Autonomic Neuroscience-Basic & Clinical最新文献_第5页

Ex vivo calcium imaging of sympathetic neurons in intact mouse stellate ganglia 完整小鼠星状神经节交感神经元的离体钙成像

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-08-11 DOI: 10.1016/j.autneu.2025.103336

Arianna Scalco , Nathan Balthazor , Beth A. Habecker

Sympathetic hyperactivity is a common feature of cardiovascular diseases including hypertension, and sympathetic neurons are hyperactive after a week of angiotensin II (AngII) hypertension. Nerve firing increases intracellular Ca²⁺ and we wanted to develop a Ca²⁺ imaging method to quantify activity across many neurons at once. Here we describe a method for ex vivo Ca²⁺ imaging in intact mouse stellate ganglia. We imaged ganglia from control and AngII (700 ng/min/Kg) hypertensive mice to determine if we could identify Ca²⁺ parameters that reflected hyperactivity. We expressed GCaMP6s in tyrosine hydroxylase (TH)-positive neurons (TH^GCaMP6s). Male and female TH^GCaMP6s mice 17–25 weeks old were used. Images were obtained under baseline conditions, after stimulation with nicotine (10 μM), and after stimulation with potassium chloride (KCl, 40 mM) as a positive control for GCaMP6s expression. Differential fluorescence responses were quantified using an open-source MATLAB processing tool. An additional MATLAB script was composed to analyze and characterize features of the fluorescent responses. The peak Ca²⁺ response after nicotine treatment trended higher in left but not right stellates from AngII-treated mice, and the distribution of peak responses differed significantly in left ganglia. Decay times were similar in all groups. We compared the peak Ca²⁺ response after nicotine treatment vs. KCl and found altered frequency distribution of nicotine: KCl responses in left but not right stellates from AngII mice, raising the possibility of selective modulation of cholinergic responses. Calcium imaging allowed simultaneous analysis of multiple cells within ganglia, but did not recapitulate the bilateral hyperactivity identified by electrophysiology.

交感神经过度活跃是包括高血压在内的心血管疾病的共同特征，在血管紧张素II （AngII）高血压一周后交感神经过度活跃。神经放电增加细胞内Ca2+，我们想开发一种Ca2+成像方法来量化许多神经元的活动。在这里，我们描述了一种完整的小鼠星状神经节的离体Ca2+成像方法。我们对对照和AngII （700 ng/min/Kg）高血压小鼠的神经节进行成像，以确定我们是否可以识别反映多动症的Ca2+参数。我们在酪氨酸羟化酶（TH）阳性神经元（THGCaMP6s）中表达GCaMP6s。选取17-25周龄的雄性和雌性THGCaMP6s小鼠。分别在基线条件下、尼古丁（10 μM）刺激后和氯化钾（KCl, 40 mM）刺激后获得GCaMP6s表达的图像。差分荧光响应使用开源MATLAB处理工具进行量化。另外编写了MATLAB脚本来分析和表征荧光响应的特征。尼古丁处理后，左星状核的Ca2+反应峰升高，而右星状核的Ca2+反应峰不升高，且左神经节的Ca2+反应峰分布差异显著。各组的衰变时间相似。我们比较了尼古丁治疗与KCl治疗后的Ca2+峰值反应，发现尼古丁的频率分布发生了变化：KCl反应在AngII小鼠的左星状细胞中，而不是在右星状细胞中，这增加了选择性调节胆碱能反应的可能性。钙显像可以同时分析神经节内的多个细胞，但不能概括电生理学鉴定的双侧过度活跃。

{"title":"Ex vivo calcium imaging of sympathetic neurons in intact mouse stellate ganglia","authors":"Arianna Scalco , Nathan Balthazor , Beth A. Habecker","doi":"10.1016/j.autneu.2025.103336","DOIUrl":"10.1016/j.autneu.2025.103336","url":null,"abstract":"<div><div>Sympathetic hyperactivity is a common feature of cardiovascular diseases including hypertension, and sympathetic neurons are hyperactive after a week of angiotensin II (AngII) hypertension. Nerve firing increases intracellular Ca<sup>2+</sup> and we wanted to develop a Ca<sup>2+</sup> imaging method to quantify activity across many neurons at once. Here we describe a method for ex vivo Ca<sup>2+</sup> imaging in intact mouse stellate ganglia. We imaged ganglia from control and AngII (700 ng/min/Kg) hypertensive mice to determine if we could identify Ca<sup>2+</sup> parameters that reflected hyperactivity. We expressed GCaMP6s in tyrosine hydroxylase (TH)-positive neurons (TH<sup>GCaMP6s</sup>). Male and female TH<sup>GCaMP6s</sup> mice 17–25 weeks old were used. Images were obtained under baseline conditions, after stimulation with nicotine (10 μM), and after stimulation with potassium chloride (KCl, 40 mM) as a positive control for GCaMP6s expression. Differential fluorescence responses were quantified using an open-source MATLAB processing tool. An additional MATLAB script was composed to analyze and characterize features of the fluorescent responses. The peak Ca<sup>2+</sup> response after nicotine treatment trended higher in left but not right stellates from AngII-treated mice, and the distribution of peak responses differed significantly in left ganglia. Decay times were similar in all groups. We compared the peak Ca<sup>2+</sup> response after nicotine treatment vs. KCl and found altered frequency distribution of nicotine: KCl responses in left but not right stellates from AngII mice, raising the possibility of selective modulation of cholinergic responses. Calcium imaging allowed simultaneous analysis of multiple cells within ganglia, but did not recapitulate the bilateral hyperactivity identified by electrophysiology.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103336"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840722","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

