Targeting Parasympathetic Activity to Improve Autonomic Tone & Clinical Outcomes

Physiology ◽  
2021 ◽  
Author(s):  
Matthew W Kay ◽  
Vivek Jain ◽  
Gurusher Panjrath ◽  
David Mendelowitz
Keyword(s):  
Clinical Outcomes ◽  
Parasympathetic Activity ◽  
Autonomic Tone ◽  
Autonomic Imbalance ◽  
The Brain

In this review we will briefly summarize the evidence that autonomic imbalance, and more specifically, reduced parasympathetic activity to the heart generates and/or maintains many cardiorespiratory diseases; and discuss mechanisms and sites, from myocytes to the brain, that are potential translational targets for restoring parasympathetic activity and improving cardiorespiratory health.

scholarly journals Neurotransmission to parasympathetic cardiac vagal neurons in the brain stem is altered with left ventricular hypertrophy-induced heart failure

2015 ◽  
Vol 309 (8) ◽  
pp. H1281-H1287 ◽  
Author(s):  
Edmund Cauley ◽  
Xin Wang ◽  
Jhansi Dyavanapalli ◽  
Ke Sun ◽  
Kara Garrott ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Diseases ◽  
Left Ventricular Hypertrophy ◽  
Cardiac Hypertrophy ◽  
Brain Stem ◽  
Ventricular Hypertrophy ◽  
Cardiac Activity ◽  
Left Ventricular ◽  
Parasympathetic Activity ◽  
The Brain

Hypertension, cardiac hypertrophy, and heart failure (HF) are widespread and debilitating cardiovascular diseases that affect nearly 23 million people worldwide. A distinctive hallmark of these cardiovascular diseases is autonomic imbalance, with increased sympathetic activity and decreased parasympathetic vagal tone. Recent device-based approaches, such as implantable vagal stimulators that stimulate a multitude of visceral sensory and motor fibers in the vagus nerve, are being evaluated as new therapeutic approaches for these and other diseases. However, little is known about how parasympathetic activity to the heart is altered with these diseases, and this lack of knowledge is an obstacle in the goal of devising selective interventions that can target and selectively restore parasympathetic activity to the heart. To identify the changes that occur within the brain stem to diminish the parasympathetic cardiac activity, left ventricular hypertrophy was elicited in rats by aortic pressure overload using a transaortic constriction approach. Cardiac vagal neurons (CVNs) in the brain stem that generate parasympathetic activity to the heart were identified with a retrograde tracer and studied using patch-clamp electrophysiological recordings in vitro. Animals with left cardiac hypertrophy had diminished excitation of CVNs, which was mediated both by an augmented frequency of spontaneous inhibitory GABAergic neurotransmission (with no alteration of inhibitory glycinergic activity) as well as a diminished amplitude and frequency of excitatory neurotransmission to CVNs. Opportunities to alter these network pathways and neurotransmitter receptors provide future targets of intervention in the goal to restore parasympathetic activity and autonomic balance to the heart in cardiac hypertrophy and other cardiovascular diseases.

scholarly journals The Stroke-Induced Blood-Brain Barrier Disruption: Current Progress of Inspection Technique, Mechanism, and Therapeutic Target

2020 ◽  
Vol 18 (12) ◽  
pp. 1187-1212 ◽  
Author(s):  
Takeshi Okada ◽  
Hidenori Suzuki ◽  
Zachary D. Travis ◽  
John H. Zhang
Keyword(s):  
Endothelial Cells ◽  
Clinical Outcomes ◽  
Imaging Techniques ◽  
Myeloid Cells ◽  
In Vivo Studies ◽  
Secondary Products ◽  
Characteristic Structure ◽  
Inflammatory Phenotype ◽  
Anti Inflammatory ◽  
The Brain

