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Acute hypernatremia increases functional connectivity of NaCl sensing regions in the human brain: An fMRI pilot study 急性高钠血症会增加人脑中NaCl感应区的功能连接:一项 fMRI 试验研究
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-05-19 DOI: 10.1016/j.autneu.2024.103182
Joseph M. Stock , Nathan T. Romberger , Ronald K. McMillan , Jae Woo Chung , Megan M. Wenner , Sean D. Stocker , William B. Farquhar , Roxana G. Burciu

Rodent studies demonstrated specialized sodium chloride (NaCl) sensing neurons in the circumventricular organs, which mediate changes in sympathetic nerve activity, arginine vasopressin, thirst, and blood pressure. However, the neural pathways involved in NaCl sensing in the human brain are incompletely understood. The purpose of this pilot study was to determine if acute hypernatremia alters the functional connectivity of NaCl-sensing regions of the brain in healthy young adults. Resting-state fMRI scans were acquired in 13 participants at baseline and during a 30 min hypertonic saline infusion (HSI). We used a seed-based approach to analyze the data, focusing on the subfornical organ (SFO) and the organum vasculosum of the lamina terminalis (OVLT) as regions of interest (ROIs). Blood chemistry and perceived thirst were assessed pre- and post-infusion. As expected, serum sodium increased from pre- to post-infusion in the HSI group. The primary finding of this pilot study was that the functional connectivity between the SFO and a cluster within the OVLT increased from baseline to the late-phase of the HSI. Bidirectional connectivity changes were found with cortical regions, with some regions showing increased connectivity with sodium-sensing regions while others showed decreased connectivity. Furthermore, the functional connectivity between the SFO and the posterior cingulate cortex (a control ROI) did not change from baseline to the late-phase of the HSI. This finding indicates a distinct response within the NaCl sensing network in the human brain specifically related to acute hypernatremia that will need to be replicated in large-scale studies.

啮齿类动物的研究表明,环状器官中专门的氯化钠(NaCl)感觉神经元介导交感神经活动、精氨酸加压素、口渴和血压的变化。然而,人们对人脑中氯化钠感应神经通路的了解尚不全面。这项试验性研究的目的是确定急性高钠血症是否会改变健康年轻人大脑中钠感应区域的功能连接。我们采集了 13 名参与者在基线和 30 分钟高渗盐水输注(HSI)期间的静息态 fMRI 扫描。我们采用基于种子的方法来分析数据,并将角膜下器官(SFO)和末端薄层血管器官(OVLT)作为感兴趣区(ROI)。对输液前后的血液生化指标和口渴感进行了评估。不出所料,恒定血压组从输液前到输液后的血清钠都有所增加。这项试验性研究的主要发现是,从基线到恒定血压后期,SFO 与 OVLT 中的一个集群之间的功能连通性增加了。皮质区域的双向连通性发生了变化,一些区域与钠传感区域的连通性增强,而另一些区域的连通性减弱。此外,SFO 与后扣带回皮层(对照组 ROI)之间的功能连接从基线到 HSI 后期阶段没有变化。这一发现表明,人脑中的NaCl感知网络与急性高钠血症有特殊的反应,这需要在大规模研究中加以验证。
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引用次数: 0
Neural mechanisms of respiratory interoception 呼吸互感的神经机制
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-25 DOI: 10.1016/j.autneu.2024.103181
Pei-Ying Sarah Chan , Lu-Yuan Lee , Paul W. Davenport

Respiratory interoception is one of the internal bodily systems that is comprised of different types of somatic and visceral sensations elicited by different patterns of afferent input and respiratory motor drive mediating multiple respiratory modalities. Respiratory interoception is a complex system, having multiple afferents grouped into afferent clusters and projecting into both discriminative and affective centers that are directly related to the behavioral assessment of breathing. The multi-afferent system provides a spectrum of input that result in the ability to interpret the different types of respiratory interceptive sensations. This can result in a response, commonly reported as breathlessness or dyspnea. Dyspnea can be differentiated into specific modalities. These respiratory sensory modalities lead to a general sensation of an Urge-to-Breathe, driven by a need to compensate for the modulation of ventilation that has occurred due to factors that have affected breathing. The multiafferent system for respiratory interoception can also lead to interpretation of the sensory signals resulting in respiratory related sensory experiences, including the Urge-to-Cough and Urge-to-Swallow. These behaviors are modalities that can be driven through the differentiation and integration of multiple afferent input into the respiratory neural comparator. Respiratory sensations require neural somatic and visceral interoceptive elements that include gated attention and detection leading to respiratory modality discrimination with subsequent cognitive decision and behavioral compensation. Studies of brain areas mediating cortical and subcortical respiratory sensory pathways are summarized and used to develop a model of an integrated respiratory neural network mediating respiratory interoception.

