cimino FA, Belval LN, Hinojosa‐Laborde C, Crandall CG. Low dose ketamine reduces pain perception and blood pressure, but not muscle sympathetic nerve activity, responses during a cold pressor test. J Physiol 2020; 599:67-81. [DOI: 10.1113/jp280706] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/01/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Joseph C. Watso
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
| | - Mu Huang
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
- Department of Applied Clinical Research University of Texas Southwestern Medical Center Dallas TX USA
| | - Gilbert Moralez
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
- Department of Applied Clinical Research University of Texas Southwestern Medical Center Dallas TX USA
| | - Matthew N. Cramer
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
| | - Joseph M. Hendrix
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
- Department of Anesthesiology University of Texas Southwestern Medical Center Dallas TX USA
| | - Frank A. Cimino
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
| | - Luke N. Belval
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
| | | | - Craig G. Crandall
- Institute for Exercise and Environmental Medicine Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center Dallas TX USA
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32
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Hissen SL, Taylor CE. Sex differences in vascular transduction of sympathetic nerve activity. Clin Auton Res 2020; 30:381-392. [PMID: 32865664 DOI: 10.1007/s10286-020-00722-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Sympathetic vasoconstriction plays a major role in the beat-to-beat control of blood pressure. To be effective and thus avoid dangerously high or low blood pressures, this mechanism relies upon transduction of sympathetic nerve activity at the level of the vasculature. However, recent evidence suggests that considerable variability exists in beat-to-beat vascular transduction, particularly between the sexes. METHODS We reviewed the methods available for quantifying beat-to-beat transduction of muscle sympathetic nerve activity (MSNA) and explored the recent evidence for sex differences in vascular transduction. We paid specific attention to relationships between vascular transduction and factors such as resting levels of sympathetic nerve activity and baroreflex sensitivity. RESULTS There are two dominant methods now available for the quantification of beat-to-beat transduction of muscle sympathetic nerve activity at rest. Whilst there is some evidence to suggest that young females exhibit lower levels of vascular transduction, results vary depending on the method used and the direction of change in MSNA. Evidence suggests that compensatory relationships may exist between key components of neurovascular control, such as vascular transduction and resting levels of MSNA. Also consistent is the presence of such relationships in young males but not young females. CONCLUSION The lack of significant relationships in young females may reflect the influence of vasodilator mechanisms that counteract sympathetic vasoconstriction. The assessment of vascular transduction following MSNA bursts and non-bursts in males and females, both young and older, may help to gain a mechanistic understanding of the prevalence of hypotensive and hypertensive disorders across the lifespan.
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Affiliation(s)
- Sarah L Hissen
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas, Dallas, TX, USA
- The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, Sydney, NSW, 2751, Australia.
- School of Medicine, Western Sydney University, Sydney, Australia.
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