Neurogastroenterology: Current insights into gastrointestinal innervation in health and disease 神经胃肠病学：健康和疾病中胃肠神经支配的最新见解

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-08-29 DOI: 10.1016/j.autneu.2025.103339

Tomas Chmelir , Dagmar Jarkovska , Shashank Pandey , Magdalena Chottova Dvorakova

Neurogastroenterology, a rapidly evolving field, investigates the intricate interactions between the nervous system and the organs of the gastrointestinal tract. This review offers a comprehensive summary of innervation of the gastrointestinal tract, focusing on both extrinsic and intrinsic components. Extrinsic innervation involves the autonomic nervous system, with sympathetic and parasympathetic fibers controlling various digestive functions, while intrinsic innervation, represented by the enteric nervous system, operates largely independently, orchestrating complex processes such as motility, secretion, and immune responses. Recent advances highlight the crucial role of the enteric nervous system, often referred to as the second brain, in maintaining gastrointestinal health and its involvement in various pathologies. The text also provides a basic overview of the pathophysiology of achalasia, Chagas disease, gastroesophageal reflux disease, gastroparesis, diabetic gastroenteropathy, irritable bowel syndrome, chronic intestinal pseudo-obstruction, and Hirschsprung's disease, which are conditions in which innervation of the gastrointestinal tract is more or less affected. The insights provided could pave the way for new interventions, offering hope for patients suffering from related conditions.

神经胃肠病学是一个快速发展的领域，研究神经系统和胃肠道器官之间复杂的相互作用。这篇综述提供了胃肠道神经支配的综合总结，重点是外在和内在成分。外神经支配涉及自主神经系统，由交感和副交感神经纤维控制各种消化功能，而以肠神经系统为代表的内在神经支配在很大程度上独立运作，协调运动、分泌和免疫反应等复杂过程。最近的进展强调了肠神经系统的关键作用，通常被称为第二大脑，在维持胃肠道健康及其参与各种病理。文本还提供了贲门失弛缓症，恰加斯病，胃食管反流病，胃轻瘫，糖尿病胃肠炎，肠易激综合征，慢性肠假性梗阻，和先天性巨结肠病的病理生理学的基本概述，这是条件下，其中胃肠道的神经支配或多或少受到影响。所提供的见解可以为新的干预措施铺平道路，为患有相关疾病的患者带来希望。

{"title":"Neurogastroenterology: Current insights into gastrointestinal innervation in health and disease","authors":"Tomas Chmelir , Dagmar Jarkovska , Shashank Pandey , Magdalena Chottova Dvorakova","doi":"10.1016/j.autneu.2025.103339","DOIUrl":"10.1016/j.autneu.2025.103339","url":null,"abstract":"<div><div>Neurogastroenterology, a rapidly evolving field, investigates the intricate interactions between the nervous system and the organs of the gastrointestinal tract. This review offers a comprehensive summary of innervation of the gastrointestinal tract, focusing on both extrinsic and intrinsic components. Extrinsic innervation involves the autonomic nervous system, with sympathetic and parasympathetic fibers controlling various digestive functions, while intrinsic innervation, represented by the enteric nervous system, operates largely independently, orchestrating complex processes such as motility, secretion, and immune responses. Recent advances highlight the crucial role of the enteric nervous system, often referred to as the second brain, in maintaining gastrointestinal health and its involvement in various pathologies. The text also provides a basic overview of the pathophysiology of achalasia, Chagas disease, gastroesophageal reflux disease, gastroparesis, diabetic gastroenteropathy, irritable bowel syndrome, chronic intestinal pseudo-obstruction, and Hirschsprung's disease, which are conditions in which innervation of the gastrointestinal tract is more or less affected. The insights provided could pave the way for new interventions, offering hope for patients suffering from related conditions.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103339"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931899","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

Reduced resting beat-to-beat blood pressure variability in patients with Parkinson's disease 降低帕金森病患者静息搏动血压变异性

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-07-28 DOI: 10.1016/j.autneu.2025.103332

Rosa V.D. Guerrero , Jeann L. Sabino-Carvalho , Pedro R.P. Brandão , Jhenny V. Neri , Lauro C. Vianna

Purpose

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects both motor and non-motor functions, including autonomic regulation. In the cardiovascular system, autonomic dysfunction may result in blood pressure (BP) abnormalities, such as altered variability. Therefore, the present study aimed to test the hypothesis that patients with PD exhibit increased resting beat-to-beat blood pressure variability (BPV) compared to healthy controls.

