scholarly journals Establishment of an Individualized Chronotherapy, Autonomic Nervous System, and Variability-Based Dynamic Platform for Overcoming the Loss of Response to Analgesics

2021 ◽  
pp. 243-252
Author(s):  
Yaron Ilan
Keyword(s):  
Drug Resistance ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Unmet Need ◽  
Compensatory Mechanisms ◽  
Analgesic Tolerance ◽  
Autonomic Nervous ◽  
Loss Of Response ◽  
Pain Medications ◽  
The Subject

Background: Control of chronic pain and mainly the partial or complete loss of response to analgesics is a major unmet need. Multiple mechanisms underline the development of tolerance to analgesics in general and specifically to opioids. The autonomic nervous system (ANS) plays a role in the development of analgesic tolerance and chronobiology. Objectives: To review the mechanisms associated with the development of nonresponsiveness to analgesics. Study Design: Literature review. Setting: The review is followed by a description of a new method for overcoming resistance and improving the response to analgesics. Methods: Conducted a detailed review of the relevant studies describing the mechanisms that underlie tolerance to pain medications, and the potential roles of the ANS and chronobiology in the development of drug resistance. Results: The autonomic balance is reflected by heart rate variability, an example of a fundamental variability that characterizes biological systems. Chronotherapy, which is based on the circadian rhythm, can improve the efficacy and reduce the toxicity of chronic medications. In this article, we present the establishment of an individualized variability- and chronobiology-based therapy for overcoming the compensatory mechanisms associated with a loss of response to analgesics. We describe the premise of implementing personalized signatures associated with the ANS, and chronobiology, as well as with the pathophysiology of pain for establishing an adaptive model that could improve the efficacy of opioids, in a highly dynamic system. Limitations: The studies presented were selected based on their relevance to the subject. Conclusions: The described variability-based system may ensure prolonged effects of analgesics while reducing the toxicity associated with increasing dosages. Key words: Painkillers, opioids, drug resistance, compensatory mechanisms

scholarly journals The prevalence of neurocirculatory astheniaamong adolescents and young men of military age with bradyarrhythmia based on the results of screening diagnostics

2018 ◽  
Vol 9 (4) ◽  
pp. 73-80
Author(s):  
Inna A. Klubkova ◽  
Marina V. Avdeeva ◽  
Larisa V. Shcheglova ◽  
Dina R. Kiryanova ◽  
Marina Yu. Erina
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Functional State ◽  
Sinus Bradycardia ◽  
Cardiac Activity ◽  
Young Men ◽  
Heart Rhythm ◽  
Severe Form ◽  
Compensatory Mechanisms ◽  
Autonomic Nervous

The article presents the results of clinical and instrumental examination of adolescents and young men of military age with bradyarrhythmia. The study involved 2067 people (mean age19,7 ± 2,7 years), subject to conscription (from 17 to 27 years) and potential conscripts (16-year-olds). According to the results of the screening ECG, bradyarrhythmia (sinus bradycardia, sinus bradyarrhythmia, rhythm and conduction disorders) was diagnosed in 630 adolescents and young men of military age. We studied the functional status of the autonomic nervous system on the device “Cardiometry-MT” (Russia). The functional state of the autonomic nervous system was studied on the basis of cardiointervalography and correlation rhythmography. Evaluation of the functional state of the autonomic nervous system was carried out according to three parameters: the type of vegetative regulation of the heart rhythm (normotonic, vagotonic, sympathicotonic); reactivity of the sympathetic and parasympathetic parts of the autonomic nervous system (normal reactivity, hyperreactivity, low reactivity, and paradoxical reactions); nature of vegetative maintenance of cardiac activity (normal vegetative maintenance of cardiac activity, vegetative maintenance with adaptation, vegetative maintenance with disadaptation). According to the results of respiratory samples from 81,9% of adolescents and young men of military age with bradyarrhythmia diagnosed neurocirculatory asthenia, of whom 63,6% – light, while 18,3% – severe degree. With a mild form of neurocirculatory asthenia, compensatory mechanisms are connected, so vegetative homeostasis is not generally disturbed and the heart rhythm responds adequately to the effect of physiological stimuli. Severe form of neurocirculatory asthenia is characte rized by disadaptation of vegetative maintenance of cardiac activity. Such patients need regular follow-up because they are at risk for developing cardiovascular diseases.

Autonomic Activity and Induced Convulsions

1946 ◽  
Vol 92 (386) ◽  
pp. 146-149
Author(s):  
F. Reitman
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Epileptic Activity ◽  
Central Action ◽  
Autonomic Activity ◽  
Autonomic Nervous ◽  
Cerebral Activity ◽  
The Subject ◽  
Convulsive Threshold ◽  
The Brain

Since the influence of the autonomic nervous system on epileptic phenomena became the subject of intensive investigations, several contradictory reports have been published. Williams and Russell (1941) and Williams (1941) found that parasympathetic overactivity (induced chemically and registered by electro-encephalography) increases epileptic activity. Darrow (1944) reported opposite results, his observations being based on electrically induced parasympathetic overactivity on animals. He registered his observations by electroencephalography. Cohen, Thale and Tissenbaum (1044) induced convulsions for therapeutical purposes by administering the parasympathomimetic drug, acetylcholine, and Chatfield and Dempsey (1942) observed the production of fits in cats, when giving acetylcholine and prostigmine together. Though the results were contradictory, the main aim of all these investigations was to establish the cholinergic neurohumoral changes in relation to epilepsy. But, as Williams pointed out, it is impossible to say whether the results are due to a direct central action, are consequent upon changes in the pH or of a respiratory or a circulatory nature. The investigations described in this paper were devised to re-examine these problems clinically. They were based on the hypothesis that if cholinergic overactivity enhances epileptic cerebral activity, the convulsive threshold of the brain should be lowered after administration of anticholinesterases, in particular prostigmine.