呼吸互感是身体内部系统之一,它由不同类型的躯体和内脏感觉组成,这些感觉是由不同模式的传入输入和呼吸运动驱动引起的,介导多种呼吸模式。呼吸互感是一个复杂的系统,由多个传入系统组成传入群,并投射到与呼吸行为评估直接相关的辨别中枢和情感中枢。多传入系统提供了一系列输入,从而能够解释不同类型的呼吸感觉。这可能导致一种反应,通常报告为呼吸困难或呼吸困难。呼吸困难可分为不同的模式。这些呼吸感觉模式会导致 "急迫呼吸 "的一般感觉,其驱动力是需要补偿由于影响呼吸的因素而发生的通气调节。呼吸互感的多传感系统也会导致对感觉信号的解读,从而产生与呼吸有关的感觉体验,包括 "想咳嗽 "和 "想吞咽"。这些行为模式可以通过将多种传入输入分化和整合到呼吸神经比较器来驱动。呼吸感觉需要神经躯体和内脏互感元素,其中包括门控注意和检测,从而导致呼吸方式的分辨,以及随后的认知决策和行为补偿。本文总结了介导皮层和皮层下呼吸感觉通路的脑区研究,并利用这些研究建立了一个介导呼吸互感的综合呼吸神经网络模型。
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引用次数: 0
Interoceptive signals from the heart and coronary circulation in health and disease 健康和疾病中来自心脏和冠状循环的互感信号
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-24 DOI: 10.1016/j.autneu.2024.103180
Jonathan P. Moore

This review considers interoceptive signalling from the heart and coronary circulation. Vagal and cardiac sympathetic afferent sensory nerve endings are distributed throughout the atria, ventricles (mainly left), and coronary artery. A small proportion of cardiac receptors attached to thick myelinated vagal afferents are tonically active during the cardiac cycle. Dependent upon location, these mechanoreceptors detect fluctuations in atrial volume and coronary arterial perfusion. Atrial volume and coronary arterial signals contribute to beat-to-beat feedback control and physiological homeostasis. Most cardiac receptors are attached to thinly myelinated or nonmyelinated C fibres, many of which are unresponsive to the cardiac cycle. Of these, there are many chemically sensitive cardiac receptors which are activated during myocardial stress by locally released endogenous substances. In contrast, some tonically inactive receptors become activated by irregular ventricular wall mechanics or by distortion of the ischaemic myocardium. Furthermore, some are excited both by chemical mediators of ischaemia and wall abnormalities. Reflex responses arising from cardiac receptors attached to thinly myelinated or nonmyelinated are complex. Impulses that project centrally through vagal afferents elicit sympathoinhibition and hypotension, whereas impulses travelling in cardiac sympathetic afferents and spinal pathways elicit sympathoexcitation and hypertension. Two opposing cardiac reflexes may provide a mechanism for fine-tuning a composite haemodynamic response during myocardial stress. Sympathetic afferents provide the primary pathway for transmission of cardiac nociception to the central nervous system. However, activation of sympathetic afferents may increase susceptibility to life-threatening arrhythmias. Notably, the cardiac sympathetic afferent reflex predominates in pathophysiological states including hypertension and heart failure.

