The features of autonomic nervous system homeostasis and adaptive potential in children with syncope

The investigation of the nature of syncope shows that it is caused by failure of compensatory reflex mechanisms of the autonomic nervous system. Therefore, the determination of specific parameters of autonomic nervous system homeostasis and adaptive potential improves the approach to determining the clinical predictors of the syncope and facilitate its early diagnosis. Purpose — to determine the nature and compare of autonomic dysregulation and functional changes of in children with syncope of different genesis, to identify the circumstances for the formation of insufficient autonomic regulation. Materials and methods. The enrolled subjects were 125 children with syncope, aged 8–17 years, and 41 controls. Children were divided into three groups for analysis: 81 — with vasovagal syncope, 25 — with syncope due to orthostatic hypotension, 19 — with cardiogenic syncope. All children underwent a clinical and functional examination of the cardiovascular system to identify features of autonomic homeostasis. Results. Autonomic imbalance with a predominance of sympathetic autonomic regulation was detected in children of all study groups. The results of functional tests and quantitative integrative indicators showed significantly increased autonomic reactivity with depletion of adaptive potential in all study groups (p<0.05). Children with vasovagal syncope had excessive levels more often (p<0.05), and children with syncope due to orthostatic hypotension had insufficient levels of autonomic support (p<0.05). Violations of cardiorespiratory inter systemic connections were found in children with vasovagal and cardiogenic syncope significantly more often, compared to the control group (p <0.05). Correlations were found between the parameters of the initial autonomic balance, autonomic support of the circulatory system, and the manifestations of syncope in children. Conclusions. The correlation between pathological types of autonomic response and the frequency and duration of syncopal episode indicates a pathogenetic relationship between the state of autonomic support and the ability of the circulatory system to respond to triggers. Therefore, indicators of the autonomic homeostasis and adaptive potential can be applied for predicting the occurrence of syncopal episodes and monitoring of effective management of syncope in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, syncope, autonomic nervous system homeostasis, adaptive potential.

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Spectral analysis of heart rate in vasovagal syncope: The autonomic nervous system in vasovagal syncope

Clinical Autonomic Research ◽

10.1007/bf01829016 ◽

1993 ◽

Vol 3 (4) ◽

pp. 261-269 ◽

Cited By ~ 17

Author(s):

A. Baharav ◽

M. Mimouni ◽

T. Lehrman-Sagie ◽

S. Izraeli ◽

S. Akselrod

Keyword(s):

Heart Rate ◽

Nervous System ◽

Spectral Analysis ◽

Autonomic Nervous System ◽

Vasovagal Syncope ◽

Autonomic Nervous

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Beta 3 subunit of G-protein and its influence on autonomic nervous system in patients with vasovagal syncope

Bratislava Medical Journal ◽

10.4149/bll_2016_027 ◽

2016 ◽

Vol 116 (03) ◽

pp. 142-147

Author(s):

L. Evin ◽

P. Mitro ◽

V. Habalova ◽

M. Simurda ◽

E. Muller ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

G Protein ◽

Vasovagal Syncope ◽

Autonomic Nervous

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Blood Pressure and Orthostatic Hypotension: Faints, Near-Faints, and Lightheadedness

Dementia with Lewy Body and Parkinson's Disease Patients ◽

10.1093/oso/9780199977567.003.0022 ◽

2013 ◽

Author(s):

J. Eric Ahlskog

Keyword(s):