Stroke is one of the leading causes of mortality and morbidity worldwide. The bloodbrain barrier (BBB) is a characteristic structure of microvessel within the brain. Under normal physiological conditions, the BBB plays a role in the prevention of harmful substances entering into the brain parenchyma within the central nervous system. However, stroke stimuli induce the breakdown of BBB leading to the influx of cytotoxic substances, vasogenic brain edema, and hemorrhagic transformation. Therefore, BBB disruption is a major complication, which needs to be addressed in order to improve clinical outcomes in stroke. In this review, we first discuss the structure and function of the BBB. Next, we discuss the progress of the techniques utilized to study BBB breakdown in in-vitro and in-vivo studies, along with biomarkers and imaging techniques in clinical settings. Lastly, we highlight the mechanisms of stroke-induced neuroinflammation and apoptotic process of endothelial cells causing BBB breakdown, and the potential therapeutic targets to protect BBB integrity after stroke. Secondary products arising from stroke-induced tissue damage provide transformation of myeloid cells such as microglia and macrophages to pro-inflammatory phenotype followed by further BBB disruption via neuroinflammation and apoptosis of endothelial cells. In contrast, these myeloid cells are also polarized to anti-inflammatory phenotype, repairing compromised BBB. Therefore, therapeutic strategies to induce anti-inflammatory phenotypes of the myeloid cells may protect BBB in order to improve clinical outcomes of stroke patients.

The Vegetative Status Correction in the Patients with Chronic Dyscirculatory Encephalopathy on the Sanatorium Rehabilitation Stage

10.12737/5760 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-6
Author(s):  
Куликов ◽  
N. Kulikov ◽  
Череващенко ◽  
Lyubov Cherevashchenko ◽  
Череващенко ◽  
...  
Keyword(s):  
Laser Therapy ◽  
The State ◽  
The Body ◽  
Brain Diseases ◽  
Control Group ◽  
Autonomic Imbalance ◽  
Dyscirculatory Encephalopathy ◽  
Before And After ◽  
The Brain ◽  
Adaptive Reactions

Among vascular brain diseases a special place in its importance takes chronic cerebrovascular pathology in the form of dyscirculatory encephalopathy. The most frequently affected cerebral structures with discirculatory encephalopathy are those parts of the brain that are largely responsible for shaping over segmental vegetative disorders, which are characteristic of clinics chronic cerebrovascular insufficiency. The purpose of this work is to develop a new modern high technology of sanatorium rehabilitation of the patients with circulatory encephalopathy on stage I and to correct autonomic imbalance. The authors observed 60 patients who were divided into 2 groups. The control group received radon baths, the patients from the main group in addition to radon baths received laser therapy paravertebrally C1-Th3, according to scanning technique. In all patients before and after treatment the state of the autonomic nervous system studied. It was found that the initial manifestations of vascular encephalopathy accompanied by autonomic imbalance with a predominance of sympathetic tone, activation and inhibition effects of ergotrop activities segmental systems, primarily due to the parasympathetic division. The results of this study demonstrate feasibility of incorporating laser therapy in complex radon baths for rehabilitation of patients with circulatory encephalopathy autonomic imbalance. The findings suggest that improving the functional state mechanisms vegetative maintenance activities, which help to eliminate the state of surge and flow of adaptive reactions in the body.

Assessment of heart rate variability for different somatotype category among adolescents

2018 ◽  
Vol 30 (3) ◽  
Author(s):  
Senthil Kumar Subramanian ◽  
Vivek Kumar Sharma ◽  
Rajathi Rajendran
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Sympathetic Activity ◽  
Parasympathetic Activity ◽  
Age Group ◽  
Autonomic Tone ◽  
Non Invasive ◽  
Invasive Test ◽  
Obesity And Overweight ◽  
The Time Domain

Abstract Background Somatotype is a quantified expression of the morphological conformation of a person in terms of three-numeral rating each representing one component; fat (endomorphy), muscle mass (mesomorphy) and bone length (ectomorphy) in the same order. Certain somatotypes are more prone to develop the particular disease. Obesity and overweight are already epidemic among Indian adolescents and are increasing at an alarming rate, and obesity is linked to cardiovascular (CV) risk in this age group. Identifying the heart rate variability (HRV) is an established non-invasive test to identify the CV risk. The objective of this study is to record the HRV data for each somatotype category and to compare the HRV data among these somatotype categories in adolescents. Methods The volunteer adolescents in the age group of 12–17 years were classified into a different somatotyping categories based on the Heath Carter somatotyping method. The short-term HRV was recorded in all the subjects using wireless BioHarness 3.0. Results Based on the time domain and frequency domain parameters, the parasympathetic activity showed decreasing order as follows: central>ectomorphy>mesomorphy>endomorphy, whereas sympathetic activity showed increasing order as follows: central<ectomorphy<mesomorphy<endomorphy in both boys and girls. Girls have higher parasympathetic activity and lesser sympathetic activity than boys in ectomorphy and mesomorphy. In the central somatotype and endomorphy categories, genders were comparable. Conclusion Our study suggests that endomorphy and mesomorphy have poorer autonomic tone when compared to other somatotype categories.