Methods

Beat-to-beat heart rate (via electrocardiography) and BP (via photoplethysmography) were continuously recorded in 19 patients with PD, 15 age-matched older adults, and 19 young adults. Cardiac output (CO) and total peripheral resistance (TPR) were estimated using the ModelFlow method. BPV was assessed using several indices, including the standard deviation (SD) and average real variability (ARV).

Results

Compared to both older and younger control groups, patients with PD exhibited lower ARV values for systolic (1.6 ± 0.5 vs. 2.3 ± 0.5 and 3.1 ± 1.1 mm Hg, P = 0.001), diastolic (0.9 ± 0.2 vs. 1.1 ± 0.4 and 1.5 ± 0.6 mm Hg, P = 0.001), and mean (0.9 ± 0.2 vs. 1.2 ± 0.4 and 1.5 ± 0.5 mm Hg, P = 0.001) BP. In addition, patients with PD showed reduced ARV in TPR compared to the older control group (0.5 ± 0.2 vs. 0.7 ± 0.7 mm Hg/L/min, P = 0.045). However, ARV in CO did not differ significantly between PD patients and older adults (119 ± 68 vs. 136 ± 48 mL/min, P = 0.806). Similar patterns were observed when using other BPV indices.

Conclusion

These findings suggest that Parkinson's disease may lead to a reduction in beat-to-beat blood pressure variability, potentially driven by changes in total peripheral resistance rather than cardiac output.

目的：帕金森病（PD）是一种进行性神经退行性疾病，影响运动和非运动功能，包括自主调节。在心血管系统中，自主神经功能障碍可导致血压（BP）异常，如变异性改变。因此，本研究旨在验证PD患者比健康对照者表现出更高的静息搏动血压变异性（BPV）的假设。方法连续记录19例PD患者、15例年龄匹配的老年人和19例年轻人的搏动心率（通过心电图）和血压（通过光容积脉搏波）。采用ModelFlow方法估计心输出量（CO）和总外周阻力（TPR）。BPV采用几个指标进行评估，包括标准偏差（SD）和平均真实变异性（ARV）。结果与老年和年轻对照组相比，PD患者的收缩压（1.6±0.5 vs. 2.3±0.5和3.1±1.1 mm Hg, P = 0.001）、舒张压（0.9±0.2 vs. 1.1±0.4和1.5±0.6 mm Hg, P = 0.001）和平均血压（0.9±0.2 vs. 1.2±0.4和1.5±0.5 mm Hg, P = 0.001）的ARV值均较低。此外，与老年对照组相比，PD患者TPR的ARV降低（0.5±0.2 vs. 0.7±0.7 mm Hg/L/min, P = 0.045）。然而，PD患者与老年人CO的ARV差异无统计学意义（119±68 vs 136±48 mL/min, P = 0.806）。在使用其他BPV指数时也观察到类似的模式。这些发现表明帕金森病可能导致搏动间血压变异性的降低，这可能是由总外周阻力而不是心输出量的变化引起的。

{"title":"Reduced resting beat-to-beat blood pressure variability in patients with Parkinson's disease","authors":"Rosa V.D. Guerrero , Jeann L. Sabino-Carvalho , Pedro R.P. Brandão , Jhenny V. Neri , Lauro C. Vianna","doi":"10.1016/j.autneu.2025.103332","DOIUrl":"10.1016/j.autneu.2025.103332","url":null,"abstract":"<div><h3>Purpose</h3><div>Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects both motor and non-motor functions, including autonomic regulation. In the cardiovascular system, autonomic dysfunction may result in blood pressure (BP) abnormalities, such as altered variability. Therefore, the present study aimed to test the hypothesis that patients with PD exhibit increased resting beat-to-beat blood pressure variability (BPV) compared to healthy controls.</div></div><div><h3>Methods</h3><div>Beat-to-beat heart rate (via electrocardiography) and BP (via photoplethysmography) were continuously recorded in 19 patients with PD, 15 age-matched older adults, and 19 young adults. Cardiac output (CO) and total peripheral resistance (TPR) were estimated using the ModelFlow method. BPV was assessed using several indices, including the standard deviation (SD) and average real variability (ARV).</div></div><div><h3>Results</h3><div>Compared to both older and younger control groups, patients with PD exhibited lower ARV values for systolic (1.6 ± 0.5 vs. 2.3 ± 0.5 and 3.1 ± 1.1 mm Hg, <em>P</em> = 0.001), diastolic (0.9 ± 0.2 vs. 1.1 ± 0.4 and 1.5 ± 0.6 mm Hg, <em>P</em> = 0.001), and mean (0.9 ± 0.2 vs. 1.2 ± 0.4 and 1.5 ± 0.5 mm Hg, <em>P</em> = 0.001) BP. In addition, patients with PD showed reduced ARV in TPR compared to the older control group (0.5 ± 0.2 vs. 0.7 ± 0.7 mm Hg/L/min, <em>P</em> = 0.045). However, ARV in CO did not differ significantly between PD patients and older adults (119 ± 68 vs. 136 ± 48 mL/min, <em>P</em> = 0.806). Similar patterns were observed when using other BPV indices.</div></div><div><h3>Conclusion</h3><div>These findings suggest that Parkinson's disease may lead to a reduction in beat-to-beat blood pressure variability, potentially driven by changes in total peripheral resistance rather than cardiac output.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103332"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771565","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

