Autonomic Neuroscience-Basic & Clinical最新文献_第9页

The effects of isometric handgrip and post-exercise circulatory occlusion on muscle sympathetic nerve activity: A systematic review and meta-analysis 等长握力和运动后循环闭塞对肌肉交感神经活动的影响：一项系统回顾和荟萃分析

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-02-24 DOI: 10.1016/j.autneu.2025.103251

Lauren E. Maier , Sarah E. Meyer , Andy Deprato , Stephen Busch , Allison Sivak , Margie H. Davenport , Craig D. Steinback

This systematic review and meta-analysis was conducted to identify a ‘normative’ sympathetic response to isometric handgrip and post-exercise circulatory occlusion. Structured searches of databases were performed until June 2024. We included all primary studies (other than systematic reviews and meta-analyses), and inclusion criteria were: population (all populations); intervention (isometric handgrip and post-exercise circulatory occlusion); comparator (baseline); and outcome (MSNA). One-hundred fifty-eight studies (n = 3551) were included. Burst frequency was elevated during handgrip (n = 1853; MD, 12.19bursts/min; 95 % CI, 11.09, 13.28; I² = 94 %; p < 0.00001) and during PECO (n = 948; MD, 11.42bursts/min; 95 % CI, 10.10, 12.75; I² = 65 %; p < 0.00001). A similar pattern was observed for burst incidence in handgrip (n = 1074; MD, 8.50bursts/100 hbs; 95 % CI, 7.07, 9.93; I2 = 39 %; p < 0.00001) and PECO (n = 560; MD, 14.87bursts/100 hbs; 95 % CI, 12.65, 17.10; I2 = 43 %; p < 0.00001). Subgroup analyses indicated a larger response in burst frequency and incidence during handgrip exercise in healthy individuals compared to individuals with cardiovascular diseases or other conditions (p < 0.05). A similar response in burst frequency to PECO was observed with subgroup differences between healthy individuals and individuals with cardiovascular diseases and other conditions (p < 0.00001). MSNA is elevated during handgrip exercise across a range of handgrip protocols, populations, and co-interventions. Increases in MSNA during PECO supports the role of the metaboreflex separate to the exercise pressor reflex. A blunted sympathetic response to handgrip and PECO in individuals with cardiovascular diseases contradicts the current understanding of general sympathetic hyperactivity in these populations.

本系统综述和荟萃分析旨在确定对等距握力和运动后循环闭塞的“规范”交感神经反应。数据库的结构化搜索一直进行到2024年6月。我们纳入了所有的初步研究（除了系统评价和荟萃分析），纳入标准为：人群（所有人群）；干预（等距握拳和运动后循环闭塞）；比较器(基线);结果（MSNA）。纳入158项研究（n = 3551）。握力时突发频率升高(n = 1853；医学博士,12.19 /分钟爆发;95% ci, 11.09, 13.28；i2 = 94%；p & lt;0.00001)和PECO期间(n = 948；医学博士,11.42 /分钟爆发;95% ci, 10.10, 12.75；i2 = 65%；p & lt;0.00001)。在握力中也观察到类似的爆裂发生率(n = 1074；MD: 8.50脉冲/100小时；95% ci, 7.07, 9.93；i2 = 39%；p & lt;0.00001)和PECO (n = 560；MD， 14.87脉冲/100小时；95% ci, 12.65, 17.10；i2 = 43%；p & lt;0.00001)。亚组分析表明，与患有心血管疾病或其他疾病的个体相比，健康个体在握力锻炼期间突发频率和发生率方面的反应更大(p <；0.05)。在健康个体和心血管疾病及其他疾病个体之间观察到对PECO突发频率的类似反应，但存在亚组差异(p <；0.00001)。在一系列的握法、人群和联合干预措施中，握法运动期间的MSNA升高。在PECO期间，MSNA的增加支持代谢反射与运动加压反射分离的作用。心血管疾病患者对握力和PECO的交感神经反应迟钝，这与目前对这些人群交感神经过度活跃的理解相矛盾。

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引用次数: 0

Colonic mucosal TRPA1 expression profiles in irritable bowel syndrome and its correlation to symptom severity: An exploratory study 肠易激综合征结肠黏膜TRPA1表达谱及其与症状严重程度的相关性：一项探索性研究

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-25 DOI: 10.1016/j.autneu.2025.103273

