Autonomic Neuroscience-Basic & Clinical最新文献

Objective: This study assessed heart rate variability (HRV) alterations in amyotrophic lateral sclerosis (ALS) patients compared to healthy control groups using both frequency-domain and time-domain HRV parameters.

Methods: A systematic review and meta-analysis were conducted using studies retrieved from PubMed, Embase, Web of Science, and Cochrane Library databases up to November 13, 2024. Fourteen studies were included in the qualitative synthesis and eight in the quantitative analysis.

Results: ALS patients exhibited significantly reduced Low Frequency (LF) and High Frequency (HF) HRV parameters compared to healthy controls (p < 0.001 and p = 0.02, respectively). Time-domain parameters also showed significant reductions: RMSSD (p < 0.001), SDNN (p < 0.001), and pNN50% (p = 0.01). Despite an overall decrease in HRV, the LF/HF ratio did not show a statistically significant difference (p = 0.12).

Conclusion: Patients with ALS demonstrate autonomic dysfunction, evidenced by significant reductions in key time-domain (RMSSD, SDNN, pNN50%) and frequency-domain (LF, HF) parameters, suggesting impaired parasympathetic modulation. HRV may serve as a valuable, non-invasive biomarker for the early detection and management of cardiorespiratory complications in ALS.

The vagus nerve connects the brain and the heart, allowing communication between the body and the mind. Studies have strengthened the meaning of the brain to control heart rate variability (HRV), however, brain research has largely overlooked the effects of age on the association between phasic changes in HRV and resting state functional brain connectivity. To close this gap, we studied a large open data set of 69 old and 134 young participants with two consecutive fMRI resting state scans in combination with the corresponding physiological HRV data assessed via photoplethysmography (PPG). We quantified spontaneous HRV changes from one resting state to the other and studied the unique information about the relationship between changes in functional coupling between brain areas and spontaneous HRV changes. Using a fc-MVPA, we identified functional brain coupling patterns associated with changes in HRV within brain networks, including the anterior cingulate cortex (ACC), the cerebellum, the brainstem, and the temporal lobe. These patterns were not significantly different between the two age groups - indicating age invariance of brain heart communication. Post hoc seed-to-voxel analyses indicated a stronger functional coupling of these identified clusters with brain regions such as the insula, the opercular cortex, the superior frontal gyrus, and the cerebellum when HRV increased. This pattern of findings is in accordance with prominent theories and provides further insights into the neural mechanisms underlying brain-heart communication.

Background: Orthostatic hypotension (OH) is a common complication in Parkinson's disease (PD) patients, significantly impacting their quality of life. Recent evidence suggests a potential link between liver fibrosis, indicated by the Fibrosis-4 (FIB-4) index, and autonomic dysfunction. However, its relationship with OH in PD remains unexplored.

Methods: A cross-sectional analysis was conducted using data from 1268 PD patients. The FIB-4 index was calculated based on age, AST, ALT, and platelet count. The association between FIB-4 and OH was assessed using multivariate logistic regression, with further curve fitting and subgroup analyses to test robustness.

Results: The FIB-4 index was significantly associated with OH. For each 0.2-unit increase in FIB-4, the odds ratio (OR) for OH was 1.11 (95% CI: 1.05-1.17, p < 0.001). Tertile analysis showed ORs of 2.05 (95% CI: 1.27-3.31, p = 0.003) for T2 and 2.61 (95% CI: 1.64-4.17, p < 0.001) for T3, compared to T1. Curve fitting indicated a linear relationship, with no evidence of non-linearity. Sensitivity and subgroup analyses confirmed robustness.

Conclusions: Higher FIB-4 index values are independently associated with an increased risk of OH in PD patients, suggesting that liver fibrosis may contribute to OH development. Further longitudinal studies are needed to explore the underlying mechanisms.

Objectives: To establish a novel spinal cord hemisection-induced neurogenic bladder (SCHNB) rat model combined with sacral neuromodulation (SNM) and evaluate the immediate effects of SNM on bladder function and morphology in SCHNB.

Materials and methods: Female Sprague-Dawley rats were randomly assigned to three groups: control, SCHNB, and SCHNB + SNM groups. Rats in control group underwent only T9-T10 laminectomy, SCHNB group received right T9-T10 spinal cord hemisection and electrode implantation without electrical stimulation, SCHNB + SNM group underwent the same procedure as SCHNB group but also received daily 3-hours SNM beginning on postoperative day 1 for 3 weeks. All rats subsequently underwent motor function assessment, bladder ultrasonography and cystography, cystometric testing, and histological analysis of spinal cord and bladder tissues.

Results: Ultrasonography revealed significantly increased post void residual in SCHNB group compared to control and SCHNB + SNM groups. Bladder weight in SCHNB group was significantly higher than in control and SCHNB + SNM groups. Cystometric analysis showed a shorter voiding contraction interval in SCHNB + SNM group than control group but longer than SCHNB group. During bladder filling, SCHNB group exhibited multiple uninhibited detrusor contractions, SCHNB + SNM group showed fewer uninhibited contractions and a lower maximum pressure. Histological examination revealed that compared to control and SCHNB + SNM groups, SCHNB group displayed disorganized bladder mucosal epithelium, disrupted and loosened lamina propria, tissue edema, and increased fibrosis.

Conclusions: This model of SCHNB combined with SNM provides a new experimental platform for SNM research. Immediate SNM effectively inhibited bladder overactivity and partially improved functional and structural abnormalities of the bladder.