Chronic intermittent hypoxia alters neurotransmission from lateral paragigantocellular nucleus to parasympathetic cardiac neurons in the brain stem

2015 ◽  
Vol 113 (1) ◽  
pp. 380-389 ◽  
Author(s):  
Olga Dergacheva
Keyword(s):  
Brain Stem ◽  
Rem Sleep ◽  
Cardiovascular Events ◽  
Intermittent Hypoxia ◽  
Female Rats ◽  
Parasympathetic Activity ◽  
Male Rats ◽  
Chronic Intermittent Hypoxia ◽  
Gabaergic Neurotransmission ◽  
The Brain

Patients with sleep-related disorders, including obstructive sleep apnea (OSA), have an increased risk of cardiovascular diseases. OSA events are more severe in rapid eye movement (REM) sleep. REM sleep further increases the risk of adverse cardiovascular events by diminishing cardioprotective parasympathetic activity. The mechanisms underlying REM sleep-related reduction in parasympathetic activity likely include activation of inhibitory input to cardiac vagal neurons (CVNs) in the brain stem originating from the lateral paragigantocellular nucleus (LPGi), a nucleus that plays a role in REM sleep control. This study tests the hypothesis that chronic intermittent hypoxia and hypercapnia (CIHH), an animal model of OSA, inhibits CVNs because of exaggeration of the GABAergic pathway from the LPGi to CVNs. GABAergic neurotransmission to CVNs evoked by electrical stimulation of the LPGi was examined with whole cell patch-clamp recordings in an in vitro brain slice preparation in rats exposed to CIHH and control rats. GABAergic synaptic events were enhanced after 4-wk CIHH in both male and female rats, to a greater degree in males. Acute hypoxia and hypercapnia (H/H) reversibly diminished the LPGi-evoked GABAergic neurotransmission to CVNs. However, GABAergic synaptic events were enhanced after acute H/H in CIHH male animals. Orexin-A elicited a reversible inhibition of LPGi-evoked GABAergic currents in control animals but evoked no significant changes in CIHH male rats. In conclusion, exaggerated inhibitory neurotransmission from the LPGi to CVNs in CIHH animals would reduce cardioprotective parasympathetic activity and enhance the risk of adverse cardiovascular events.

Chronic infusion of angiotensin-(1-7) into the lateral ventricle of the brain attenuates hypertension in DOCA-salt rats

2012 ◽  
Vol 303 (3) ◽  
pp. H393-H400 ◽  
Author(s):  
Priscila S. Guimaraes ◽  
Nivia M. Santiago ◽  
Carlos H. Xavier ◽  
Elizabeth P. P. Velloso ◽  
Marco A. P. Fontes ◽  
...  
Keyword(s):  
Left Ventricle ◽  
Mrna Expression ◽  
Collagen Type ◽  
Collagen Type I ◽  
Type I ◽  
Sprague Dawley ◽  
Autonomic Tone ◽  
Baroreflex Control ◽  
Salt Hypertension ◽  
The Brain

Angiotensin-(ANG)-(1-7) is known by its central and peripheral actions, which mainly oppose the deleterious effects induced by accumulation of ANG II during pathophysiological conditions. In the present study we evaluated whether a chronic increase in ANG-(1-7) levels in the brain would modify the progression of hypertension. After DOCA-salt hypertension was induced for seven days, Sprague-Dawley rats were subjected to 14 days of intracerebroventricular (ICV) infusion of ANG-(1-7) (200 ng/h, DOCA-A7) or 0.9% sterile saline. As expected, on the 21st day, DOCA rats presented increased mean arterial pressure (MAP) (≈40%), and impaired baroreflex control of heart rate (HR) and baroreflex renal sympathetic nerve activity (RSNA) in comparison with that in normotensive control rats (CTL). These changes were followed by an overactivity of the cardiac sympathetic tone and reduction of the cardiac parasympathetic tone, and exaggerated mRNA expression of collagen type I (≈9-fold) in the left ventricle. In contrast, DOCA rats treated with ANG-(1-7) ICV had an improvement of baroreflex control of HR, which was even higher than that in CTL, and a restoration of the baroreflex control of RSNA, the balance of cardiac autonomic tone, and normalized mRNA expression of collagen type I in the left ventricle. Furthermore, DOCA-A7 had MAP lowered significantly. These effects were not accompanied by significant circulating or cardiac changes in angiotensin levels. Taken together, our data show that chronic increase in ANG-(1-7) in the brain attenuates the development of DOCA-salt hypertension, highlighting the importance of this peptide in the brain for the treatment of cardiovascular diseases.

