scholarly journals Gastric Myoelectrical Activity and Autonomic Nervous System Abnormalities in Patients with Chronic Unexplained Nausea and Vomiting and in Patients with Gastroparesis

2019 ◽  
pp. 163-171
Author(s):  
Stefi E ◽  
Koch K ◽  
Brown A ◽  
Shaltout H
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Gastric Emptying ◽  
Solid Phase ◽  
Nausea And Vomiting ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Therapeutic Approaches ◽  
Gastric Myoelectrical Activity ◽  
Myoelectrical Activity ◽  
Autonomic Nervous

Background: Patients with chronic unexplained nausea and vomiting (CUNV) and Gastroparesis (GP) have similar symptoms, suggesting they share pathophysiological abnormalities along a continuum of disease.Objectives: To determine the incidence of gastric myoelectrical, accommodation dysfunction and autonomic abnormalities in patients with CUNV and GP.Methods: Outpatients with CUNV and GP who underwent standard 4-hr solid phase gastric emptying, upright tilt table test and electrogastrogram (EGG) recordings with water load satiety test (WLST) were identified from chart review. Subjects with normal emptying were in the CUNV group; those with delayed emptying were in the GP group. EGGs were recorded before and 30 minutes after the WLST and symptoms were recorded on a 100mm visual analog scale.Results: 44 patients (35 women and 9 men, ages 17-76 years) were identified: 24 had normal gastric emptying and CUNV and 20 had GP. Gastric dysrhythmias were found in 70% of CUNV and 69% of GP patients. Twenty percent of CUNV patients and 44% of GP patients ingested abnormally low volumes (< 300mL) during the WLST. Nausea increased similarly after the WLST in the subjects with CUNV and GP (Ps > 0.05). Postural orthostatic tachycardia syndrome (POTS) was diagnosed in 17% of CUNV patients and 20% of GP patients.Conclusions: Gastric myoelectrical and accommodation abnormalities and autonomic nervous system (ANS) dysfunctions frequently occur in subjects with CUNV and GP. These pathophysiological abnormalities support the idea that CUNV and GP occur along the same continuum of gastric neuromuscular dysfunction and may be targets for therapeutic approaches.  

Effect of Electroacupuncture on St. 36 (Zusanli) and LI. 10 (Shousanli) Acupuncture Points on Heart Rate Variability

2010 ◽  
Vol 38 (02) ◽  
pp. 231-239 ◽  
Author(s):  
Chi-Sen Chang ◽  
Chung-Wang Ko ◽  
Han-Chung Lien ◽  
Ming-Chih Chou
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Electrical Stimulation ◽  
Autonomic Nervous System ◽  
Sympathetic Activity ◽  
Vagal Activity ◽  
Gastric Myoelectrical Activity ◽  
Myoelectrical Activity ◽  
Autonomic Nervous

Electrical stimulation of St. 36 (Zusanli) has been shown to enhance the regularity of gastric myoelectrical activity in healthy subjects. However, the underlying mechanism by which acupuncture alters gastric myoelectrical activity is still not clear. To elucidate the possible role of the autonomic nervous system in mediating the effect of acupuncture, we monitored heart rate variability (HRV), a widely used index of vagal discharge at the sinoatrial node of the heart before, during and after electroacupuncture. In this study, we applied two different frequencies (2 Hz and 100 Hz) of electrical stimulation at St. 36 (Zusanli) and LI. 10 (Shousanli) in 15 healthy volunteers. Low frequency (LF, sympathetic activity), high frequency (HF, vagal activity) and LF/HF ratio (sympathovagal balance) were analyzed and compared at the two different frequencies. The results showed an increase in the LF/HF ratio (indicating greater sympathetic activity) during the post-acupuncture period using 2 Hz of electrical stimulation at St. 36 (Zusanli). However, the overall change was not statistically significant. In addition, the power of LF and HF did not change significantly with electroacupuncture at St. 36 (Zusanli) and LI. 10 (Shousanli). In conclusion, applying 2 Hz or 100 Hz electroacupuncture at St. 36 (Zusanli) or LI. 10 (Shousanli) did not affect cardiovagal activity in normal volunteers. This phenomenon might be due to a difference in presentation in the autonomic nervous system between cardiac and abdominal vagal activity.