这篇综述探讨了来自心脏和冠状动脉循环的互感信号。迷走神经和心脏交感传入感觉神经末梢分布于心房、心室(主要是左心室)和冠状动脉。在心动周期中,一小部分附着在粗髓鞘迷走神经传入上的心脏感受器处于强直性活跃状态。根据位置的不同,这些机械感受器可检测到心房容积和冠状动脉灌注的波动。心房容积和冠状动脉信号有助于每搏反馈控制和生理平衡。大多数心脏感受器附着在髓鞘较细或无髓鞘的 C 纤维上,其中许多对心动周期无反应。在这些受体中,有许多对化学物质敏感的心脏受体,在心肌受压时会被局部释放的内源性物质激活。与此相反,一些音调不活跃的受体会因心室壁力学不规则或缺血心肌变形而被激活。此外,有些受体会同时被缺血和室壁异常的化学介质激发。附着在薄髓鞘或非髓鞘上的心脏感受器所产生的反射反应非常复杂。通过迷走神经传入中枢的冲动会引起交感抑制和低血压,而通过心脏交感传入和脊髓通路的冲动则会引起交感兴奋和高血压。两种对立的心脏反射可能为心肌应激时的综合血流动力学反应提供了一种微调机制。交感神经传入是心脏痛觉传递到中枢神经系统的主要途径。然而,交感神经传入的激活可能会增加对危及生命的心律失常的易感性。值得注意的是,在高血压和心力衰竭等病理生理状态下,心脏交感传入反射占主导地位。
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引用次数: 0
Anticipating noxious stimulation rather than afferent nociceptive input may evoke pupil asymmetry 预期有害刺激而非传入痛觉输入可能会诱发瞳孔不对称
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-23 DOI: 10.1016/j.autneu.2024.103179
Peter D. Drummond

Unilateral nociceptive stimulation is associated with subtle signs of pupil asymmetry that may reflect lateralized activity in the locus coeruleus. To explore drivers of this pupil asymmetry, electrical stimuli, delivered alone or 200 ms before or after an acoustic startle stimulus, were administered to one ankle under four experimental conditions: with or without a 1.6 s anticipatory period, or while the forearm ipsilateral or contralateral to the electrical stimulus was heated tonically to induce moderate pain (15 healthy participants in each condition). Pupil diameter was measured at the start of each trial, at stimulus delivery, and each second for 5 s after stimulus delivery. At the start of the first trial, the pupil ipsilateral to the side on which electric shocks were later delivered was larger than the contralateral pupil. Both pupils dilated robustly during the anticipatory period and dilated further during single- and dual-stimulus trials. However, pupil asymmetry persisted throughout the experiment. Tonically-applied forearm heat-pain modulated the pupillary response to phasic electrical stimuli, with a slight trend for dilatation to be greater contralateral to the forearm being heated. Together, these findings suggest that focusing anxiously on the expected site of noxious stimulation was associated with dilatation of the ipsilateral pupil whereas phasic nociceptive stimuli and psychological arousal triggered bilateral pupillary dilatation. It was concluded that preparatory cognitive activity rather than phasic afferent nociceptive input is associated with pupillary signs of lateralized activity in the locus coeruleus.

单侧痛觉刺激与瞳孔不对称的微妙迹象有关,而瞳孔不对称可能反映了神经中枢的侧向活动。为了探究这种瞳孔不对称的驱动因素,我们在四种实验条件下对一只脚踝进行了电刺激(单独刺激或在声学惊吓刺激前后 200 毫秒刺激):有或没有 1.6 秒的预期时间,或在电刺激的同侧或对侧前臂被加热以诱发中度疼痛时(每种条件下有 15 名健康参与者)。瞳孔直径在每次试验开始时、刺激发出时以及刺激发出后 5 秒钟内每秒测量一次。在第一次试验开始时,随后发出电击的同侧瞳孔大于对侧瞳孔。在预期期间,两侧瞳孔都强烈放大,并在单刺激和双刺激试验期间进一步放大。然而,瞳孔不对称现象在整个实验过程中持续存在。前臂热痛调节了瞳孔对阶段性电刺激的反应,在前臂被加热的对侧,瞳孔扩张的趋势更明显。这些发现共同表明,焦虑地关注预期的有害刺激部位与同侧瞳孔扩张有关,而相位痛觉刺激和心理唤醒会引发双侧瞳孔扩张。结论是准备性认知活动而非阶段性传入痛觉输入与瞳孔中侧性活动的位置相关。
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引用次数: 0
Tributyltin (TBT) toxicity: Effects on enteric neuronal plasticity and intestinal barrier of rats' duodenum 三丁基锡(TBT)毒性:对大鼠十二指肠肠道神经元可塑性和肠道屏障的影响
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-18 DOI: 10.1016/j.autneu.2024.103176
I.C.C.S. Oliveira , G.P. Marinsek , L.V.B. Correia , R.C.B. da Silva , I.B. Castro , R.B. Mari