Blood Pressure ◽

Nervous System ◽

Autonomic Nervous System ◽

Orthostatic Hypotension ◽

Vessel Diameter ◽

Upright Position ◽

Grocery Store ◽

The Body ◽

Autonomic Nervous ◽

Neurodegenerative Process

Case example: Mrs. H. feels lightheaded intermittently during the day. This happens exclusively when she is up and about. Sometimes she notes graying of vision with these episodes. The feeling is not spinning (i.e., not vertigo). She has fainted twice when standing in line at the grocery store. If she sits, she feels much better. It is worse in the morning but may recur any time of the day. She feels fine while lying in bed at night. Older adults often worry about high blood pressure (BP), yet the opposite problem, low BP, is common among those with DLB or PDD. This is because the Lewy neurodegenerative process impairs the autonomic nervous system. The specific condition that may afflict those with DLB or PDD is orthostatic hypotension. The term orthostatic implies the upright position (i.e., standing); hypotension translates into low BP. Thus, the low BP occurring in these Lewy disorders develops in the upright position; conversely, it is normal or even high when lying down. When standing or walking, the BP may drop so low that fainting occurs. Among people with orthostatic hypotension, the BP is normal when sitting, although in severe cases, even the sitting BP is low. Whereas most people with DLB or PDD do not experience symptoms of orthostatic hypotension, it is sufficiently frequent to deserve attention. It often goes undiagnosed, even when fainting occurs. Unrecognized orthostatic hypotension may limit activities and impair the person’s quality of life. The first half of this chapter provides further background, with focus on BP measurement and recognition of orthostatic hypotension. The last half addresses treatment. The normal autonomic nervous system senses the position of our body with respect to the pull of gravity. It is able to reflexively counter gravity’s downward pull on the blood volume when standing (gravity tends to draw blood toward our feet when standing). An important mechanism for countering gravity’s pull is the constriction of blood vessel diameter in the lower half of the body. These vessels reflexively constrict during standing, in effect forcing blood up to the brain. The autonomic nervous system mediates these and other reflexive changes to stabilize BP.

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Orthostatic Hypotension in Human Immunodeficiency Virus Infection May Be the Result of Generalized Autonomic Nervous System Dysfunction

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/00126334-199101000-00004 ◽

1991 ◽

Vol 4 (1) ◽

pp. 31???33 ◽

Cited By ~ 11

Author(s):

Jeffrey A. Cohen ◽

Laurel Miller ◽

Lou Polish

Keyword(s):

Human Immunodeficiency Virus ◽

Nervous System ◽

Autonomic Nervous System ◽

Virus Infection ◽

Human Immunodeficiency Virus Infection ◽

Orthostatic Hypotension ◽

Autonomic Nervous System Dysfunction ◽

Autonomic Nervous ◽

Immunodeficiency Virus

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Autonomic Nervous System Dysregulation in Response To Postural Change in Patients with Pectus Excavatum in Taiwan: A Pilot Study

10.21203/rs.3.rs-855992/v1 ◽

2021 ◽

Author(s):

Yu-Ting Hsu ◽

Yeung-Leung Cheng ◽

Yi-Wei Chang ◽

Chou-Chin Lan ◽

Yao-Kuang Wu ◽

...

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Sleep Quality ◽

Pectus Excavatum ◽

Study Groups ◽

Control Group ◽

Study Group ◽

Postural Change ◽

Psychological Function ◽

Autonomic Nervous

Abstract Background Pectus excavatum (PE) negatively impacts psychological function, but its effect on autonomic nervous system (ANS) function has not been investigated. We evaluated ANS function following postural changes in patients with PE.Methods The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). ANS regulation in response to postural change was measured in the supine position and immediately after sitting. All measurements were compared between the control and study groups at baseline and between the study groups before and after Nuss surgery.ResultsAt baseline, upon postural change, symptomatic activity increased in the control group (50.3% to 67.4%, p=0.035) but not in the study group (55.0% to 54.9%, p=0.654); parasympathetic activity decreased in the control group (49.7% to 32.6%, p=0.035) but not in the study group (45.1% to 45.1%, p=0.654); and overall ANS regulation increased in the control group (1.02 to 2.08, p=0.030) but not in the study group (1.22 to 1.22, p=0.322). In response to postural change after Nuss surgery in the study group, sympathetic activity increased (48.7% to 70.2%, p=0.005), parasympathetic activity decreased (51.3% to 29.8%, p=0.005), and overall ANS regulation increased (0.95 to 2.36, p=0.012).Conclusion ANS function in response to postural change is dysregulated in patients with PE, which improved after Nuss surgery.Trial registration: ClinicalTrials.gov, ID: NCT03346876, November 15, 2017, retrospectively registered,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007KGI&selectaction=Edit&uid=U0003JZU&ts=2&cx=cstxeg