Sylvester R. Groen , Daniel Keszthelyi , Ellen Wilms , Justin Huig , Pan Xu , Montserrat Elizalde , Lisa Vork , Daisy M.A.E. Jonkers , Zsuzsanna Helyes , Ad A.M. Masclee , Zsa Zsa R.M. Weerts

Introduction

Visceral hypersensitivity is a hallmark of irritable bowel syndrome (IBS). A putative involvement of the Transient Receptor Potential Ankyrin-1 (TRPA1) cation channel has been suggested by several animal studies. Main objective of this study is to assess location-specific TRPA1 expression in the colonic mucosa and its correlation with symptom severity in IBS patients.

Methods

Biopsies were obtained from the sigmoid of 30 IBS patients (Rome III; median age 39.0 years, 80 % female) and 23 healthy controls (median age 22.7 years, 43.5 % female). Additional biopsies of the proximal colon were obtained in 24 IBS patients. TRPA1 expression levels were measured in duplicate by quantitative reverse-transcriptase–polymerase-chain-reaction, normalized to GAPDH, and assessed as relative mRNA values using the −2^ΔCt method. In IBS patients, symptoms were assessed and correlated with TRPA1 expression.

Results

Relative TRPA1 expression in the sigmoid was significantly higher in IBS patients compared to healthy controls (P < 0.001). Within IBS patients TRPA1 expression of sigmoid biopsies was significantly higher compared to proximal colon samples (p < 0.001). No significant correlation was found between TRPA1 expression in sigmoid or proximal colon samples and the symptom severity (abdominal discomfort, abdominal pain and bloating).

Conclusion

These findings suggest a potential role for the TRPA1 related pathway as a target for IBS treatment in the future. Since there was no correlation found in the current exploratory study between TRPA1 expression and symptom severity, further research towards the clinical relevance of the increased TRPA1 expression in IBS-patients along with its location-specific expression is warranted.

内脏过敏是肠易激综合征（IBS）的一个标志。一些动物研究表明，瞬时受体电位锚蛋白-1 （TRPA1）阳离子通道可能参与其中。本研究的主要目的是评估肠易激综合征患者结肠黏膜中TRPA1的位置特异性表达及其与症状严重程度的相关性。方法对30例IBS患者进行乙状结肠活检(Rome III；中位年龄39.0岁，80%为女性)和23名健康对照（中位年龄22.7岁，43.5%为女性）。对24例IBS患者进行了近端结肠活检。通过定量逆转录-聚合酶链反应检测TRPA1的表达水平，归一化为GAPDH，并使用−2ΔCt方法评估相对mRNA值。在IBS患者中，评估症状并与TRPA1表达相关。结果IBS患者乙状结肠中TRPA1的相对表达明显高于健康对照组(P <；0.001)。在IBS患者中，乙状结肠活检组织中TRPA1的表达明显高于近端结肠样本(p <；0.001)。在乙状结肠或近端结肠样本中TRPA1表达与症状严重程度（腹部不适、腹痛和腹胀）无显著相关性。结论这些发现提示TRPA1相关通路在未来作为IBS治疗靶点的潜在作用。由于目前的探索性研究未发现TRPA1表达与症状严重程度之间的相关性，因此需要进一步研究TRPA1在ibs患者中表达升高及其部位特异性表达的临床相关性。

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引用次数: 0

Mechanism of heat treatment on exercise pressor reflex in hindlimb ischemia-reperfusion: Does the temperature gradient matter? 热处理对后肢缺血-再灌注运动压力反射的影响机制：温度梯度是否有影响？

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-05-15 DOI: 10.1016/j.autneu.2025.103290

Lu Qin, Xuexin Zhang, Jianhua Li

Purpose

To examine the effect of heat treatment (HT) with two temperature gradients in skeletal muscle: 1.5 and 3 °C, on the exercise pressor reflex (EPR) responses following limb ischemia-reperfusion (IR). Specifically, the involvement role of the P2Xs (receptors of ATP) pathway in the muscle afferent neurons was accessed.