Tributyltin (TBT) is a biocide used in the formulation of antifouling paints and it is highly harmful. Despite the ban, the compound persists in the environment, contaminating marine foodstuffs and household products. Therefore, considering the route of exposure to the contaminant, the gastrointestinal tract (GIT) acts as an important barrier against harmful substances and is a potential biomarker for understanding the consequences of these agents. This work aimed to evaluate histological and neuronal alterations in the duodenum of male Wistar rats that received 20 ng/g TBT and 600 ng/g via gavage for 30 consecutive days. After the experimental period, the animals were euthanized, and the duodenum was intended for neuronal histochemistry (total and metabolically active populations) and histological routine (morphometry and histopathology). The results showed more severe changes in neuronal density and intestinal morphometry in rats exposed to 20 ng/g, such as total neuronal density decrease and reduction of intestinal layers. In rats exposed to 600 ng/g of TBT, it was possible to observe only an increase in intraepithelial lymphocytes. We conclude that TBT can be more harmful to intestinal homeostasis when consumed in lower concentrations.

三丁基锡(TBT)是一种用于配制防污漆的生物杀灭剂,危害极大。尽管已被禁用,但该化合物仍在环境中持续存在,污染海洋食品和家用产品。因此,考虑到接触污染物的途径,胃肠道(GIT)是抵御有害物质的重要屏障,也是了解这些制剂后果的潜在生物标志物。这项研究旨在评估连续 30 天灌胃 20 纳克/克三丁基锡化合物和 600 纳克/克三丁基锡化合物的雄性 Wistar 大鼠十二指肠组织学和神经元的变化。实验结束后,动物被处以安乐死,十二指肠将被用于神经元组织化学(总种群和代谢活性种群)和组织学常规(形态计量学和组织病理学)。结果显示,暴露于 20 纳克/克的大鼠神经元密度和肠道形态学变化更为严重,如神经元总密度下降和肠道层数减少。在暴露于 600 纳克/克三丁基锡化合物的大鼠中,只能观察到上皮内淋巴细胞的增加。我们的结论是,摄入较低浓度的三丁基锡化合物会对肠道稳态造成更大危害。
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引用次数: 0
Effects of oral administration of ondansetron, a 5-HT3 receptor antagonist, on anxiety-related behaviors and colonic hypercontractility in repeated stress-induced mice 口服 5-HT3 受体拮抗剂昂丹司琼对反复应激诱导小鼠焦虑相关行为和结肠过度收缩的影响
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-18 DOI: 10.1016/j.autneu.2024.103178
Affan Waemong , Sarunnuch Sattayachiti , Dania Cheaha , Nipaporn Konthapakdee

Purpose

Chronic psychological stress develops and exacerbates irritable bowel syndrome (IBS). 5-hydroxytryptamine (5-HT) via activation of intestinal 5-HT3 receptors involves impairment of intestinal functions. This study aimed to investigate the effects of ondansetron, a 5-HT3 receptor antagonist, on locomotor activity, anxiety-related behaviors, and colonic functions in repeated water avoidance stress.

Materials and methods

Food intake and fecal pellet output (FPO) of sham stress (SS), water avoidance stress (WS), and water avoidance stress with oral administration of ondansetron (1 mg/kg BW) (WA) groups were monitored along the water avoidance stress protocol for 10 consecutive days. On day 11, locomotor activity and anxiety-related behaviors were determined using an open field test. Contractile properties of colonic tissues in response to KCl and a cumulative dose of carbachol (CCh) were determined using in vitro organ bath technique.

Results

FPO was significantly increased in the WS group after 7 days of water avoidance stress, which was reversed in WA group. WS group decreased unsupported rearing behavior compared to WS group, which was not altered in the WA group. The colon of the WS group had a higher tonic contraction in response to CCh than the SS and WA groups, which was reversed with ondansetron pre-incubation.

Conclusions

Oral administration of ondansetron prevented increased FPO but did not affect anxiety-related behavior in repeated stress model. Colonic hypercontractility in the stressed mice was related to increased responses to cholinergic-induced contractions, which involved 5-HT3 receptors. Our findings suggest the modulatory roles of 5-HT3 receptors to mediate stress-induced colonic dysfunction.