Symmetric projection attractor reconstruction: Transcutaneous auricular vagus nerve stimulation for visually induced motion sickness 对称投影吸引器重建：经皮耳迷走神经刺激治疗视觉晕车

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-07-11 DOI: 10.1016/j.autneu.2025.103318

Emmanuel Molefi , Ian McLoughlin , Ramaswamy Palaniappan

Motion sickness is an enigma that has plagued humans for millennia – and could be exacerbated by automated vehicles and virtual reality. Here, we examined the neuromodulatory effects of transcutaneous auricular vagus nerve stimulation (taVNS) – a non-invasive brain stimulation tool – on autonomic function in response to motion sickness-induced nausea. We conducted a crossover randomized controlled study of healthy participants (n = 29) administered with active taVNS and sham, concurrent with visually-induced motion sickness during electrocardiogram (ECG) acquisition. Using symmetric projection attractor reconstruction (SPAR), a recent mathematical tool that computes images (“attractors”) of morphology and variability of any approximately periodic signals, we show that taVNS induces a significant reduction in measures derived from these attractor image data, compared to sham. Notably, we found that a taVNS-evoked decrease in peak theta density showed a marked correlation with improvements in motion-induced nausea symptom severity. Furthermore, the use of machine learning revealed differential discriminatory power of taVNS response with an area under the receiver operating characteristic curve (AUC) of 0.81. Taken together, these findings provide novel insights into taVNS for motion-induced nausea; and additionally suggest that ECG SPAR-based features may be important for evaluating taVNS therapy response — with implications for adaptive taVNS.

晕动病是一个困扰人类数千年的谜，而自动驾驶汽车和虚拟现实可能会加剧晕动病。在这里，我们研究了经皮耳迷走神经刺激(taVNS) -一种非侵入性脑刺激工具-对运动病引起的恶心反应中的自主神经功能的神经调节作用。我们进行了一项交叉随机对照研究，29名健康参与者（n = 29）在心电图（ECG）获取期间接受主动taVNS和假药治疗，同时伴有视觉诱发的晕动病。使用对称投影吸引子重建（SPAR），一个最近的数学工具，计算任何近似周期信号的形态学和可变性的图像（“吸引子”），我们表明，与假相比，taVNS诱导了从这些吸引子图像数据中得出的测量的显着减少。值得注意的是，我们发现tavns诱发的θ波峰密度下降与运动引起的恶心症状严重程度的改善有显著的相关性。此外，机器学习的使用揭示了taVNS响应的差分判别能力，其接受者工作特征曲线（AUC）下的面积为0.81。综上所述，这些发现为taVNS治疗运动引起的恶心提供了新的见解；此外，基于ECG spar的特征可能对评估taVNS治疗反应很重要-对适应性taVNS有影响。

{"title":"Symmetric projection attractor reconstruction: Transcutaneous auricular vagus nerve stimulation for visually induced motion sickness","authors":"Emmanuel Molefi , Ian McLoughlin , Ramaswamy Palaniappan","doi":"10.1016/j.autneu.2025.103318","DOIUrl":"10.1016/j.autneu.2025.103318","url":null,"abstract":"<div><div>Motion sickness is an enigma that has plagued humans for millennia – and could be exacerbated by automated vehicles and virtual reality. Here, we examined the neuromodulatory effects of transcutaneous auricular vagus nerve stimulation (taVNS) – a non-invasive brain stimulation tool – on autonomic function in response to motion sickness-induced nausea. We conducted a crossover randomized controlled study of healthy participants (<em>n</em> = 29) administered with active taVNS and sham, concurrent with visually-induced motion sickness during electrocardiogram (ECG) acquisition. Using symmetric projection attractor reconstruction (SPAR), a recent mathematical tool that computes images (“attractors”) of morphology and variability of any approximately periodic signals, we show that taVNS induces a significant reduction in measures derived from these attractor image data, compared to sham. Notably, we found that a taVNS-evoked decrease in peak theta density showed a marked correlation with improvements in motion-induced nausea symptom severity. Furthermore, the use of machine learning revealed differential discriminatory power of taVNS response with an area under the receiver operating characteristic curve (AUC) of 0.81. Taken together, these findings provide novel insights into taVNS for motion-induced nausea; and additionally suggest that ECG SPAR-based features may be important for evaluating taVNS therapy response — with implications for adaptive taVNS.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103318"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653148","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

Inspiratory muscle training enhances cardiac autonomic response to orthostatic stress in patients with Parkinson's disease: a preliminary study 吸气肌训练增强帕金森病患者对直立应激的心脏自主神经反应：一项初步研究