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Peculiarities of vegetative provision and disorders of tolerance to exercise in children with endocrine and cardiac pathology

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(4)-13 ◽

2020 ◽

Vol 24 (4) ◽

pp. 634-639

Author(s):

K. Shtrakh ◽

O. Tsiura ◽

L. Rak ◽

N. Shevchenko

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Nervous System ◽

Autonomic Nervous System ◽

Arterial Hypertension ◽

Exercise Tolerance ◽

The State ◽

Cardiac Pathology ◽

Autonomic Nervous ◽

Autonomic Support

Annotation. The aim – to find out the features of autonomic support and exercise tolerance of the cardiovascular system in children with chronic non-infectious diseases, in the future will be able to improve the results of diagnosis and rehabilitation of patients, as well as differentially regulate the mode of the exercise regime for patients. The study included 58 children aged 10-17 years, with cardiac and endocrine pathology: group 1 – 23 children with endocrine pathology (type 1 diabetes mellitus), group 2 – 23 children with cardiac pathology (AH stages I-II). The study included clinical examinations, anthropometry, a questionnaire of physical activity by MAOFA, ECG, ultrasound examination of the heart and Rufier's test were performed. Assessment of the state of the autonomic nervous system was carried out using the Kerdo index and COT. Statistical analysis was performed using s/n program SPSS 17 4a 180844250981. It was found that there is a tendency to outstrip the normative values and increased body weight indicators in the examined children with chronic pathology of the endocrine and cardiovascular systems. According to the Rufier test, it was found that in the group of children with diabetes mellitus, 69.5±9.6% of the examined had low results. Among children with hypertension, 30.7±10.4% of the test indicators were regarded as weak, and in 26.9±5.8% – unsatisfactory. The results of Rufier's test were significantly lower in children with endocrine pathology, both in comparison with the group of children with cardiac pathology (p<0.05) and with the control group (p≤0.001). In 70.0±15.3% of cases, weak and unsatisfactory indicators of the Ruffier test were observed against the background of hyperdiastolic autonomic support. In physically nonactive adolescents, asympathicotonic and hyperdiastolic types of COT were observed. Thus, almost 70% of children with diabetes mellitus and 57% of children with arterial hypertension have reduced exercise tolerance. This is associated with hyperdiastolic autonomic support. Physical activity has a positive effect on the state of the autonomic nervous system in children with arterial hypertension and diabetes mellitus.

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Autonomic nervous system dysfunction

Oxford Textbook of Neurorehabilitation ◽

10.1093/med/9780199673711.003.0010 ◽

2015 ◽

pp. 89-111 ◽

Cited By ~ 1

Author(s):

Angela Gall ◽

Mike Craggs

Keyword(s):

Nervous System ◽

Autonomic Nervous System ◽

Circulatory System ◽

Brain Structures ◽

Gastrointestinal Function ◽

Metabolic Disturbances ◽

Autonomic Nervous System Dysfunction ◽

Future Directions ◽

Autonomic Nervous ◽

Whole Systems

This chapter delivers an overview of autonomic functions, their control and pathophysiology, reviews the most important and specific autonomic system disorders, their causes, management, and assessment, and future directions for neurorehabilitation following autonomic failure. The autonomic nervous system (ANS)regulates responses to exercise, environmental challenges, and emotional responses.The system has two main divisions, sympathetic and parasympathetic, continuously monitoring and controlling the visceral organs. Many brain structures are essential to the ANS.ANS disorders can affect a single organ or whole systems and can result in neuropathies.Alterations in ANS function can impair the ability of the circulatory system to maintain blood flow and pressure, impair gastrointestinal function, lead to metabolic disturbances, and aberrant supraspinal affects can lead to urogenital dysfunction.In acute stroke the pathophysiology is not always immediately clear somanagement has to be guided by sound assessment. Modern techniques in neurorehabilitation are continually being explored and tested to address these dysfunctions.

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