目的 长期心理压力会导致肠易激综合征(IBS)的发生和加重。5-羟色胺(5-HT)通过激活肠道 5-HT3 受体导致肠道功能受损。本研究旨在探讨5-HT3受体拮抗剂昂丹司琼在重复避水应激中对运动活动、焦虑相关行为和结肠功能的影响。材料与方法在连续10天的避水应激方案中监测假应激组(SS)、避水应激组(WS)和口服昂丹司琼(1 mg/kg BW)的避水应激组(WA)的食物摄入量和粪便排出量(FPO)。第 11 天,使用开放场地试验测定运动活动和焦虑相关行为。采用体外器官浴技术测定结肠组织对氯化钾和累积剂量卡巴胆碱(CCh)的收缩特性。与 WS 组相比,WS 组无支撑饲养行为减少,而 WA 组无变化。结论在重复应激模型中,口服昂丹司琼可防止 FPO 增加,但不会影响焦虑相关行为。应激小鼠的结肠过度收缩与胆碱能诱导的收缩反应增加有关,而胆碱能诱导的收缩反应涉及 5-HT3 受体。我们的研究结果表明,5-HT3 受体在介导应激诱导的结肠功能障碍方面起着调节作用。
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引用次数: 0
Voluntary wheel running as a promising strategy to promote autonomic resilience to social stress in females: Vagal tone lies at the heart of the matter 自愿轮跑是促进女性自律神经对社会压力恢复能力的一种有前途的策略:迷走神经张力是问题的核心
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-15 DOI: 10.1016/j.autneu.2024.103175
Brittany S. Pate , Cora E. Smiley , Evelynn N. Harrington , B. Hunter Bielicki , J. Mark Davis , Lawrence P. Reagan , Claudia A. Grillo , Susan K. Wood

Social stress is a major risk factor for comorbid conditions including cardiovascular disease and depression. While women exhibit 2–3× the risk for these stress-related disorders compared to men, the mechanisms underlying heightened stress susceptibility among females remain largely unknown. Due to a lack in understanding of the pathophysiology underlying stress-induced comorbidities among women, there has been a significant challenge in developing effective therapeutics. Recently, a causal role for inflammation has been established in the onset and progression of comorbid cardiovascular disease/depression, with women exhibiting increased sensitivity to stress-induced immune signaling. Importantly, reduced vagal tone is also implicated in stress susceptibility, through a reduction in the vagus nerve's well-recognized anti-inflammatory properties. Thus, examining therapeutic strategies that stabilize vagal tone during stress may shed light on novel targets for promoting stress resilience among women. Recently, accumulating evidence has demonstrated that physical activity exerts cardio- and neuro-protective effects by enhancing vagal tone. Based on this evidence, this mini review provides an overview of comorbid cardiovascular and behavioral dysfunction in females, the role of inflammation in these disorders, how stress may impart its negative effects on the vagus nerve, and how exercise may act as a preventative. Further, we highlight a critical gap in the literature with regard to the study of females in this field. This review also presents novel data that are the first to demonstrate a protective role for voluntary wheel running over vagal tone and biomarkers of cardiac dysfunction in the face of social stress exposure in female rats.

社会压力是心血管疾病和抑郁症等并发症的主要风险因素。与男性相比,女性罹患这些压力相关疾病的风险是男性的 2-3 倍,但女性易受压力影响的机制在很大程度上仍不为人所知。由于对女性压力引起的并发症的病理生理学缺乏了解,因此在开发有效的治疗方法方面面临着巨大的挑战。最近,炎症在心血管疾病/抑郁症并发症的发生和发展中的因果关系已被证实,女性对压力诱导的免疫信号敏感性更高。重要的是,迷走神经具有公认的抗炎特性,迷走神经张力降低也与压力易感性有关。因此,研究在压力期间稳定迷走神经张力的治疗策略可能会为促进女性抗压能力的新目标提供启示。最近,越来越多的证据表明,体育锻炼可通过增强迷走神经张力发挥保护心血管和神经的作用。基于这些证据,本微型综述概述了女性合并心血管和行为功能障碍的情况、炎症在这些疾病中的作用、压力如何对迷走神经产生负面影响,以及运动如何起到预防作用。此外,我们还强调了这一领域在女性研究方面的文献空白。本综述还介绍了一些新数据,这些数据首次证明了在雌性大鼠面临社会压力时,自愿轮跑对迷走神经张力和心脏功能障碍生物标志物具有保护作用。
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引用次数: 0
Localization of sensory nerve terminals containing calcitonin gene-related peptide (CGRP) on striated muscle fibers in the rat esophagus: Evidence for triple innervation via motor endplates 大鼠食管横纹肌纤维上含有降钙素基因相关肽 (CGRP) 的感觉神经末梢定位:通过运动终板进行三重神经支配的证据
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-04-12 DOI: 10.1016/j.autneu.2024.103177
Hirofumi Kuramoto , Mana Yabe , Ryo Morishita , Ryoichi Yoshimura , Hiroshi Sakamoto

Background

Many esophageal striated muscles of mammals are dually innervated by the vagal and enteric nerves. Recently, substance P (SP)-sensory nerve terminals with calcitonin gene-related peptide (CGRP) were found on a few striated muscle fibers in the rat esophagus, implying that these muscle fibers are triply innervated. In this study, we examined the localization and origin of CGRP-nerve endings in striated muscles to consider their possible roles in the esophagus regarding triple innervation.