Role of the autonomic nervous system in the thermogenic response to food in lean individuals

1997 ◽  
Vol 272 (5) ◽  
pp. E775-E780 ◽  
Author(s):  
L. De Jonge ◽  
D. R. Garrel
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Gastric Emptying ◽  
Statistical Significance ◽  
Nervous Activity ◽  
Oral Feeding ◽  
Oral Ingestion ◽  
Autonomic Nervous ◽  
Thermogenic Response

The aim of this study was to determine the role of the autonomic nervous system (ANS) in obligatory and facultative components of the thermogenic response to food (TRF). Nineteen lean, healthy subjects participated in this study, which comprised two protocols, each exploring one component of the ANS. In the first experimental group, propranolol (prime: 80 micrograms/kg; continuous: 1 microgram.kg-1.min-1) was infused intravenously to inhibit sympathetic nervous activity (SNA), whereas in the second group atropine (prime: 5 micrograms/kg; continuous: 5 micrograms.kg-1.min-1) was used to inhibit parasympathetic nervous activity (PNA). The TRF was measured on four occasions: 1) after oral ingestion of a breakfast, during 0.9% NaCl perfusion, 2) after oral ingestion of the same breakfast, during the perfusion of one of the drugs, 3) after intragastric injection of a pureed form of the same meal as in part 1, during 0.9% NaCl perfusion, and 4) after intragastric feeding, during the administration of one of the drugs. Energy expenditure was measured by indirect calorimetry for 30 min before and 6 h after ingestion of the meal. Facultative TRF was defined as the difference between oral and intragastric TRF. Intragastric feeding significantly reduced TRF in both studies: 6.6 +/- 1.0 vs. 8.7 +/- 0.8% of the ingested energy in the SNA study and 5.5 +/- 1.6 vs. 7.4 +/- 3.1% in the PNA study. During propranolol infusion, TRF was significantly lower than it was during saline infusion after oral feeding (6.9 +/- 1.0% vs. 8.7 +/- 0.8% of ingested energy) but not after intragastric feeding. During atropine administration, TRF was reduced after both oral and intragastric feeding, although statistical significance was not reached in the latter. Atropine administration decreased gastric emptying (measured with an isotopic method) 2 h postingestion by 50%. These results show that the SNA is necessary for the facultative component of TRF to occur in humans. The role of the PNA appears to be related to its action on gastric emptying.

scholarly journals Sensitivity of the Baroreceptors and the State of the Autonomic Nervous System in Patients with Chronic Impairment of Consciousness Due to Severe Brain Damage

2019 ◽  
Vol 15 (5) ◽  
pp. 61-73 ◽  
Author(s):  
V. N. Dorogovtsev ◽  
D. S. Yankevich ◽  
A. L. Parfenov ◽  
A. E. Skvortsov ◽  
A. V. Kotelnikova
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Orthostatic Hypotension ◽  
Brain Damage ◽  
Main Trend ◽  
Control Group ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Orthostatic Test ◽  
Autonomic Nervous ◽  
Group 1

Purpose of the study: to examine sensibility of baroreceptors and the autonomic nervous in the passive orthostatic test in patients with chronic impairment of consciousness due to severe brain damage and determine their role in the rehabilitation process.Materials and methods. The study included 30 patients with long-term impairment of consciousness due to severe brain damage (group 1), 10 of them being in the vegetative state (VS) and 20 being in the minimally conscious state (MCS). Craniocerebral trauma was the main cause of severe damage in that group (53% of patients). The comparison group included 24 patients with focal neurological symptoms caused predominantly — 79.2% of cases — by cerebrovascular disorders (group 2). The control group (group 3) consisted of 22 healthy volunteers of a comparable age. All measurements were done with the help of a Task Force Monitor 1030i (CNSystem, Austria) in the course of passive orthostatic test at 0°–30°–60°–0°. Changes in the power of low-frequency (LFS) and highfrequency spectrum (HFS) of heart rate variability and baroreceptors sensibility (BRS) were analyzed. Statistical analysis was carried out using Statistica-10 software. Significance of inter-group differences on unrelated samples was determined by the Mann–Whitney U-test. Differences between groups were considered significant at P 0.05.Results. Maximal background values of BRS were found in the control group. In group 1 and 2 patients, considerable decrease of that index was noted, which was proportional to the brain damage severity. Similar dynamics was observed for the indices of autonomic nervous system sensibility (LFS and HFS). The main trend of orthostatic changes of BRS, LFS, and HFS was characterized by progressive decrease of the indices with increase of the patients’ angle of tilting and their return to the baseline level after the patients were put back into the horizontal position. 4 patients of group 1 (14%) displayed signs of orthostatic disorders upon tilting to 30°: in 3 cases, orthostatic hypotension was observed, and in one case the postural orthostatic tachycardia syndrome (POTS) was diagnosed. Those patients differed by lower BRS and higher sympathetic system activity (LFS) vs. the same indices of other patients in that group.Conclusion. Patients with chronic impairment of consciousness during the post-comatose period after a severe brain damage display a significant decrease of baroreceptors sensibility and autonomic nervous system disorders manifesting in significantly lower activity of the sympathetic and parasympathetic systems. The prominence of such disorders is associated with brain damage severity. Their risk of developing orthostatic hypotension during tilting towards a vertical position is higher in patients who have lower baroreceptors sensibility, and this should be taken into account beginning the process of their verticalization.

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