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-07-21 DOI: 10.1016/j.autneu.2025.103334

Felipe Castro Ferreira , Michelle Cristina Salabert Vaz Padilha , Pedro Paulo da Silva Soares , Marco Antônio Araujo-Leite , Gabriel Dias Rodrigues

In this pilot study, eight patients with Parkinson's disease (PD) and eight age-matched healthy controls completed a 5-week home-based inspiratory muscle training (IMT) program. Maximal inspiratory pressure and heart rate variability during sitting (SIT) and orthostatic stress were assessed before and after IMT. Both groups exhibited better maximal inspiratory pressure and vagal modulation of the heart in the SIT position post-IMT. However, only patients with PD showed enhanced cardiac autonomic modulation during orthostatic stress. These findings suggest that IMT may improve the cardiac autonomic response to orthostatic stress in patients with PD, warranting further investigation.

在这项初步研究中，8名帕金森病患者（PD）和8名年龄匹配的健康对照者完成了为期5周的家庭吸气肌训练（IMT）计划。在IMT之前和之后评估坐姿时的最大吸气压力和心率变异性（SIT）和直立压力。两组均表现出更好的最大吸气压力和迷走神经调节。然而，只有PD患者在直立应激时表现出增强的心脏自主调节。这些发现表明，IMT可能改善PD患者对直立应激的心脏自主神经反应，值得进一步研究。

引用次数: 0

From discovery to debate: The history of menopausal hormone therapy and its impact on cardiovascular health 从发现到争论：绝经期激素治疗的历史及其对心血管健康的影响

IF 3.3 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-07-31 DOI: 10.1016/j.autneu.2025.103335

Allyson I. Schwab , Virginia R. Nuckols , Katherine Haigh , Megan M. Wenner

Cardiovascular disease (CVD) continues to be the leading cause of death in women. Menopause is associated with a variety of physiological changes, including hallmark vasomotor symptoms and an increased risk of CVD. Traditional hormone therapy (HT) was the primary form of menopausal management for women until the Women's Health Initiative (WHI) trial found an increased risk of heart disease and stroke with HT use. Since the WHI publication in 2002, prescriptions for HT have plummeted and remained low, leaving menopausal women with few options for treatment and management. Although HT is very effective at treating menopausal symptoms, the data regarding cardiovascular benefits have been mixed, and reduction in CVD risk with HT may be related to the timing of initiation. The purpose of this review is to provide a clear timeline of HT usage and trials in overall support of HT as a safe and beneficial strategy for menopausal women, with an emphasis on advocacy for continued research on menopausal treatment options to improve women's health across the lifespan.

心血管疾病（CVD）仍然是妇女死亡的主要原因。更年期与多种生理变化有关，包括标志性的血管舒缩症状和心血管疾病的风险增加。传统的激素疗法（HT）是妇女更年期管理的主要形式，直到妇女健康倡议（WHI）试验发现使用激素会增加患心脏病和中风的风险。自2002年WHI发表以来，治疗激素疗法的处方急剧下降并保持在低位，使更年期妇女几乎没有治疗和管理的选择。虽然激素疗法在治疗绝经期症状方面非常有效，但有关心血管益处的数据好坏参半，激素疗法降低心血管疾病风险可能与开始治疗的时间有关。本综述的目的是提供一个明确的激素治疗使用时间表和试验，以全面支持激素治疗作为一种安全有益的绝经妇女策略，重点是倡导继续研究更年期治疗方案，以改善妇女整个生命周期的健康。

{"title":"From discovery to debate: The history of menopausal hormone therapy and its impact on cardiovascular health","authors":"Allyson I. Schwab , Virginia R. Nuckols , Katherine Haigh , Megan M. Wenner","doi":"10.1016/j.autneu.2025.103335","DOIUrl":"10.1016/j.autneu.2025.103335","url":null,"abstract":"<div><div>Cardiovascular disease (CVD) continues to be the leading cause of death in women. Menopause is associated with a variety of physiological changes, including hallmark vasomotor symptoms and an increased risk of CVD. Traditional hormone therapy (HT) was the primary form of menopausal management for women until the Women's Health Initiative (WHI) trial found an increased risk of heart disease and stroke with HT use. Since the WHI publication in 2002, prescriptions for HT have plummeted and remained low, leaving menopausal women with few options for treatment and management. Although HT is very effective at treating menopausal symptoms, the data regarding cardiovascular benefits have been mixed, and reduction in CVD risk with HT may be related to the timing of initiation. The purpose of this review is to provide a clear timeline of HT usage and trials in overall support of HT as a safe and beneficial strategy for menopausal women, with an emphasis on advocacy for continued research on menopausal treatment options to improve women's health across the lifespan.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103335"},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828182","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

Crosstalk between bladder-cardiovascular autonomic nervous system in synucleinopathies 突触核蛋白病中膀胱-心血管自主神经系统间的串扰

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-10-01 Epub Date: 2025-07-09 DOI: 10.1016/j.autneu.2025.103320

Ryuji Sakakibara , Tomoyuki Uchiyama , Tatsuya Yamamoto

Objective

Parkinson's disease (PD) and multiple system atrophy (MSA) are major neurogenerative diseases characterized pathologically by abnormal alpha-synuclein aggregation, called synucleinopathy. PD and MSA are clinically characterized by motor disorder and autonomic dysfunction (particularly lower urinary tract dysfunction, LUTD and orthostatic hypotension, OH). However, few literatures are available concerning mutual interaction between bladder-cardiovascular autonomic disorders in PD or MSA.