Methods

Wholemounts of the rat esophagus were immunolabeled to detect CGRP-nerve endings in striated muscles. Also, retrograde tracing was performed by injecting Fast Blue (FB) into the esophagus, and cryostat sections of the medulla oblongata, nodose ganglion (NG), and the tenth thoracic (T10) dorsal root ganglion (DRG) were immunostained to identify the origin of the CGRP-nerve endings.

Results

CGRP-fine, varicose nerve endings were localized in motor endplates on a few esophageal striated muscle fibers (4 %), most of which received nitric oxide (NO) synthase nerve terminals, and most of the CGRP nerve endings were SP- and transient receptor potential vanilloid member 1 (TRPV1)-positive. Retrograde tracing showed many FB-labeled CGRP-neurons positive for SP and TRPV1 in the NG and T10 DGR.

Conclusions

This study suggests that the CGRP-varicose nerve endings containing SP and TRPV1 in motor endplates are sensory, and a few esophageal striated muscle fibers are triply innervated. The nerve endings may detect acetylcholine-derived acetic acid from the vagal motor nerve endings and NO from esophageal intrinsic nerve terminals in the motor endplates to regulate esophageal motility.

背景哺乳动物的许多食管横纹肌都由迷走神经和肠神经双重支配。最近,在大鼠食管的一些横纹肌纤维上发现了带有降钙素基因相关肽(CGRP)的P物质(SP)感觉神经末梢,这意味着这些肌纤维受到三重神经支配。本研究探讨了 CGRP 神经末梢在横纹肌中的定位和起源,以考虑它们在食管中三重神经支配方面可能发挥的作用。同时,通过向食管注射快速蓝(FB)进行逆行追踪,并对延髓、结节神经节(NG)和第十胸椎(T10)背根神经节(DRG)的冷冻切片进行免疫染色,以确定 CGRP 神经末梢的起源。结果CGRP细小的曲张神经末梢位于少数食管横纹肌纤维(4%)的运动终板上,其中大部分接受一氧化氮(NO)合成酶神经末梢,大部分CGRP神经末梢呈SP和瞬时受体电位类香草素1(TRPV1)阳性。逆行追踪显示,在 NG 和 T10 DGR 中,许多 FB 标记的 CGRP 神经元对 SP 和 TRPV1 呈阳性。这些神经末梢可能检测到来自迷走运动神经末梢的乙酰胆碱衍生乙酸和来自运动终板食管固有神经末梢的 NO,从而调节食管运动。
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引用次数: 0
Longitudinal prevalence of neurogenic orthostatic hypotension in the idiopathic Parkinson Progression Marker Initiative (PPMI) cohort 特发性帕金森病进展标志物倡议(PPMI)队列中神经源性正张力性低血压的纵向患病率
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-03-31 DOI: 10.1016/j.autneu.2024.103173
Paul Beach , J. Lucas McKay

Background

Reported orthostatic hypotension (OH) prevalence in Parkinson's disease (PD) varies widely, with few studies evaluating specifically neurogenic-OH (nOH). The ratio of orthostatic heart rate (HR) to systolic blood pressure (SBP) change (Δ) is a valid screening method to stratify nOH/non-nOH but has had minimal epidemiologic application.

Objective

To estimate the prevalence of nOH and non-nOH in the PPMI using the ΔHR/ΔSBP ratio and examine associations between nOH and various motor and non-motor measures.

Methods

Longitudinal orthostatic vitals and motor and non-motor measures were extracted (baseline-month 48). Patients were consensus criteria classified as OH+/−, with ΔHR/ΔSBP sub-classification to nOH (ΔHR/ΔSBP < 0.5) or non-nOH (ratio ≥ 0.5). Prevalence was determined across visits. Independent linear mixed models tested associations between nOH/non-nOH and clinical variables.