Methods

An experimental IR model was induced by 6 h of ischemia followed by 18 h of reperfusion in rats (IR rats). For HT groups, three HT sessions (muscle temperature increased by 1.5 or 3 °C) lasted for 30 mins each were applied. EPR responses were evoked by static muscle contraction (30s). Protein expression of P2X3 receptor in dorsal root ganglions (DRGs) was evaluated by western blot. In addition, a calcium imaging study was applied to detect calcium influx induced by activation of P2X3 in the isolated muscle DRG neurons of studied animal groups. Data are presented as mean ± standard deviation (M ± SD).

Results

The mean arterial pressure (MAP) response to the static muscle contraction was significantly exaggerated in rats of IR 18 h (vs. sham, p < 0.01). The exaggerated BP response was attenuated with increasing Tm by 1.5 and 3 °C (vs. IR, p < 0.05). The expression of the P2X3 receptor was significantly enhanced in the DRGs of IR 18 h rats (vs. sham, p < 0.01). The upregulated P2X3 was suppressed in the DRGs of IR 18 h rats +HT of 1.5 °C and 3 °C (vs. IR, p < 0.05). In the isolated muscle afferent neurons, the Ca²⁺ entry induced by extracellular application of α,β-Me-ATP (30 μM) were significantly increased in IR rats (vs. sham, p < 0.001). Both HT protocols suppressed the enhanced IR-induced Ca²⁺ entry (vs. IR, p < 0.001). There was no difference between the BP responses in HT1.5 °C and 3 °C groups, nor P2X3 expression in muscle afferent DRG, P2X-mediated Ca²⁺ entry in isolated muscle afferent neurons (all p > 0.05).

Conclusion

IR injury leads to upregulation of EPR responses, and HT attenuates this effect. The P2X3 signaling pathway was involved in the beneficial regulatory effect of HT on EPR in IR. The temperature gradient did not play a role in the extent of BP and muscle afferent P2X pathway activity attenuation in the present study.

目的探讨骨骼肌温度梯度1.5℃和3℃热处理对肢体缺血再灌注（IR）后运动加压反射（EPR）反应的影响。具体来说，P2Xs （ATP受体）通路在肌肉传入神经元中的参与作用被访问。方法采用缺血6 h再灌注18 h的方法建立IR大鼠模型。高温组，肌肉温度分别升高1.5°C或3°C，每次持续30分钟。静肌收缩（30s）诱发EPR反应。western blot检测P2X3受体在大鼠背根神经节（DRGs）中的蛋白表达。此外，应用钙显像研究检测P2X3在研究动物组离体肌肉DRG神经元中激活引起的钙内流。数据以均数±标准差（M±SD）表示。结果IR 18 h大鼠对静态肌肉收缩的平均动脉压（MAP）反应显著升高(与假手术相比，p <；0.01)。随着温度升高1.5°C和3°C，夸大的BP反应减弱(相对于IR， p <；0.05)。P2X3受体在IR 18 h大鼠DRGs中的表达显著增强(与sham相比，p <；0.01)。上调的P2X3在IR 18 h大鼠+ 1.5°C和3°C的DRGs中被抑制(与IR相比，p <；0.05)。在离体肌肉传入神经元中，细胞外施加α，β-Me-ATP （30 μM）诱导的Ca2+进入在IR大鼠中显著增加(与sham相比，p <；0.001)。两种HT方案都抑制了增强的IR诱导的Ca2+进入(vs. IR, p <；0.001)。HT1.5°C和3°C组的BP反应没有差异，肌肉传入DRG中P2X3的表达也没有差异，p2x介导的Ca2+进入在离体肌肉传入神经元中也没有差异(均p >；0.05)。结论ir损伤可导致EPR反应上调，而HT可减弱这一作用。P2X3信号通路参与了HT对IR中EPR的有益调节作用。在本研究中，温度梯度对血压和肌肉传入P2X通路活性衰减的程度没有影响。

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引用次数: 0

Dissecting the exercise pressor reflex in heart failure: A multi-step failure 剖析心力衰竭的运动加压反射：多步骤失败。

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-13 DOI: 10.1016/j.autneu.2025.103269

