Autonomic Nervous System
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2021 ◽  
Vol 15 ◽  
Francesco Cerritelli ◽  
Martin G. Frasch ◽  
Marta C. Antonelli ◽  
Chiara Viglione ◽  
Stefano Vecchi ◽  

The autonomic nervous system (ANS) is one of the main biological systems that regulates the body's physiology. Autonomic nervous system regulatory capacity begins before birth as the sympathetic and parasympathetic activity contributes significantly to the fetus' development. In particular, several studies have shown how vagus nerve is involved in many vital processes during fetal, perinatal, and postnatal life: from the regulation of inflammation through the anti-inflammatory cholinergic pathway, which may affect the functioning of each organ, to the production of hormones involved in bioenergetic metabolism. In addition, the vagus nerve has been recognized as the primary afferent pathway capable of transmitting information to the brain from every organ of the body. Therefore, this hypothesis paper aims to review the development of ANS during fetal and perinatal life, focusing particularly on the vagus nerve, to identify possible “critical windows” that could impact its maturation. These “critical windows” could help clinicians know when to monitor fetuses to effectively assess the developmental status of both ANS and specifically the vagus nerve. In addition, this paper will focus on which factors—i.e., fetal characteristics and behaviors, maternal lifestyle and pathologies, placental health and dysfunction, labor, incubator conditions, and drug exposure—may have an impact on the development of the vagus during the above-mentioned “critical window” and how. This analysis could help clinicians and stakeholders define precise guidelines for improving the management of fetuses and newborns, particularly to reduce the potential adverse environmental impacts on ANS development that may lead to persistent long-term consequences. Since the development of ANS and the vagus influence have been shown to be reflected in cardiac variability, this paper will rely in particular on studies using fetal heart rate variability (fHRV) to monitor the continued growth and health of both animal and human fetuses. In fact, fHRV is a non-invasive marker whose changes have been associated with ANS development, vagal modulation, systemic and neurological inflammatory reactions, and even fetal distress during labor.

2021 ◽  
Yu-Ting Hsu ◽  
Yeung-Leung Cheng ◽  
Yi-Wei Chang ◽  
Chou-Chin Lan ◽  
Yao-Kuang Wu ◽  

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:, ID: NCT03346876, November 15, 2017, retrospectively registered,

2021 ◽  
Vol 5 (03) ◽  
pp. E73-E80
Masaki Nishida ◽  
Kei Yamamoto ◽  
Yusuke Murata ◽  
Atsushi Ichinose ◽  
Kohei Shioda

AbstractThis study explored the effect of long naps on handball-related performance and assessed the role of the cardiac autonomic nervous system in this process. Eleven male collegiate handball players performed a repeated sequential trial consisting of a 20-m consecutive turnaround run, 10-m run with a load, and shooting the ball into a target. Participants were allocated randomly and sequentially to have a short (20 minutes) nap, long (60 minutes) nap, or no nap. The Pittsburgh Sleep Quality Index was used to assess regular sleep quality. Subjective sleepiness before and after napping was measured using the Karolinska Sleepiness Scale. Heart rate variability was recorded to assess cardiac autonomic nervous function during napping. The Pittsburgh Sleep Quality Index score was correlated with shot accuracy only after long naps (ρ=0.636, r=0.048). A negative correlation was observed between the root mean square of successive differences and average load run time (ρ=−0.929, p<0.001). Long napping was associated with a significant benefit on performance in athletes with poor sleep quality, implying a role of the autonomic nervous system in this regard. Our findings indicate the effect of sleep quality on the endurance and resistance of handball players.