Results

Of N = 907 PD with baseline orthostatic vitals, 3.9 % and 1.8 % exhibited nOH and non-nOH, respectively. Prevalence of nOH/non-nOH increased yearly (P = 0.012, chi-square), though with modest magnitude (baseline: 5.6 % [95 % CI: 4.3–7.3 %]; month 48: 8.6 % [6.4–11.5 %]). nOH patients were older than PD with no OH and nOH was associated with greater impairment of motor and independent functioning than non-nOH/OH- groups. Cognitive function and typical OH symptoms were worse in PD + OH, generally.

Conclusions

nOH prevalence was greater than non-nOH in the PPMI early PD cohort, with modest prevalence increase over time. Our findings are consistent with prior studies of large cohorts that evaluated nOH, specifically. Those with early PD and nOH were likelier to be older and suffer from greater motor and functional impairment, but OH presence was generally associated with more cognitive impairment.

背景据报道,帕金森病(PD)中的正静性低血压(OH)患病率差异很大,很少有研究专门评估神经源性低血压(nOH)。正静态心率(HR)与收缩压(SBP)变化的比值(Δ)是一种有效的筛查方法,可对正静态低血压/非正静态低血压进行分层,但在流行病学中的应用却很少。方法提取纵向正静息生命体征以及运动和非运动指标(基线-月 48)。根据共识标准将患者划分为OH+/-,并将ΔHR/ΔSBP细分为nOH(ΔHR/ΔSBP <0.5)或非nOH(比率≥0.5)。患病率在各次就诊时确定。独立线性混合模型检验了 nOH/non-nOH 与临床变量之间的关联。结果 在基线正压生命体征的 907 名患者中,分别有 3.9% 和 1.8% 表现出 nOH 和 non-nOH。nOH/non-nOH的患病率逐年增加(P = 0.012,秩和检验),但幅度不大(基线:5.6% [95 % CI:4.3-7.3%];第48个月:8.6% [6.4-11.5%])。结论在 PPMI 早期 PD 队列中,nOH 患病率高于非 nOH,且患病率随时间略有增加。我们的研究结果与之前评估 nOH 的大型队列研究结果一致。那些患有早期帕金森病并伴有 nOH 的患者年龄更大,运动和功能障碍更严重,但一般来说,存在 OH 与认知障碍更严重有关。
{"title":"Longitudinal prevalence of neurogenic orthostatic hypotension in the idiopathic Parkinson Progression Marker Initiative (PPMI) cohort","authors":"Paul Beach ,&nbsp;J. Lucas McKay","doi":"10.1016/j.autneu.2024.103173","DOIUrl":"https://doi.org/10.1016/j.autneu.2024.103173","url":null,"abstract":"<div><h3>Background</h3><p>Reported orthostatic hypotension (OH) prevalence in Parkinson's disease (PD) varies widely, with few studies evaluating specifically neurogenic-OH (nOH). The ratio of orthostatic heart rate (HR) to systolic blood pressure (SBP) change (Δ) is a valid screening method to stratify nOH/non-nOH but has had minimal epidemiologic application.</p></div><div><h3>Objective</h3><p>To estimate the prevalence of nOH and non-nOH in the PPMI using the ΔHR/ΔSBP ratio and examine associations between nOH and various motor and non-motor measures.</p></div><div><h3>Methods</h3><p>Longitudinal orthostatic vitals and motor and non-motor measures were extracted (baseline-month 48). Patients were consensus criteria classified as OH+/−, with ΔHR/ΔSBP sub-classification to nOH (ΔHR/ΔSBP &lt; 0.5) or non-nOH (ratio ≥ 0.5). Prevalence was determined across visits. Independent linear mixed models tested associations between nOH/non-nOH and clinical variables.</p></div><div><h3>Results</h3><p>Of <em>N</em> = 907 PD with baseline orthostatic vitals, 3.9 % and 1.8 % exhibited nOH and non-nOH, respectively. Prevalence of nOH/non-nOH increased yearly (<em>P</em> = 0.012, chi-square), though with modest magnitude (baseline: 5.6 % [95 % CI: 4.3–7.3 %]; month 48: 8.6 % [6.4–11.5 %]). nOH patients were older than PD with no OH and nOH was associated with greater impairment of motor and independent functioning than non-nOH/OH- groups. Cognitive function and typical OH symptoms were worse in PD + OH, generally.</p></div><div><h3>Conclusions</h3><p>nOH prevalence was greater than non-nOH in the PPMI early PD cohort, with modest prevalence increase over time. Our findings are consistent with prior studies of large cohorts that evaluated nOH, specifically. Those with early PD and nOH were likelier to be older and suffer from greater motor and functional impairment, but OH presence was generally associated with more cognitive impairment.</p></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"253 ","pages":"Article 103173"},"PeriodicalIF":2.7,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140813211","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
Hepatic interoception in health and disease 健康与疾病中的肝脏截获功能
IF 2.7 4区 医学 Q2 NEUROSCIENCES Pub Date : 2024-03-29 DOI: 10.1016/j.autneu.2024.103174
Hans-Rudolf Berthoud , Heike Münzberg , Christopher D. Morrison , Winfried L. Neuhuber