Danilo Iannetta , Fabio Giuseppe Laginestra , D. Walter Wray , Markus Amann

The contribution of neural feedback originating from exercising limb muscles to the cardiovascular response to exercise was first recognized nearly 100 years ago. Today, it is well established that this influence is initiated by the activation of group III and IV sensory neurons with terminal endings located within contracting skeletal muscle. During exercise, these sensory neurons project feedback related to intramuscular mechanical and metabolic perturbations to medullary neural circuits which reflexively evoke decreases in parasympathetic and increases in sympathetic nervous system activity with the purpose of optimizing central and peripheral hemodynamics. Considerable evidence from animal and human studies suggests that the function of this regulatory control system, known as the exercise pressor reflex (EPR), is abnormal in heart failure and exaggerates sympatho-excitation which impairs the hemodynamic response to exercise and contributes to the functional limitations characterizing these patients. This review briefly introduces the key determinants of EPR control in health and covers the impact of heart failure on the integrity of each of its components and overall function. These include the sensitivity of group III/IV muscle afferents, afferent signal transmission in the spinal cord, and the central integration and processing of sensory feedback within the brainstem. Importantly, although most data relevant for this review come from studies in HFrEF, the limited HFpEF-specific insights are included when available. While arguably not part of the EPR, we also discuss the impact of heart failure on the exercise-induced increase of intramuscular stimuli of group III/IV muscle afferents and end-organ responsiveness to sympathetic/neurochemical stimulation.

源自肢体肌肉运动的神经反馈对心血管运动反应的贡献在近100年前首次被认识到。今天，已经确定这种影响是由末端位于收缩骨骼肌内的III和IV组感觉神经元的激活引起的。在运动过程中，这些感觉神经元将与肌内机械和代谢扰动相关的反馈投射到延髓神经回路，从而反射性地引起副交感神经系统活动的减少和交感神经系统活动的增加，以优化中枢和外周血流动力学。来自动物和人体研究的大量证据表明，这种被称为运动加压反射（EPR）的调节控制系统的功能在心力衰竭中是异常的，它会夸大交感神经兴奋，从而损害对运动的血液动力学反应，并导致这些患者的功能限制。本文简要介绍了健康中EPR控制的关键决定因素，并涵盖了心力衰竭对其每个组成部分的完整性和整体功能的影响。这些包括III/IV组肌肉传入神经的敏感性，脊髓传入信号的传递，以及脑干内感觉反馈的中枢整合和处理。重要的是，尽管与本综述相关的大多数数据来自HFrEF研究，但有限的hfpef特异性见解也包括在内。虽然可以说不是EPR的一部分，但我们也讨论了心力衰竭对运动诱导的III/IV组肌肉传入刺激增加和终末器官对交感/神经化学刺激的反应的影响。

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引用次数: 0

Renal nerve afferents drive preferential renal sympathoexcitation in response to acute renal ischemia/reperfusion in rats 大鼠急性肾缺血/再灌注时肾神经传入驱动优先的肾交感神经兴奋

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI: 10.1016/j.autneu.2025.103268

A.C. Marreiros , M.I.O. Milanez , R.S. Carvalhal , E.E. Nishi , D.D. Santos , C.D. Gil , R. Lantyer , M.M. Knuepfer , C.T. Bergamaschi , R.R. Campos

Renal nerve activity is composed of afferent (sensory) and efferent (sympathetic) nerve activity. Ischemia/reperfusion (IR) of the kidney increases renal sympathetic nerve activity (rSNA) and depresses renal function. As the role of renal afferent fibers in acute renal IR is unclear, we tested the hypothesis that renal IR increases rSNA triggered by renal afferent nerves responding to acute ischemia. Two experimental series were performed in adult male Wistar rats. IR was induced by total obstruction of blood flow to the left kidney by clamping the renal artery for 60 min and reperfusion for 120 min. We recorded MAP, HR, rSNA, and splanchnic sympathetic vasomotor activity (sSNA) in 8 normal IR rats and 6 left kidney deafferented IR rats (IR ARD). Renal deafferentation was performed using capsaicin administration to the left renal nerve 2 weeks before the experiments. Blood samples were collected before ischemia and at the end of reperfusion for total and differential leukocyte counts. Renal ischemia significantly increased rSNA 23 % (20 min: 0,07 ± 0,04mVs P < 0.05) but not sSNA. The increase in rSNA was triggered by activation of renal afferent fibers, since IR significantly reduced rSNA in the IR ARD group maximal decrease in frequency 22 % (180 min: −62 ± 29Δspikes/s) and in amplitude 41 % (−0,29 ± 0, 12mVs, P < 0.05) and induced hypotension and bradycardia. However, no significant difference was observed between groups in blood leukocyte profile, but a significant reduction in renal IL-6 was found in IR ARD, suggesting a reduction in renal inflammation in deafferented IR rats. The results show that renal afferent nerves trigger a preferential increase in rSNA and inflammation in the kidney during acute IR.