Boram Chae ◽  
June Kang ◽  
Cheolmin Shin ◽  
Young-Hoon Ko ◽  
Ho-Kyoung Yoon

2021 ◽  
Vol 6 (2) ◽  
pp. 029-032
Sarebanha Melodie ◽  
Valente Laura ◽  
Kalra Minnea ◽  
Joseph Layon A ◽  
Crimi Ettore

Familial dysautonomia is a rare autosomal recessive neurodegenerative disease affecting cells of the autonomic nervous system. Patients with this disease are insensitive to pain but their autonomic nervous system is still activated with noxious stimuli. This report details a case of a patient with familial dysautonomia who underwent right ankle open reduction and internal fixation for a bimalleolar right ankle fracture. The patients preoperative and intraoperative course were uneventful but shortly after handoff to the intensive care unit, the patient experienced an autonomic crisis. Management of these patients is complex, requiring maintenance of physiologic homeostasis as well as preventing hemodynamic instability caused by noxious stimuli. Any deviations from baseline may cause an autonomic crisis, as happened in our patient. Herein, we detail the perioperative management of a patient with familial dysautonomia in further detail.

2021 ◽  
Vol 22 (8) ◽  
pp. 972-972
A. T.

Kalotli (Arch. F. G., Bd. 125) thinks that the primary leucorrhoea occurs when irritation touches organs with parasympathetic innervation. This fluor is the result of increased secretion of the cervical glands, and not extravasation of the vaginal wall. Neither the nature of the vaginal flora, nor the glycogen content, nor the degree of acidity are the primary causes of such leucorrhoea.

2021 ◽  
Vol 21 (1) ◽  
Hakan Kaya ◽  
Arif Suner ◽  
Mehtap Koparal ◽  
S. Cem Yucetas ◽  
Safiye Kafadar

Abstract Background Tinnitus is a common auditory symptom. Dysfunction in the autonomic nervous system (ANS) is an essential part of the etiopathogenesis of tinnitus. ANS regulates heart rate and heart rhythm and can lead to ventricular repolarization changes, which can cause malignant ventricular arrhythmias. T wave peak-to-end T(p-e) interval and T(p-e)/QT ratio are known ventricular arrhythmia indexes, and the index of cardiac-electrophysiological balance (iCEB) is a novel index that can be used to predict the risk of malignant ventricular arrhythmia. The goal of the study was to investigate these ventricular arrhythmia indexes in patients with tinnitus. Methods The study population consisted of 240 patients with tinnitus and 240 healthy subjects. A standard 12-channel surface electrocardiogram was applied to both groups. T(p-e) interval, QT interval and QRS duration were determined. Corrected QT (QTc) was determined via Bazett’s formula. To predict ventricular arrhythmia, iCEB (QT/QRS), T(p-e)/QT, corrected iCEB (QTc/QRS) and T(p-e)/QTc values were determined and compared between groups. Results Compared to the control group, QT (376.46 ± 36.54 vs 346.52 ± 24.51 ms), QTc (426.68 ± 24.68 vs 390.42 ± 24.04 ms), T(p-e) (75.86 ± 14.68 vs 62.42 ± 8.64 ms), T(p-e)/QT (0.201 ± 0.06 vs 0.180 ± 0.01) and T(p-e)/QTc (0.177 ± 0.06 vs 0.159 ± 0.02) were significantly higher in patients with tinnitus (p < 0.001 for all). QT/QRS (3.92 ± 0.68 vs 3.56 ± 0.32) and QTc/QRS (4.44 ± 1.03 vs 4.01 ± 0.64) were also significantly higher in patients with tinnitus (p = 0.018 and p = 0.008, respectively). In addition, significant positive correlations were found between T(p-e), T(p-e)/QTc ratio and disease duration (r = 0.792, p < 0.001; r = 0.500, p < 0.001, respectively). Conclusion As a result, patients with tinnitus may have an increased risk of malignant ventricular arrhythmia.

Shadie Kurtieva ◽  

This work is based on the results of clinical and functional studies of the cardiovascular and respiratory systems in adolescents with ADS, depending on the presence of perinatal pathology. In order to identify the features of the state of the respiratory system and cardiac activity in children with autonomic dysfunctions, depending on gender. We examined 243 adolescents 12-18 years old with clinically and laboratory-instrumental confirmed dysfunction of the autonomic nervous system - autonomic dystonia syndrome. It was found that signs of cardiac dysfunction are more often observed in adolescents with ADS with a history of perinatal pathology, mostly in males. The risk of developing violations of bronchial patency was identified in adolescents with ADS with a history of perinatal pathology, to a greater extent in females.

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