Autonomic Neuroscience-Basic & Clinical最新文献_第3页

Psychosocial profiles of autonomic dysfunction 自主神经功能障碍的社会心理特征

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.1016/j.autneu.2025.103365

William S. Frye , Sydney Ward , Daniel Mauriello , Brooke Mitchell , Jamie Decker

Forms of dysautonomia, including Postural Orthostatic Tachycardia Syndrome (POTS), significantly impacts youth, yet psychosocial aspects remain under-researched, particularly outside of patients diagnosed with POTS. This study examines the clinical and psychosocial profiles of youth with autonomic dysfunction and compares findings between groups with different heart rate (HR) responses to orthostatic testing.

This retrospective review analyzed demographics, symptoms, quality of life (QoL), and mental health variables (e.g., anxiety, depression, ADHD) in youth with autonomic dysfunction. Differences between higher and lower HR response groups were compared. QoL was assessed using the PedsQL™ and symptom severity was measured with the Malmö POTS Symptom Score (MAPS). Medical history and psychosocial concerns were extracted from electronic medical records.

Symptom severity scores exceeded clinical cutoffs for the full sample (65.8) and across HR groups. Independent t-tests showed no differences between groups for any variable. Pain (92.5 %) and impaired eating (42.5 %) were prevalent across the sample. QoL was clinically impaired in all domains, and mental health concerns, such as anxiety (83.3 %) and depression (54.3 %), were common.

Findings describe the pervasive symptom and psychosocial burden in youth with autonomic dysfunction, which was consistent across higher and lower HR response groups. The study emphasizes the importance of addressing medical, mental health, and daily life challenges in all patients seen for autonomic dysfunction. Additionally, it highlights the importance of expanding research and clinical focus to include all youth with autonomic dysfunction, regardless of HR response to ensure youth who are experiencing impairment obtain the comprehensive care they need.

自主神经异常的各种形式，包括体位性站立性心动过速综合征（POTS），对年轻人的影响很大，但社会心理方面的研究仍不足，特别是在被诊断为POTS的患者之外。本研究考察了自主神经功能障碍青年的临床和社会心理特征，并比较了不同心率（HR）组对直立测试的反应。本回顾性研究分析了自主神经功能障碍青年的人口统计学、症状、生活质量（QoL）和心理健康变量（如焦虑、抑郁、多动症）。比较高、低HR反应组之间的差异。使用PedsQL™评估生活质量，使用Malmö POTS症状评分（MAPS）测量症状严重程度。从电子病历中提取病史和心理社会问题。症状严重程度评分超过了整个样本（65.8）和HR组的临床临界值。独立t检验显示各组间任何变量均无差异。疼痛（92.5%）和进食障碍（42.5%）在整个样本中普遍存在。所有领域的临床生活质量都受到损害，心理健康问题，如焦虑（83.3%）和抑郁（54.3%）是常见的。研究结果描述了自主神经功能障碍青年的普遍症状和心理社会负担，这在高HR反应组和低HR反应组中是一致的。该研究强调了解决所有自主神经功能障碍患者的医疗、心理健康和日常生活挑战的重要性。此外，它强调了扩大研究和临床重点的重要性，以包括所有患有自主神经功能障碍的青年，而不管HR的反应如何，以确保经历损伤的青年获得所需的全面护理。

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引用次数: 0

Autonomic symptom burden, comorbidities and quality of life in women with Hypermobility Spectrum Disorders and hypermobile Ehlers-Danlos syndrome 自主神经症状负担、合并症和生活质量的女性与多动谱系障碍和多动ehers - danlos综合征。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.autneu.2025.103356

Meagan L. Collins Hutchinson , Emily Liang , Emily Fuster , Svetlana Blitshteyn

Background

Hypermobility Spectrum Disorders (HSD) and hypermobile Ehlers-Danlos syndrome (h-EDS) are multisystemic connective tissue disorders involving joint hypermobility and numerous other manifestations. Autonomic dysfunction, chronic pain, and chronic fatigue are known comorbidities of HSD and h-EDS that can affect patient quality of life (QoL), but there are limited data on the severity of autonomic symptoms, prevalence of comorbid conditions and QoL in patients with HSD/h-EDS.