肾脏神经活动由传入（感觉）和传出（交感）神经活动组成。肾脏缺血/再灌注（IR）会增加肾交感神经活动（rSNA）并抑制肾功能。由于肾传入纤维在急性肾脏 IR 中的作用尚不清楚，我们测试了肾脏 IR 会增加肾传入神经对急性缺血的反应所引发的 rSNA 的假设。我们对成年雄性 Wistar 大鼠进行了两个系列的实验。通过夹闭肾动脉完全阻断左肾血流 60 分钟和再灌注 120 分钟诱导肾红外。我们记录了 8 只正常 IR 大鼠和 6 只左肾失代偿 IR 大鼠（IR ARD）的 MAP、HR、rSNA 和脾交感血管运动活动（sSNA）。实验前 2 周，通过对左肾神经注射辣椒素进行肾脏去神经支配。在缺血前和再灌注结束时采集血液样本，以检测白细胞总数和差值。肾缺血会使 rSNA 明显增加 23 %（20 分钟：0,07 ± 0,04mVs P < 0.05），但不会使 sSNA 增加。rSNA的增加是由肾传入纤维的激活引发的，因为IR明显降低了IR ARD组的rSNA，最大频率降低了22%（180分钟：-62 ± 29Δ尖峰/秒），振幅降低了41%（-0,29 ± 0, 12mVs，P < 0.05），并诱发了低血压和心动过缓。然而，各组间血液白细胞谱无明显差异，但在 IR ARD 中发现肾 IL-6 显著减少，这表明去干扰 IR 大鼠的肾脏炎症减少。结果表明，肾传入神经在急性 IR 期间会引发 rSNA 和肾脏炎症的优先增加。

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引用次数: 0

Sympathetic reactivity to emotional stress in women with major depressive disorder 重度抑郁症女性对情绪压力的交感神经反应

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-05 DOI: 10.1016/j.autneu.2025.103257

Aaron S. Autler , Ashley M. Darling , Rachel J. Skow , Benjamin E. Young , Paul J. Fadel , Erika F.H. Saunders , Jody L. Greaney

Young women, who suffer from major depressive disorder (MDD) at twice the rate as young men, are particularly vulnerable to cardiovascular events triggered by emotional stress, an association that may be partially explained by excessive sympathetic activation. However, no studies have directly measured sympathetic activity during acute emotional stress in young women with MDD. We hypothesized that the muscle sympathetic nerve activity (MSNA) response to acute emotional stress would be greater in young women with MDD (18–30 yrs) compared to healthy non-depressed young women. MSNA (peroneal microneurography) and beat-to-beat blood pressure (BP; finger photoplethysmography) were measured at rest and during acute emotional stress evoked by viewing negative images selected from the International Affective Picture System in 17 healthy young women and in 30 young women with MDD of mild-to-moderate severity (unmedicated). There were no group differences in either the peak increase in MSNA (Δ0.1 ± 2.9 healthy vs. Δ2.0 ± 4.9 bursts/min MDD; p = 0.45) or the peak increase in mean arterial pressure (Δ0.6 ± 3.5 healthy vs. Δ1.4 ± 2.1 mmHg MDD; p = 0.67) in response to viewing negative images. However, in young women with MDD, MSNA reactivity to viewing negative images was positively related to current depressive symptom severity (r = 0.49; p = 0.04). Although these data indicate only minor MSNA responses to viewing negative images, they also highlight that sympathetic-cardiovascular reactivity to an acute, passive emotional stress stimulus is not exaggerated in young women with MDD. However, more severe current depressive symptoms may amplify emotional stress-induced sympathetic activation, thereby increasing cardiovascular risk.