The liver is a large organ with crucial functions in metabolism and immune defense, as well as blood homeostasis and detoxification, and it is clearly in bidirectional communication with the brain and rest of the body via both neural and humoral pathways. A host of neural sensory mechanisms have been proposed, but in contrast to the gut-brain axis, details for both the exact site and molecular signaling steps of their peripheral transduction mechanisms are generally lacking. Similarly, knowledge about function-specific sensory and motor components of both vagal and spinal access pathways to the hepatic parenchyma is missing. Lack of progress largely owes to controversies regarding selectivity of vagal access pathways and extent of hepatocyte innervation. In contrast, there is considerable evidence for glucose sensors in the wall of the hepatic portal vein and their importance for glucose handling by the liver and the brain and the systemic response to hypoglycemia. As liver diseases are on the rise globally, and there are intriguing associations between liver diseases and mental illnesses, it will be important to further dissect and identify both neural and humoral pathways that mediate hepatocyte-specific signals to relevant brain areas. The question of whether and how sensations from the liver contribute to interoceptive self-awareness has not yet been explored.

肝脏是一个大器官,在新陈代谢、免疫防御、血液平衡和解毒方面具有重要功能,它显然通过神经和体液途径与大脑和身体其他部位进行双向交流。人们提出了一系列神经感觉机制,但与肠-脑轴不同的是,人们普遍缺乏有关其外周传导机制的确切部位和分子信号步骤的详细信息。同样,有关肝实质迷走神经和脊髓通路的特定功能感觉和运动成分的知识也缺乏。缺乏进展在很大程度上归因于对迷走神经通路的选择性和肝细胞支配范围的争议。相反,有大量证据表明,肝门静脉壁上存在葡萄糖传感器,它们对肝脏和大脑处理葡萄糖以及对低血糖的全身反应非常重要。由于肝脏疾病在全球范围内呈上升趋势,而且肝脏疾病与精神疾病之间存在着耐人寻味的关联,因此进一步剖析和确定介导肝细胞特异性信号到相关脑区的神经和体液通路将非常重要。至于肝脏的感觉是否以及如何促进相互感知的自我意识,这一问题尚未得到探讨。
{"title":"Hepatic interoception in health and disease","authors":"Hans-Rudolf Berthoud ,&nbsp;Heike Münzberg ,&nbsp;Christopher D. Morrison ,&nbsp;Winfried L. Neuhuber","doi":"10.1016/j.autneu.2024.103174","DOIUrl":"https://doi.org/10.1016/j.autneu.2024.103174","url":null,"abstract":"<div><p>The liver is a large organ with crucial functions in metabolism and immune defense, as well as blood homeostasis and detoxification, and it is clearly in bidirectional communication with the brain and rest of the body via both neural and humoral pathways. A host of neural sensory mechanisms have been proposed, but in contrast to the gut-brain axis, details for both the exact site and molecular signaling steps of their peripheral transduction mechanisms are generally lacking. Similarly, knowledge about function-specific sensory and motor components of both vagal and spinal access pathways to the hepatic parenchyma is missing. Lack of progress largely owes to controversies regarding selectivity of vagal access pathways and extent of hepatocyte innervation. In contrast, there is considerable evidence for glucose sensors in the wall of the hepatic portal vein and their importance for glucose handling by the liver and the brain and the systemic response to hypoglycemia. As liver diseases are on the rise globally, and there are intriguing associations between liver diseases and mental illnesses, it will be important to further dissect and identify both neural and humoral pathways that mediate hepatocyte-specific signals to relevant brain areas. The question of whether and how sensations from the liver contribute to interoceptive self-awareness has not yet been explored.</p></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"253 ","pages":"Article 103174"},"PeriodicalIF":2.7,"publicationDate":"2024-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140347490","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
期刊
Autonomic Neuroscience-Basic & Clinical
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