Method

A narrative review including the past 10-year PubMed research papers on this topic. We also included dementia with Lewy bodies (DLB) that shares pathology with PD.

Results

The LUTD in MSA is more severe than that in PD for large post-void residual (PVR) or urinary retention. These LUTDs presumably reflect the different nervous system pathologies. Of particular importance is that MSA may presents with LUTD alone initially, and some PD or MSA presents with OH alone (called pure autonomic failure, PAF); needs early diagnosis and management. For treating autonomic dysfunction in PD or MSA, mutual interactions between bladder-cardiovascular are worth considering, particularly when we prescribe urology drugs (alpha blockers might worsen OH) or cardiology drugs (antihypertensive drugs might worsen OH, and drugs to treat OH might worsen PVR). Care should also be taken for micturition syncope. This care improves individual's quality of life in PD or MSA; it can also prevent emergency hospitalizations, and early institutionalization.

Conclusions

This review summarizes the pathophysiology and practical management of (mutual) bladder-cardiovascular autonomic disorders in individuals with PD or MSA.

目的帕金森病（PD）和多系统萎缩（MSA）是主要的神经发生疾病，病理特征为α -突触核蛋白异常聚集，称为突触核蛋白病。PD和MSA的临床特征是运动障碍和自主神经功能障碍（特别是下尿路功能障碍，LUTD和直立性低血压，OH）。然而，关于PD或MSA患者膀胱-心血管自主神经障碍之间相互作用的文献很少。方法回顾过去10年PubMed关于该主题的研究论文。我们还纳入了与PD有共同病理的路易体痴呆（DLB）。结果MSA患者的尿路缺损以大量空后残留（PVR）或尿潴留较PD患者更为严重。这些lutd可能反映了不同的神经系统病理。特别重要的是，MSA最初可能仅表现为LUTD，而一些PD或MSA仅表现为OH（称为纯粹自主神经衰竭，PAF）；需要早期诊断和治疗。在治疗PD或MSA的自主神经功能障碍时，膀胱-心血管之间的相互作用值得考虑，特别是当我们开泌尿科药物（α受体阻滞剂可能加重OH）或心脏病学药物（降压药可能加重OH，治疗OH的药物可能加重PVR）时。对排尿性晕厥也要注意。这种护理提高了PD或MSA患者的生活质量；它还可以防止紧急住院和早期机构化。本文综述了PD或MSA患者（互）膀胱-心血管自主神经障碍的病理生理学和实际治疗。

{"title":"Crosstalk between bladder-cardiovascular autonomic nervous system in synucleinopathies","authors":"Ryuji Sakakibara , Tomoyuki Uchiyama , Tatsuya Yamamoto","doi":"10.1016/j.autneu.2025.103320","DOIUrl":"10.1016/j.autneu.2025.103320","url":null,"abstract":"<div><h3>Objective</h3><div>Parkinson's disease (PD) and multiple system atrophy (MSA) are major neurogenerative diseases characterized pathologically by abnormal alpha-synuclein aggregation, called synucleinopathy. PD and MSA are clinically characterized by motor disorder and autonomic dysfunction (particularly lower urinary tract dysfunction, LUTD and orthostatic hypotension, OH). However, few literatures are available concerning mutual interaction between bladder-cardiovascular autonomic disorders in PD or MSA.</div></div><div><h3>Method</h3><div>A narrative review including the past 10-year PubMed research papers on this topic. We also included dementia with Lewy bodies (DLB) that shares pathology with PD.</div></div><div><h3>Results</h3><div>The LUTD in MSA is more severe than that in PD for large post-void residual (PVR) or urinary retention. These LUTDs presumably reflect the different nervous system pathologies. Of particular importance is that MSA may presents with LUTD alone initially, and some PD or MSA presents with OH alone (called pure autonomic failure, PAF); needs early diagnosis and management. For treating autonomic dysfunction in PD or MSA, mutual interactions between bladder-cardiovascular are worth considering, particularly when we prescribe urology drugs (alpha blockers might worsen OH) or cardiology drugs (antihypertensive drugs might worsen OH, and drugs to treat OH might worsen PVR). Care should also be taken for micturition syncope. This care improves individual's quality of life in PD or MSA; it can also prevent emergency hospitalizations, and early institutionalization.</div></div><div><h3>Conclusions</h3><div>This review summarizes the pathophysiology and practical management of (mutual) bladder-cardiovascular autonomic disorders in individuals with PD or MSA.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"261 ","pages":"Article 103320"},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144597417","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