年轻女性患重度抑郁症（MDD）的几率是年轻男性的两倍，她们特别容易受到情绪压力引发的心血管事件的影响，这种关联可能部分归因于过度的交感神经激活。然而，目前还没有研究直接测量患有重度抑郁症的年轻女性急性情绪压力时的交感神经活动。我们假设肌肉交感神经活动（MSNA）对急性情绪应激的反应在MDD年轻女性（18-30岁）中比健康的非抑郁年轻女性更大。腓骨微神经造影（MSNA）和搏动间血压(BP；17名健康年轻女性和30名轻中度重度重度抑郁症年轻女性（未服药）在休息时和在观看国际情感图像系统（International Affective Picture System）中选择的负面图像引起的急性情绪应激时测量手指光体积脉搏波。在MSNA峰值增加（Δ0.1±2.9健康组vs Δ2.0±4.9次/分钟MDD组）方面均无组间差异；p = 0.45)或平均动脉压峰值升高(Δ0.6±3.5健康vs Δ1.4±2.1 mmHg MDD；P = 0.67)。然而，在患有重度抑郁症的年轻女性中，MSNA对负面图像的反应与当前抑郁症状严重程度呈正相关(r = 0.49；p = 0.04)。虽然这些数据表明只有轻微的MSNA对观看负面图像的反应，但它们也强调了年轻的MDD女性对急性、被动的情绪压力刺激的交感心血管反应并没有夸大。然而，更严重的抑郁症状可能会放大情绪压力引起的交感神经激活，从而增加心血管风险。

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引用次数: 0

Interoception in Parkinson's disease: A narrative review and framework for translational research 帕金森氏病的内感受：一个叙事回顾和翻译研究的框架

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-08 DOI: 10.1016/j.autneu.2025.103258

Katherine Longardner , Senegal Alfred Mabry , Gloria Chen , Roy Freeman , Sahib S. Khalsa , Paul Beach

Parkinson's disease (PD) is the second most common, and the fastest growing, neurodegenerative disease worldwide. Non-motor manifestations, particularly autonomic nervous system dysfunction, are common throughout the disease course, in some cases preceding motor symptom onset by years, and are often more disabling and harder to treat than motor symptoms and contribute significantly to disability. An understudied consequence of autonomic and visceral dysfunction in PD is interoception, the neural processing of internal organ system signals. Interoceptive processes form a foundational body-brain interface, mediating basic homeostatic reflexes and complex physiologic and behavioral adaptive responses to internal perturbations. Emerging evidence exists that interoception is impaired in some individuals with PD, potentially explaining why those who have objective evidence of autonomic dysfunction do not always report typical symptoms. Failure to recognize these impairments may lead to missed opportunities for early intervention, particularly in addressing ‘silent’ autonomic disturbances (e.g., orthostatic hypotension leading to sudden falls, dysphagia leading to aspiration pneumonia). In this narrative review, we synthesize current findings on the neuroanatomical networks underlying interoception, examine clinical manifestations of interoceptive dysfunction across multiple organ systems in PD, and identify key gaps in knowledge. We propose a translational research framework to enhance early detection, symptom management, and intervention strategies for PD. This framework integrates cognitive, mood, and autonomic dysfunctions with clinical factors (disease stage, duration, motor subtype, levodopa status) to understand interoceptive dysfunction within a translational model. This approach highlights novel opportunities for personalized care and improved therapeutic interventions in PD.

帕金森氏病（PD）是世界上第二常见、增长最快的神经退行性疾病。非运动表现，特别是自主神经系统功能障碍，在整个病程中都很常见，在某些情况下，运动症状出现前几年，通常比运动症状更致残，更难治疗，并显著导致残疾。PD患者自主神经和内脏功能障碍的一个未被充分研究的后果是内感受，即内部器官系统信号的神经处理。内感受过程形成了一个基本的身体-大脑界面，介导基本的稳态反射和复杂的生理和行为适应性反应。新出现的证据表明，一些PD患者的内感受功能受损，这可能解释了为什么那些有自主神经功能障碍客观证据的人并不总是报告典型症状。未能认识到这些损害可能会导致错过早期干预的机会，特别是在处理“无声”自主神经障碍时（例如，直立性低血压导致突然跌倒，吞咽困难导致吸入性肺炎）。在这篇叙述性综述中，我们综合了当前关于内感受神经解剖学网络的研究结果，检查了PD患者多器官系统内感受功能障碍的临床表现，并确定了知识上的关键空白。我们提出了一个转化研究框架，以加强PD的早期发现，症状管理和干预策略。该框架将认知、情绪和自主神经功能障碍与临床因素（疾病分期、持续时间、运动亚型、左旋多巴状态）结合起来，在翻译模型中理解内感受功能障碍。这种方法强调了个性化护理和改进PD治疗干预的新机会。