Methods

We utilized the Composite Autonomic Symptom Scale (COMPASS-31) to assess autonomic symptom severity, Short-Form 36 (SF-36) to assess QoL, and the Beck Depression Inventory Second Edition (BDI-II) in a cohort of women with physician-diagnosed HSD or h-EDS, who completed these questionnaires anonymously.

Results

84 women (mean age of 37.1 ± 8.4 years) completed the study. 58.3 % reported having physician-diagnosed postural orthostatic tachycardia syndrome (POTS), 32.1 % had mast cell activation syndrome (MCAS), 54.8 % had migraine, 26.2 % had myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and 98.8 % reported experiencing chronic pain. Importantly, 25 % of patients reported having all three diagnoses: HSD/h-EDS, POTS and MCAS. Mean COMPASS-31 score was 54.45 (range 18.79–80.93), indicating severe autonomic dysfunction, which was significantly higher than in patients with multiple sclerosis, diabetic neuropathy, scleroderma, and psoriatic arthritis as shown in prior studies. Mean SF-36 score was 32.38 (SD = 22.91) indicating poor QoL, which was worse than in patients with POTS, multiple sclerosis, rheumatoid arthritis, and lupus as determined by prior studies.

Conclusions

This study demonstrates that women with HSD/h-EDS experience severe autonomic dysfunction, chronic pain, chronic comorbid conditions and reduced QoL. More than half of participants in this cohort had POTS and migraine, with one in four having a clinical triad of HSD/h-EDS, POTS and MCAS.

背景：多活动谱系障碍（HSD）和多活动ehers - danlos综合征（h-EDS）是多系统结缔组织疾病，涉及关节过度活动和许多其他表现。自主神经功能障碍、慢性疼痛和慢性疲劳是已知的HSD和h-EDS的合并症，可影响患者的生活质量（QoL），但关于HSD/h-EDS患者自主神经症状的严重程度、合并症的患病率和生活质量的数据有限。方法：我们采用自主神经症状综合量表（COMPASS-31）评估自主神经症状的严重程度，采用短表36 （SF-36）评估生活质量，采用贝克抑郁量表第二版（BDI-II）对医生诊断为HSD或h-EDS的女性进行匿名问卷调查。结果：84名女性（平均年龄37.1±8.4岁）完成研究。58.3%报告有医生诊断的体位性站立性心动过速综合征（POTS）， 32.1%有肥大细胞活化综合征（MCAS）， 54.8%有偏头痛，26.2%有肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）， 98.8%报告有慢性疼痛。重要的是，25%的患者报告了所有三种诊断：HSD/h-EDS， POTS和MCAS。COMPASS-31平均评分为54.45（范围18.79-80.93），提示自主神经功能严重障碍，明显高于既往研究中多发性硬化症、糖尿病性神经病变、硬皮病、银屑病关节炎患者。SF-36平均评分为32.38 (SD = 22.91)，生活质量较差，较既往研究确定的POTS、多发性硬化症、类风湿关节炎和狼疮患者更差。结论：本研究表明，患有HSD/h-EDS的女性存在严重的自主神经功能障碍、慢性疼痛、慢性合并症和生活质量降低。在这个队列中，超过一半的参与者患有盆腔痉挛和偏头痛，四分之一的人患有HSD/h-EDS、盆腔痉挛和MCAS的临床三联症。

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引用次数: 0

Autonomic phenotyping, brain blood flow control, and cognitive-motor-integration in Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study 自主神经表型、脑血流控制和认知运动整合在长COVID和肌痛性脑脊髓炎/慢性疲劳综合征中的应用：一项初步研究

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.autneu.2025.103358

Smriti Badhwar , Tania J. Pereira , Kathleen Kerr , Riina Bray , Farah Tabassum , Lauren Sergio , Heather Edgell