Deep brain stimulation for control of refractory hypertension 深部脑刺激控制顽固性高血压

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-08-01 Epub Date: 2025-04-27 DOI: 10.1016/j.autneu.2025.103286

Zoe H. Adams , Emma C. Hart , Nikunj K. Patel

Deep brain stimulation (DBS) is an emerging treatment for patients with severe drug-resistant hypertension, particularly for those in whom other non-pharmacological treatments (e.g., renal denervation, baroreflex activation therapy) have failed. Growing numbers of case studies demonstrate long-term reductions in blood pressure with DBS of the ventrolateral periaqueductal gray. This is likely achieved via modulation of autonomic blood pressure control centres, reducing sympathetic outflow to the vasculature. We discuss recent advances, including whether the ventrolateral periaqueductal gray alone is a robust enough target, and whether DBS has the potential to reinstate beneficial physiological characteristics of blood pressure, such as diurnal variation.

脑深部电刺激（DBS）是治疗严重耐药高血压患者的一种新兴治疗方法，特别是对于那些其他非药物治疗（如肾去神经、压力反射激活治疗）失败的患者。越来越多的病例研究表明腹外侧导水管周围灰质的DBS可以长期降低血压。这可能是通过调节自主血压控制中心，减少交感神经向脉管系统的流出来实现的。我们讨论了最近的进展，包括腹外侧导尿管周围灰质是否是一个足够强大的靶标，以及DBS是否有可能恢复血压的有益生理特征，如昼夜变化。

引用次数: 0

‘Transient immediate orthostatic hypotension’ is preferable to ‘initial’ orthostatic hypotension “短暂性即刻体位性低血压”优于“初始性”体位性低血压

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-08-01 Epub Date: 2025-05-16 DOI: 10.1016/j.autneu.2025.103288

David G. Benditt , Artur Fedorowski , Richard Sutton , J. Gert van Dijk , G. Baron-Esquivas , I. Biaggioni , M. Brignole , J.S.Y. De Jong , F.J. De Lange , R. Freeman , R. Furlan , B. Grubb , M.H. Hamdan , R.A. Kenny , P.B. Lim , Moya Mitjans Angel , B. Olshansky , M. Rafanelli , S.R. Raj , J. Reyes , I.A. Van Rossum

A drop of systemic blood pressure (BP) occurring shortly after individuals move from supine or seated position to upright posture with subsequent prompt spontaneous resolution is a common physiological occurrence in humans. If the induced hypotension is severe, lightheadedness or postural instability leading to falls and injury may occur. By consensus, a transient systolic BP drop >40 mmHg within 15 s of standing is deemed abnormal and has become termed ‘initial orthostatic hypotension’ (initial OH, iOH). However, the term ‘initial OH’ implies that another hypotensive event will follow shortly. In essence, if an OH event is deemed to be ‘initial’, then one might reasonably assume that a subsequent OH event is imminent. However, in the setting of abrupt movement to upright posture, the BP drop is usually solitary and brief (resolution within 15–30 s); thereafter the individual is usually OH symptom-free until they undertake another similar postural change. Currently, there is no single descriptor for a posture change driven, short-lived, spontaneously resolving OH event, without the implication that further hypotension is imminent as is implied by the term ‘initial OH’. In order to foster more accurate nomenclature, we recommend that ‘initial OH’ be retired, and ‘immediate OH’ or transient ‘immediate OH’ be substituted. While ‘immediate’ OH may be imperfect, it conveys an early onset event without implying additional imminent OH. Thus immediate OH or transient immediate are more accurate descriptors of this common transient hypotensive event. The abbreviation, ‘iOH’, remains unchanged.

个体从仰卧或坐姿转变为直立姿势后，体表血压（BP）很快下降，随后迅速自发消退，这是人类常见的生理现象。如果诱发性低血压严重，可能会出现头晕或姿势不稳，导致跌倒和受伤。一般认为，站立后15秒内短暂性收缩压下降40毫米汞柱即为异常，并被称为“初始直立性低血压”（initial直立性低血压，iOH）。然而，“初始OH”一词意味着不久将出现另一次低血压事件。从本质上讲，如果一个OH事件被认为是“初始的”，那么人们可以合理地假设随后的OH事件即将发生。然而，在突然运动到直立姿势的情况下，血压下降通常是孤立的和短暂的（在15-30秒内消退）；此后患者通常无OH症状，直到再次发生类似的体位改变。目前，对于姿势改变引起的、短暂的、自发解决的OH事件，没有一个单一的描述，没有“初始OH”一词所暗示的进一步低血压迫在眉睫的含义。为了促进更准确的命名，我们建议取消“初始OH”，而替换为“立即OH”或瞬态“立即OH”。虽然“即刻”OH可能不完美，但它传达了早发事件，而不意味着额外的迫在眉睫的OH。因此，即刻OH或短暂性即刻是这种常见的短暂性低血压事件更准确的描述。缩写“iOH”保持不变。