scholarly journals The Design and Use of a Minimally-Invasive, Expandable Retractor for Deep-Seated Brain Lesions

2020 ◽  
Author(s):  
Sun Jay Yoo ◽  
Jody Mou ◽  
Reena Elizebath ◽  
Ananyaa Sivakumar ◽  
Rene DeBrabander ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Brain Lesion ◽  
Balloon Catheter ◽  
Brain Lesions ◽  
Iatrogenic Injury ◽  
Anatomic Landmarks ◽  
System A ◽  
Catheter System ◽  
The Brain

Abstract Access to deep-seated brain lesions (e.g., tumors, aneurysms, hematomas, and other malformations) is challenging due to the potential for retraction-induced injury. Traditionally, neurosurgeons use dissection and blade retractors to push apart tissue to visualize and operate on target lesions. These blades apply focal pressure onto the brain, resulting in ischemia, edema, and parenchymal trauma, leading to complications in up to 29% of cases. Tubular retractors were introduced to distribute forces radially and have led to improved safety and clinical outcomes. However, reports indicate that tubular retractors still led to complications in up to 9.1% of cases. Other concerns include significant pressure in the direction of insertion and the displacement of anatomic landmarks leading to inaccurate stereotaxis. We present a novel, minimally-invasive brain retractor that utilizes an expandable soft balloon to further reduce retraction-induced injury and increase stereotactic accuracy with a minimal port of entry. The device consists of a balloon catheter system, a clear sheath, and integration with neuronavigation stylets. This approach can reduce the rate of iatrogenic injury and improve clinical outcomes for brain lesion operations. Furthermore, we illustrate the efficacy of this device in use compared to those of conventional tubular and blade retractors in a pig cadaver.

Neuroprotective strategies following intraparenchymal hemorrhage

2017 ◽  
Vol 9 (12) ◽  
pp. 1202-1207 ◽  
Author(s):  
Robin Moshe Babadjouni ◽  
Ryan E Radwanski ◽  
Brian P Walcott ◽  
Arati Patel ◽  
Ramon Durazo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Coagulation Factors ◽  
Therapeutic Agents ◽  
Heme Iron ◽  
Hematoma Expansion ◽  
Intraparenchymal Hemorrhage ◽  
Neuroprotective Strategies ◽  
Primary Injury ◽  
The Brain

Intracerebral hemorrhage and, more specifically, intraparenchymal hemorrhage, are devastating disease processes with poor clinical outcomes. Primary injury to the brain results from initial hematoma expansion while secondary hemorrhagic injury occurs from blood-derived products such as hemoglobin, heme, iron, and coagulation factors that overwhelm the brains natural defenses. Novel neuroprotective treatments have emerged that target primary and secondary mechanisms of injury. Nonetheless, translational application of neuroprotectants from preclinical to clinical studies has yet to show beneficial clinical outcomes. This review summarizes therapeutic agents and neuroprotectants in ongoing clinical trials aimed at targeting primary and secondary mechanisms of injury after intraparenchymal hemorrhage.

scholarly journals Influence of the Volume of the Ischemic Origin on Clinical Outcomes of the Brain Stroke

2019 ◽  
pp. 1-3
Author(s):  
Z. A. Akbarkhodjaeva ◽  
G. S. Rakhimbaeva
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcomes ◽  
Brain Diseases ◽  
Brain Functions ◽  
Large Size ◽  
Brain Stroke ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic ◽  
Relationship Of ◽  
The Brain

In this article authors discussed about the influence of volume of the ischemic origin on clinical outcomes in patients with stroke. Cerebral ischemic stroke is one of the main cause of death among cardiovascular and brain diseases. The study is dedicated to learn the relationship of the dynamics of the volume of the ischemic focus with clinical outcome of stroke. For this study, 125 patients were examined and analyzed. MRI of the brain in acute period of ischemic stroke in 78% of patients were assessed that foci of ischemia of small (less than 10 cm3), medium (10-50 cm3) and large size (more than 50 cm3). Lacunarstrokes, as well as the size of the penumbra, affecting the ability to restore impaired brain functions, can be identified only by magnetic resonance imaging of the brain.

Sign in / Sign up

Export Citation Format

Share Document