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and the prolonged sequelae after COVID-19 (>3 months; Long COVID) have similar symptomology, are both associated with autonomic dysfunction, and a growing proportion of Long COVID patients are developing ME/CFS. We aimed to determine an autonomic phenotype of patients with ME/CFS vs Long COVID. We hypothesized that the groups would differ from controls yet be similar to one another. We recruited sedentary controls (n = 10), mild/moderate ME/CFS patients (n = 12), and Long COVID patients (n = 9) to undergo 1) breathing 5 % CO₂, 2) breathing 10 % O₂, and 3) 5-minutes of 70° head-up tilt. Respiratory, hemodynamic, and cerebrovascular variables were measured throughout the 3 trials. Resting vascular function and cognitive-motor-integration were also assessed. ME/CFS and Long COVID were similar to the healthy controls and each other with regard to resting vascular function and the hemodynamic responses to hypoxia, hypercapnia, and head-up tilt (p > 0.05). However, in ME/CFS we observed a greater reduction of cerebrovascular resistance (p = 0.041) and impaired autoregulation (p = 0.042) during hypercapnia alongside impaired cognitive-motor integration (p < 0.02), and in Long COVID we observed reduced peripheral and end-tidal oxygen (p < 0.04) and less vagal withdrawal during tilt (p = 0.028). Our findings suggest unique phenotypes when comparing ME/CFS and Long COVID whereby we have shown that Long COVID patients experience hypoxia while upright contributing to less vagal withdrawal, and ME/CFS patients experience impaired cerebrovascular control during hypercapnia potentially leading to reduced cognitive-motor integration. These differences could stem from disease severity/duration or some unique aspect of the COVID-19 virus.

肌痛性脑脊髓炎/慢性疲劳综合征（Myalgic encephalomyelitis/chronic fatigue syndrome, ME/CFS）与COVID-19后的长期后遗症（>；3个月；Long COVID）具有相似的症状，均与自主神经功能障碍相关，并且越来越多的Long COVID患者出现ME/CFS。我们的目的是确定ME/CFS患者与长COVID患者的自主表型。我们假设这些组与对照组不同，但彼此相似。我们招募了久坐对照组（n = 10）、轻/中度ME/CFS患者（n = 12）和长COVID患者（n = 9），分别进行了1)5% CO2呼吸、2)10% O2呼吸和3)5分钟70°仰卧倾斜。在3个试验中测量呼吸、血流动力学和脑血管变量。静息血管功能和认知-运动整合也被评估。ME/CFS组和Long COVID组在静息血管功能和缺氧、高碳酸血症、平视倾斜的血流动力学反应方面与健康对照组相似（p > 0.05）。然而，在ME/CFS中，我们观察到高碳血症期间脑血管阻力（p = 0.041）和自我调节受损（p = 0.042）以及认知运动整合受损（p < 0.02），而在长COVID中，我们观察到外周和潮末氧气减少（p < 0.04）和倾斜时迷走神经退缩减少（p = 0.028）。我们的研究结果表明，在比较ME/CFS和Long COVID时，我们的研究结果表明，Long COVID患者在直立时经历缺氧，导致迷走神经退缩较少，而ME/CFS患者在高血氧症期间脑血管控制受损，可能导致认知-运动整合降低。这些差异可能源于疾病严重程度/持续时间或COVID-19病毒的某些独特方面。

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引用次数: 0

Autonomic dysfunction in polycystic ovary syndrome 多囊卵巢综合征的自主神经功能障碍。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.autneu.2025.103357

Zoe H. Adams , Lydia L. Simpson , Emma C. Hart , Rachel N. Lord

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting premenopausal females. Alongside the endocrine, reproductive and psychological consequences of the condition, PCOS has now been linked to increased risk of cardiovascular and metabolic disease e.g., insulin resistance. The mechanisms behind this excess risk are not fully understood and multiple characteristics of PCOS (e.g., hyperandrogenism, obesity and vascular dysfunction) likely contribute to individual risk. Autonomic dysfunction may also drive cardiovascular risk in PCOS, via its effects on both blood pressure control and the modulation of sex hormone release at the ovaries. Whilst current studies are limited by moderate sample sizes and one-off measurements, evidence broadly suggests that sympathetic activity may be increased, and vagal control of heart rate may be reduced in PCOS. In this review, we examine the potential mechanisms by which autonomic dysfunction may occur in PCOS. Finally, we discuss how PCOS may interact with ageing and ethnicity to modulate cardiovascular risk secondary to autonomic dysfunction.