{"title":"‘Transient immediate orthostatic hypotension’ is preferable to ‘initial’ orthostatic hypotension","authors":"David G. Benditt , Artur Fedorowski , Richard Sutton , J. Gert van Dijk , G. Baron-Esquivas , I. Biaggioni , M. Brignole , J.S.Y. De Jong , F.J. De Lange , R. Freeman , R. Furlan , B. Grubb , M.H. Hamdan , R.A. Kenny , P.B. Lim , Moya Mitjans Angel , B. Olshansky , M. Rafanelli , S.R. Raj , J. Reyes , I.A. Van Rossum","doi":"10.1016/j.autneu.2025.103288","DOIUrl":"10.1016/j.autneu.2025.103288","url":null,"abstract":"<div><div>A drop of systemic blood pressure (BP) occurring shortly after individuals move from supine or seated position to upright posture with subsequent prompt spontaneous resolution is a common physiological occurrence in humans. If the induced hypotension is severe, lightheadedness or postural instability leading to falls and injury may occur. By consensus, a transient systolic BP drop >40 mmHg within 15 s of standing is deemed abnormal and has become termed ‘initial orthostatic hypotension’ (initial OH, iOH). However, the term ‘initial OH’ implies that another hypotensive event will follow shortly. In essence, if an OH event is deemed to be ‘initial’, then one might reasonably assume that a subsequent OH event is imminent. However, in the setting of abrupt movement to upright posture, the BP drop is usually solitary and brief (resolution within 15–30 s); thereafter the individual is usually OH symptom-free until they undertake another similar postural change. Currently, there is no single descriptor for a posture change driven, short-lived, spontaneously resolving OH event, without the implication that further hypotension is imminent as is implied by the term ‘initial OH’. In order to foster more accurate nomenclature, we recommend that ‘initial OH’ be retired, and ‘immediate OH’ or transient ‘immediate OH’ be substituted. While ‘immediate’ OH may be imperfect, it conveys an early onset event without implying additional imminent OH. Thus immediate OH or transient immediate are more accurate descriptors of this common transient hypotensive event. The abbreviation, ‘iOH’, remains unchanged.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103288"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134559","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

The sympathetic nervous system in normotensive and hypertensive pregnancies 正常妊娠和高血压妊娠的交感神经系统

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-08-01 Epub Date: 2025-05-27 DOI: 10.1016/j.autneu.2025.103293

Sana Ayesha , Margie H. Davenport , Craig D. Steinback

Pregnancy is associated with significant physiological adaptations that facilitate optimal foetal development and growth. Among the most notable changes in healthy pregnancies are increases in plasma volume, cardiac output, and sympathetic nervous system activity, alongside a reduction in total peripheral resistance. Normotensive pregnancies are among the few physiological states in which elevated sympathetic activity is considered normal and beneficial. However, the underlying mechanisms that reconcile this increase in SNA with the concomitant decrease in blood pressure remain incompletely understood. In contrast, excessive sympathetic activity, beyond the expected pregnancy-associated increase, has also been implicated in the pathophysiology of hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, which are major contributors to maternal and foetal morbidity and mortality. This review aims to provide an overview of the current understanding of the physiological and pathophysiological mechanisms underlying both normotensive and hypertensive pregnancies.

怀孕与促进胎儿最佳发育和生长的重要生理适应有关。健康妊娠中最显著的变化是血浆量、心输出量和交感神经系统活动增加，同时总外周阻力降低。正常妊娠是少数几个交感神经活动升高被认为是正常和有益的生理状态之一。然而，使SNA增加与伴随的血压下降相协调的潜在机制仍不完全清楚。相反，过度的交感神经活动，超出预期的妊娠相关增加，也与妊娠高血压疾病的病理生理学有关，如妊娠高血压和先兆子痫，这是孕产妇和胎儿发病率和死亡率的主要原因。本文综述了目前对正常妊娠和高血压妊娠的生理和病理生理机制的理解。

{"title":"The sympathetic nervous system in normotensive and hypertensive pregnancies","authors":"Sana Ayesha , Margie H. Davenport , Craig D. Steinback","doi":"10.1016/j.autneu.2025.103293","DOIUrl":"10.1016/j.autneu.2025.103293","url":null,"abstract":"<div><div>Pregnancy is associated with significant physiological adaptations that facilitate optimal foetal development and growth. Among the most notable changes in healthy pregnancies are increases in plasma volume, cardiac output, and sympathetic nervous system activity, alongside a reduction in total peripheral resistance. Normotensive pregnancies are among the few physiological states in which elevated sympathetic activity is considered normal and beneficial. However, the underlying mechanisms that reconcile this increase in SNA with the concomitant decrease in blood pressure remain incompletely understood. In contrast, excessive sympathetic activity, beyond the expected pregnancy-associated increase, has also been implicated in the pathophysiology of hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, which are major contributors to maternal and foetal morbidity and mortality. This review aims to provide an overview of the current understanding of the physiological and pathophysiological mechanisms underlying both normotensive and hypertensive pregnancies.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103293"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166647","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