Classical Conditioning: Still Going Strong

1991 ◽  
Vol 19 (1) ◽  
pp. 59-79 ◽  
Author(s):  
Marcel van den Hout ◽  
Harald Merckelbach
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Classical Conditioning ◽  
Unconditioned Stimulus ◽  
Immunological Parameters ◽  
Simple Result ◽  
Autonomic Nervous ◽  
Evaluative Judgments ◽  
The Subject ◽  
Common Misconceptions

This paper summarizes developments in the field of classical conditioning. Attention is paid to four common misconceptions of what is classical conditioning. First, classical conditioning does not ensue as a simple result of temporal pairing of conditioned and unconditioned stimuli. Rather, conditioned reacting occurs if and to the degree that the subject is able to predict the occurrence of one stimulus from the presence of another one. Second, what is learned during classical conditioning is not necessarily a response to a cue, but rather a probabilistic relationship between various stimuli. Third, classical conditioning is not only manifested in responses mediated by the autonomic nervous system, but also in immunological parameters, in motoric behaviour and in evaluative judgments. Fourth, the nature of the conditioned and the unconditioned stimulus is (often) not a matter of indifference: particular combinations of CS and US produce more powerful conditioning effects than do other combinations. In the second part of the paper, the potential relevance of these developments is illustrated. Discussions are included about anxiety, addictions and food aversions/conditioned nausea.

scholarly journals Medication management of autonomic nervous system disorders in adolescents with tuberculosis

2020 ◽  
Vol 98 (7) ◽  
pp. 44-50
Author(s):  
L. А. Shovkun ◽  
N. Yu. Klimenko ◽  
V. А. Аksenova ◽  
D. А. Kudlay ◽  
N. Yu. Nikolenko ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Standard Therapy ◽  
Medication Management ◽  
Comprehensive Treatment ◽  
Compensatory Mechanisms ◽  
Autonomic Nervous ◽  
Group 1

To manage autonomic disorders in adolescents with tuberculosis, 100 people from 12 to 15 years old were examined and randomly divided into two groups: Group 1 received standard anti-tuberculosis therapy, and in Group 2, additionally to standard therapy, comprehensive treatment with Magne B6 was used for 2 months, and then Valerian extract was used for another 2 months. For comparison, 50 healthy adolescents were examined. Before treatment, all adolescents with tuberculosis experienced a decrease in heart rate variability, a pronounced autonomic imbalance with the prevalence of sympathicotonia and overexertion of compensatory mechanisms. In Group 1, during the comprehensive treatment there were an increase in SDNN and Mo and decrease in AMo and tension index at rest. Active orthostatic test (AOT) was accompanied by a significant increase in SDNN, Mo and a decrease in AMo, which indicated an increase in the activity of the parasympathetic autonomic nervous system and decreased activity of the sympathetic autonomic nervous system. In the group receiving standard therapy, hypersympathycotonia persisted and manifested through significant (p < 0.05) reduction in such parameters as SDNN, increased heart rate, AMo, and Mo shift to short intervals. Medication management resulted in the vegetative balance by increasing heart rate variability, reducing hypersympathicotonia, improving the autonomic support of the cardiovascular system at rest and during AOT.

Neurobiology of Social Phobia

CNS Spectrums ◽  
1999 ◽  
Vol 4 (11) ◽  
pp. 42-48
Author(s):  
Joseph M. Bebchuk ◽  
Manuel E. Tancer
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Anxiety Disorder ◽  
Social Phobia ◽  
Healthy Controls ◽  
Specific Task ◽  
Autonomic Nervous ◽  
The Subject ◽  
And Function

AbstractSocial phobia is an anxiety disorder that is characterized by excessive fear and/or avoidance of situations in which an individual believes that he or she may be the subject of evaluation or scrutiny while interacting with other people or performing a specific task. This article reviews the available literature on the neurobiology underlying social phobia, including autonomic nervous system effects, neuroimaging findings, pharmacologic challenge studies, and neuroendocrine responsivity and function. Overall, such studies have found few consistently demonstrable differences in neurobiology between patients with social phobia and healthy controls, but further investigations are needed.

Imaging cardiac innervation

2021 ◽  
pp. 565-576
Author(s):  
Albert Flotats ◽  
Ignasi Carrió
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Prognostic Value ◽  
Sympathetic Neurons ◽  
Cardiac Innervation ◽  
Cardiac Autonomic Nervous System ◽  
Autonomic Nervous ◽  
Planar Scintigraphy ◽  
Cardiac Disorders ◽  
The Subject

Cardiac autonomic nervous system contributes to maintain haemodynamic and electrophysiological stability to changing demands. Cardiac innervation imaging can be performed by means of planar scintigraphy/SPECT or PET using different radiotracers developed for the assessment of pre- and postsynaptic receptors of the cardiac autonomic nervous system, with sufficient sensitivity to assess a process that takes place at picomolar concentrations. Clinically, cardiac innervation imaging is mainly performed targeting postganglionic presynaptic sympathetic neurons by means of myocardial 123I-metaiodobenzylguanidine (123I-mIBG) planar scintigraphy and SPECT, which has shown to be of value in the assessment of patients with different cardiac disorders, especially in those with heart failure (HF), having an independent prognostic value. This clinically oriented chapter updates the subject with inclusion of new data reinforcing the use of sympathetic cardiac innervation imaging for improving patient management.

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