多囊卵巢综合征（PCOS）是影响绝经前女性最常见的内分泌疾病。多囊卵巢综合征除了对内分泌、生殖和心理造成影响外，现在还与心血管和代谢疾病（如胰岛素抵抗）的风险增加有关。这种过度风险背后的机制尚不完全清楚，多囊卵巢综合征的多种特征（如高雄激素症、肥胖和血管功能障碍）可能导致个体风险。自主神经功能障碍也可能通过其对血压控制和卵巢性激素释放调节的影响来驱动多囊卵巢综合征的心血管风险。虽然目前的研究受到中等样本量和一次性测量的限制，但证据广泛表明，多囊卵巢综合征的交感神经活动可能增加，迷走神经对心率的控制可能降低。在这篇综述中，我们探讨了自主神经功能障碍可能在多囊卵巢综合征中发生的潜在机制。最后，我们讨论了多囊卵巢综合征如何与年龄和种族相互作用，以调节继发于自主神经功能障碍的心血管风险。

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引用次数: 0

Clinical features of paroxysmal sympathetic hyperactivity in brain tumor: a retrospective case series study and literature review 脑肿瘤阵发性交感神经亢进的临床特征：回顾性病例系列研究及文献复习。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.autneu.2025.103352

Ying Zhou, Guangqiang Chen, Guangzhi Shi

Background

Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of brain tumor, mostly occurred after craniotomy for brain tumor resection. The purpose of this study is to characterize the pathogenesis and clinical features of PSH in brain tumor.

Methods

All PSH cases with brain tumor at a single center over a 4-year period were retrospectively identified based on medical records. A systematic literature review of the PSH cases with brain tumor was also conducted. PubMed and Web of Science databases were searched.

Results

We identified nine patients at our center and 14 patients in the literature with brain tumor and PSH. There were 10 adult patients and 13 pediatric patients with a median age of 13 years. Most tumors (96 %) were located in deep brain regions. The brainstem and adjacent structures were the most common tumor locations, accounting for 70 %. Glioma (39 %) was the most common pathology type. The onset of PSH occurred after tumor resection or biopsy in 18 patients, during tumor resection in two patients, and during conservative treatment in three patients. The most common PSH symptoms in brain tumor were hypertension (100 %) and tachycardia (96 %).

Conclusions

PSH is not only an underlying complication of brain tumor resection, but also a rare clinical manifestation of brain tumor. We speculate that damage to the midbrain or pons, especially close to the midline of the tegmentum, might be one of the lesion patterns underlying PSH.

背景：阵发性交感神经亢进（PSH）是一种罕见的脑肿瘤并发症，多发生在脑肿瘤切除术开颅手术后。本研究旨在探讨脑肿瘤PSH的发病机制及临床特点。方法：回顾性分析4年内同一中心所有PSH合并脑肿瘤的病例。对PSH合并脑肿瘤的病例也进行了系统的文献回顾。检索了PubMed和Web of Science数据库。结果：我们在本中心发现了9例患者，文献中发现了14例脑肿瘤和PSH患者。成人患者10例，小儿患者13例，中位年龄13岁。大多数肿瘤（96%）位于脑深部。脑干及邻近结构是最常见的肿瘤部位，占70%。胶质瘤（39%）是最常见的病理类型。18例患者在肿瘤切除或活检后发病，2例患者在肿瘤切除期间发病，3例患者在保守治疗期间发病。脑肿瘤患者最常见的PSH症状是高血压（100%）和心动过速（96%）。结论：PSH不仅是脑肿瘤切除术的潜在并发症，而且是脑肿瘤罕见的临床表现。我们推测，中脑或脑桥的损伤，特别是靠近被盖中线的损伤，可能是PSH的病变模式之一。

{"title":"Clinical features of paroxysmal sympathetic hyperactivity in brain tumor: a retrospective case series study and literature review","authors":"Ying Zhou, Guangqiang Chen, Guangzhi Shi","doi":"10.1016/j.autneu.2025.103352","DOIUrl":"10.1016/j.autneu.2025.103352","url":null,"abstract":"<div><h3>Background</h3><div>Paroxysmal sympathetic hyperactivity (PSH) is a rare complication of brain tumor, mostly occurred after craniotomy for brain tumor resection. The purpose of this study is to characterize the pathogenesis and clinical features of PSH in brain tumor.</div></div><div><h3>Methods</h3><div>All PSH cases with brain tumor at a single center over a 4-year period were retrospectively identified based on medical records. A systematic literature review of the PSH cases with brain tumor was also conducted. PubMed and Web of Science databases were searched.</div></div><div><h3>Results</h3><div>We identified nine patients at our center and 14 patients in the literature with brain tumor and PSH. There were 10 adult patients and 13 pediatric patients with a median age of 13 years. Most tumors (96 %) were located in deep brain regions. The brainstem and adjacent structures were the most common tumor locations, accounting for 70 %. Glioma (39 %) was the most common pathology type. The onset of PSH occurred after tumor resection or biopsy in 18 patients, during tumor resection in two patients, and during conservative treatment in three patients. The most common PSH symptoms in brain tumor were hypertension (100 %) and tachycardia (96 %).</div></div><div><h3>Conclusions</h3><div>PSH is not only an underlying complication of brain tumor resection, but also a rare clinical manifestation of brain tumor. We speculate that damage to the midbrain or pons, especially close to the midline of the tegmentum, might be one of the lesion patterns underlying PSH.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"262 ","pages":"Article 103352"},"PeriodicalIF":3.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sympathetic innervation of the temporomandibular joint modulates local hyperalgesia and IL-6 levels in zymosan-induced inflammatory pain 颞下颌关节交感神经支配调节酵素诱导炎性疼痛的局部痛觉过敏和IL-6水平。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-03 DOI: 10.1016/j.autneu.2025.103351

Livia E.C. Corrêa, Tales F.V. Rosin, Fernanda C. Medeiros, Isabela P. Leirão, Eduardo Colombari, Débora S.A. Colombari, Daniel B. Zoccal, Pedro L. Katayama

The temporomandibular joint (TMJ) is critical for essential orofacial functions including chewing and speaking. Chronic pain and dysfunction of the TMJ and its associated structures are classified as temporomandibular disorders (TMDs) and represent a significant public health burden. However, the precise neurobiological mechanisms driving these conditions are still unclear. The autonomic nervous system, in particular the sympathetic nervous system, plays a modulatory role in joint homeostasis, inflammation, and pain. This study investigated the sympathetic innervation of the rat TMJ and its functional role in inflammatory hyperalgesia. We first mapped the origin of sympathetic innervation to the TMJ using retrograde tracing combined with immunostaining. After confirming that the TMJ receives sympathetic input predominantly from the ipsilateral superior cervical ganglion (SCG), we performed unilateral superior cervical ganglionectomy (SCG-X) to assess the impact of sympathetic denervation on zymosan-induced TMJ inflammatory hyperalgesia and local cytokine production. SCG-X procedure significantly exacerbated zymosan-induced mechanical hyperalgesia in the TMJ and markedly increased intra-articular interleukin-6 (IL-6) levels, while tumor necrosis factor-alpha (TNF-alpha) remained unaffected. These results demonstrate that the sympathetic nervous system exerts anti-hyperalgesic and anti-inflammatory roles in the TMJ by modulating local cytokine responses during acute inflammation. This study reveals a previously unidentified neuroimmune mechanism within the TMJ, providing a foundation for developing novel, targeted therapeutic strategies for TMDs.

颞下颌关节（TMJ）对包括咀嚼和说话在内的基本口腔面部功能至关重要。颞下颌关节及其相关结构的慢性疼痛和功能障碍被归类为颞下颌关节疾病（TMDs），是一个重大的公共卫生负担。然而，导致这些情况的确切神经生物学机制仍不清楚。自主神经系统，特别是交感神经系统，在关节内稳态、炎症和疼痛中起调节作用。本研究探讨大鼠颞下颌关节交感神经支配及其在炎性痛觉过敏中的功能作用。我们首先使用逆行示踪结合免疫染色绘制了交感神经支配在TMJ的起源。在确认TMJ主要接受来自同侧颈上神经节（SCG）的交感神经输入后，我们进行了单侧颈上神经节切除术（SCG- x），以评估交感神经去支配对酶酶酶诱导的TMJ炎症性痛觉过敏和局部细胞因子产生的影响。SCG-X手术显著加重了酶生蛋白诱导的TMJ机械痛觉过敏，显著增加了关节内白细胞介素-6 （IL-6）水平，而肿瘤坏死因子- α (tnf - α)未受影响。这些结果表明，在急性炎症时，交感神经系统通过调节局部细胞因子反应在TMJ中发挥抗痛觉和抗炎作用。该研究揭示了TMJ中先前未被发现的神经免疫机制，为开发新的靶向治疗策略提供了基础。

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引用次数: 0

Vericiguat attenuates the dynamic gain of open-loop baroreflex function in a low-frequency range Vericiguat在低频范围内衰减开环气压反射函数的动态增益。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-10 DOI: 10.1016/j.autneu.2025.103354

Aimi Yokoi , Toru Kawada , Nana Hiraki , Midori Kakuuchi , Takuya Nishikawa , Masafumi Fukumitsu , Kei Sato , Joe Alexander Jr , Ryou Tanaka , Keita Saku

Vericiguat, a soluble guanylate cyclase stimulator, enhances the production of cyclic guanosine monophosphate through nitric oxide (NO)-dependent and -independent mechanisms. We examined the effects of vericiguat on the open-loop dynamic characteristics of the carotid sinus baroreflex. In anesthetized Wistar–Kyoto rats (n = 8), sympathetic nerve activity (SNA), arterial pressure (AP), and aortic flow were measured while varying carotid sinus pressure (CSP) according to a Gaussian white noise signal with a mean of 120 mmHg and a standard deviation of 20 mmHg. The neural arc transfer function from CSP to SNA, peripheral arc transfer function from SNA to AP, and total arc transfer function from CSP to AP were compared between the baseline conditions and during intravenous administrations of vericiguat (10 μg·kg⁻¹·min⁻¹). Vericiguat treatment reduced the asymptotic dynamic gain in the peripheral arc but not in the neural arc. It also reduced the asymptotic dynamic gain and increased the corner frequency in the total arc. These findings indicate low-frequency-dominant attenuation of dynamic gain, suggesting that vericiguat enhances the negative feedback regulation of vasoconstriction mediated by endogenous NO.

Vericiguat是一种可溶性鸟苷环化酶刺激剂，通过一氧化氮（NO）依赖性和非依赖性机制促进环鸟苷单磷酸的产生。我们检查了vericiguat对颈动脉窦压力反射开环动态特性的影响。麻醉Wistar-Kyoto大鼠（n = 8），测量交感神经活动（SNA）、动脉压（AP）和主动脉流量，同时改变颈动脉窦压（CSP），根据高斯白噪声信号，平均值为120 mmHg，标准差为20 mmHg。比较基线条件和静脉给药（10 μg·kg-1·min-1）时CSP到SNA的神经弧传递函数、SNA到AP的外周弧传递函数和CSP到AP的总弧传递函数。Vericiguat治疗降低了外周弧线的渐近动态增益，但对神经弧线没有影响。减小了渐近动态增益，提高了总弧角频率。这些发现表明动态增益的低频衰减，表明vericiguat增强了内源性NO介导的血管收缩的负反馈调节。

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引用次数: 0

Stellate ganglion blockade for the treatment of post-traumatic stress disorder: A systematic review and meta-analysis 星状神经节阻滞治疗创伤后应激障碍：系统回顾和荟萃分析。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-23 DOI: 10.1016/j.autneu.2025.103360

Yihan Yang , Ruifang Pu , Diaofeng Zhang , Jie Wu , Wei Deng , Guocan Shen , Jiao Gao , Bo Feng , Liming Cheng , Jiangang Li

Background

Post-traumatic stress disorder (PTSD) is a prevalent psychiatric condition linked to diminished health-related quality of life, physical difficulties, and significant socioeconomic expenses. The stellate ganglion block (SGB) approach is increasingly utilized in patients with PTSD. Due to its efficacy and the variety of treatment alternatives, there is an urgent necessity for consistent and high-quality evidence about the usefulness of this intervention. This study aimed to investigate the effectiveness of SGB in treating PTSD and its related symptoms.

Methods

A systematic search of the PubMed, EMBASE, Web of Science, Cochrane Library, Wan Fang, VIP, and China Knowledge Network databases was performed till November 2024. Risks of bias were analyzed, and the methodological quality of the available literature was assessed. Data extraction and meta-analysis of the studies were conducted to determine the validity of SGB.

Results

Following the evaluation of 394 records, two randomized controlled trials and one case-control trial were incorporated into this meta-analysis. The methodological rigor of the included randomized controlled trials was elevated. In comparison to the control group, the pooled mean difference (MD) in the post-traumatic stress scale (CAPS) scores was diminished by −6.24 (95 % CI [−10.71, −1.78], P = 0.006) in the random-effects model, indicating that SGB treatment alleviated the symptoms of patients with PTSD.

Conclusion

The SGB treatment demonstrates efficacy in alleviating symptoms in people with PTSD. Nonetheless, the limited quantity of randomized controlled trials included necessitates a more extensive collection of high-quality randomized controlled trials to substantiate this result further.

背景：创伤后应激障碍（PTSD）是一种普遍的精神疾病，与健康相关的生活质量下降、身体困难和显著的社会经济支出有关。星状神经节阻滞（SGB）方法越来越多地用于PTSD患者。由于其疗效和治疗方案的多样性，迫切需要一致和高质量的证据来证明这种干预措施的有效性。本研究旨在探讨SGB治疗PTSD及其相关症状的有效性。方法：系统检索PubMed、EMBASE、Web of Science、Cochrane Library、万方、VIP、中国知识网等数据库，检索时间截止到2024年11月。对偏倚风险进行分析，并对现有文献的方法学质量进行评估。对研究进行数据提取和meta分析，以确定SGB的效度。结果：在对394份记录进行评估后，本meta分析纳入了2项随机对照试验和1项病例对照试验。纳入的随机对照试验的方法学严谨性得到了提高。与对照组相比，随机效应模型中创伤后应激量表（CAPS）评分的汇总平均差值（MD）降低了-6.24 (95% CI [-10.71, -1.78], P = 0.006)，表明SGB治疗减轻了PTSD患者的症状。结论：SGB治疗能有效缓解PTSD患者的症状。然而，由于纳入的随机对照试验数量有限，因此需要更广泛的高质量随机对照试验来进一步证实这一结果。

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引用次数: 0

Aging impairs urethral function in male rats: Increased outlet resistance and oxidative stress 衰老损害雄性大鼠尿道功能：增加出口阻力和氧化应激。

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-14 DOI: 10.1016/j.autneu.2025.103355

Eduardo Costa Alexandre , Alline Araujo Curiel , Jessica Mariana Dias , Fabio H. da Silva , Edson Antunes , Mariana G. de Oliveira

Epidemiological studies identify age as the primary unmodifiable risk factor for male lower urinary tract symptoms (LUTS). While research has focused on the bladder and prostate, the urethra remains understudied. This study investigates aging-induced changes in rat urethral structure and function and their impact on voiding. Male Wistar rats, young (3.5 months) and middle-aged (10 months), were used. Cystometry assessed voiding in vivo, and isolated urethras were used in vitro. Middle-aged rats showed irregular micturition with increased basal pressure, bladder capacity, compliance, and non-voiding contractions, suggesting elevated outlet resistance. Histology showed no significant differences. Contractions to electrical-field stimulation and the α1-adrenoceptor agonist phenylephrine were enhanced, along with a twofold increase in α1A-adrenoceptor mRNA. Conversely, relaxation to nitric oxide (NO) donors sodium nitroprusside (SNP) and glyceryl trinitrate (GTN) was reduced, while responses to the cGMP analog 8Br-cGMP and the soluble guanylate cyclase (sGC) stimulator BAY 41-2272 were unchanged. Lower NO levels, despite increased endothelial NO synthase (eNOS) mRNA, were observed in middle-aged urethras, with no changes in neuronal NOS (nNOS) or sGC subunit β1. Phosphodiesterase type 5 (PDE5) mRNA was elevated, correlating with reduced basal and SNP-stimulated cGMP. Oxidative stress was evident, with increased superoxide and reduced expression of antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT). NADPH oxidase 2 (NOX2) and xanthine dehydrogenase (XDH) mRNA were upregulated, while hypoxia-inducible factor 1-alpha (HIF1α) remained unchanged. In summary, middle-aged rats show urethral hypercontractility, impaired relaxation, and oxidative stress, without tissue remodeling or ischemia.

流行病学研究确定年龄是男性下尿路症状（LUTS）的主要不可改变的危险因素。虽然研究主要集中在膀胱和前列腺，但对尿道的研究仍然不足。本研究探讨衰老引起的大鼠尿道结构和功能的变化及其对排尿的影响。雄性Wistar大鼠，年轻（3.5个月）和中年（10个月）。膀胱术评估体内排尿，体外分离尿道。中年大鼠排尿不规则，基底压、膀胱容量、顺应性和非排尿性收缩增加，提示排尿口阻力升高。组织学差异无统计学意义。对电场刺激和α1-肾上腺素受体激动剂苯肾上腺素的收缩增强，α 1a -肾上腺素受体mRNA增加两倍。相反，对一氧化氮（NO）供体硝普钠（SNP）和三硝酸甘油（GTN）的松弛度降低，而对cGMP类似物8Br-cGMP和可溶性鸟苷酸环化酶（sGC）刺激剂BAY 41-2272的反应不变。尽管内皮NO合成酶（eNOS） mRNA升高，但中年尿道NO水平较低，神经元NOS （nNOS）或sGC亚基β1无变化。磷酸二酯酶5 (PDE5) mRNA升高，与基础和snp刺激的cGMP降低相关。氧化应激明显，超氧化物增加，抗氧化酶超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GPX）和过氧化氢酶（CAT）表达降低。NADPH氧化酶2 （NOX2）和黄嘌呤脱氢酶（XDH） mRNA表达上调，而缺氧诱导因子1- α (HIF1α)表达不变。总之，中年大鼠表现为尿道过度收缩、松弛受损和氧化应激，无组织重塑或缺血。

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引用次数: 0

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-12-01 Epub Date: 2025-10-20 DOI: 10.1016/j.autneu.2025.103361

Bruno Rojas-Roel , Julia Devanne , Olivier Després , Thierry Pebayle , André Dufour , Ségolène Lithfous

This study aimed to investigate the role of cutaneous vasodilation in heat pain tolerance during aging. We hypothesized that reduced vasodilation in response to heat would lead to a less efficient heat dissipation, and thus be associated with diminished heat pain tolerance. Due to their efferent role in vasomotor function, we hypothesized that C-fiber functionality would be associated to the efficacy of cutaneous vasodilation. Twenty younger and forty older subjects participated in a 15-min heat pain tolerance test, during which pain ratings were continuously measured, along with skin temperature. Participants could terminate the test at any time if the pain became unbearable. A local thermal hyperemia protocol was conducted to assess cutaneous vasodilation using laser Doppler flowmetry. Warm detection and heat pain thresholds were measured to evaluate small fiber functionality. Older subjects were divided into two groups according to their pain tolerance duration. The older MAX group (n = 22; i.e., 55 %) completed the tolerance test, while the older LOW group did not. Older MAX had preserved cutaneous vasodilation compared to young subjects, whereas older LOW had reduced heat-induced vasodilation. In addition, the skin temperature of older LOW subjects reached a higher level during the pain tolerance test, which was associated to higher pain ratings compared to the two other groups. Older LOW also had higher warm detection threshold, pointing to diminished C-fiber functionality. Reduced cutaneous vasodilation, possibly linked to impaired C-fiber functionality in aging, affects heat pain tolerance due to less efficient heat dissipation.

本研究旨在探讨皮肤血管舒张在衰老过程中热痛耐受中的作用。我们假设，对热反应的血管舒张减少会导致散热效率降低，从而与热痛耐受性降低有关。由于它们在血管舒缩功能中的传出作用，我们假设c纤维的功能可能与皮肤血管舒张的功效有关。20名年轻人和40名老年人参加了一项15分钟的热痛耐受性测试，在此期间，疼痛等级和皮肤温度被连续测量。如果疼痛变得无法忍受，参与者可以随时终止测试。采用激光多普勒血流仪进行局部热充血方案以评估皮肤血管舒张。测量热检测和热痛阈值来评估小纤维的功能。老年受试者根据疼痛耐受时间分为两组。老年MAX组（n = 22，即55%）完成了耐受性测试，而老年LOW组没有。与年轻受试者相比，老年MAX保留了皮肤血管舒张，而老年LOW则减少了热诱导的血管舒张。此外，在疼痛耐受性测试中，老年LOW受试者的皮肤温度达到了更高的水平，与其他两组相比，这与更高的疼痛评分有关。老的LOW也有更高的温度检测阈值，表明c -纤维功能减弱。皮肤血管舒张减少，可能与衰老过程中c纤维功能受损有关，由于散热效率降低，影响热痛耐受性。

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引用次数: 0