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引用次数: 0

The effects of rhythmic handgrip exercise on muscle sympathetic nerve activity: A systematic review and meta-analysis 有节奏的握力运动对肌肉交感神经活动的影响：系统回顾和荟萃分析

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-26 DOI: 10.1016/j.autneu.2025.103272

Lauren E. Maier , Sarah E. Meyer , Andy Deprato , Stephen Busch , Allison Sivak , Margie H. Davenport , Craig D. Steinback

This systematic review and meta-analysis was conducted to quantify the sympathetic response to rhythmic handgrip exercise in healthy and diseased populations. Structured searches of databases were performed until June 12, 2024. We included all primary studies (other than systematic reviews and meta-analyses), and inclusion criteria were: population (all populations); intervention (rhythmic handgrip); comparator (baseline); and outcome (MSNA, BP, HR). Forty-nine studies (n = 930) were included. Burst frequency was elevated by 6.1 bursts/min during rhythmic handgrip (95 % CI, 4.52, 7.63; I² = 53 %; p < 0.00001) across all populations. Similarly, burst incidence and total activity showed significant increases during handgrip (BI: MD, 3.0 bursts/100 hbs; 95 % CI, 0.11, 5.85; I² = 0 %; p = 0.04; TA: MD, 49.4 a.u.; 95 % CI, 36.56, 62.20; I² = 86 %; p < 0.00001). Subgroup analyses found greater responses in MSNA during rhythmic handgrip in healthy individuals compared to cardiovascular diseases and other conditions. Specifically, the change in burst frequency during handgrip (p = 0.0009) and total activity during handgrip (p < 0.00001) suggest a blunted sympathetic response to rhythmic handgrip in diseased populations. Meta-regression analyses in healthy populations found no relationship between the volume of handgrip applied with the associated change in sympathetic activity; however, there was a significant positive relationship between both the change in heart rate (slope = 0.131; adjusted R² = 0.2773; p = 0.002) and the change in mean blood pressure (slope = 0.163; adjusted R² = 0.3594; p < 0.001) with handgrip volume. An increase in MSNA is observed during rhythmic handgrip despite ranging protocols, populations, and co-interventions. These results suggest exercise is a unique stressor and challenges the understanding of general sympathetic hyperactivity in diseased populations.

本系统综述和荟萃分析旨在量化健康和患病人群对有节奏握力运动的交感神经反应。数据库的结构化搜索一直持续到2024年6月12日。我们纳入了所有的初步研究（除了系统评价和荟萃分析），纳入标准为：人群（所有人群）；干预（有节奏的握法）；比较器(基线);结果（MSNA、BP、HR）。纳入49项研究（n = 930）。节律握力时爆发频率增加6.1次/min (95% CI, 4.52, 7.63；i2 = 53%；p & lt;0.00001)。同样，握力时爆发发生率和总活动显著增加(BI: MD， 3.0次爆发/100 hbs；95% ci, 0.11, 5.85；i2 = 0%；p = 0.04；TA：医学博士，49.4 a.u.；95% ci, 36.56, 62.20；i2 = 86%；p & lt;0.00001)。亚组分析发现，与心血管疾病和其他疾病相比，健康个体在节律性握力过程中MSNA的反应更大。具体来说，握拳期间突发频率的变化（p = 0.0009）和握拳期间总活动(p <；0.00001)表明在患病人群中对有节奏的握力的交感神经反应迟钝。健康人群的meta回归分析发现，握力的量与交感神经活动的相关变化之间没有关系；然而，两者之间存在显著的正相关关系(斜率= 0.131；调整后R2 = 0.2773；P = 0.002)和平均血压变化(斜率= 0.163；调整后R2 = 0.3594；p & lt;0.001)与握把量有关。尽管有不同的方案、人群和联合干预，但在有节奏的握拍过程中观察到MSNA的增加。这些结果表明，运动是一种独特的压力源，挑战了对患病人群普遍交感神经过度活跃的理解。

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引用次数: 0

Women, orthostatic tolerance, and POTS: a narrative review 女性，直立容忍度，和盆：一个叙事回顾

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-04-27 DOI: 10.1016/j.autneu.2025.103284

L.K. Fitzgibbon-Collins , T.J. Pereira , H. Edgell

Young women experience orthostatic intolerance to a greater degree than men. Numerous physiological pathways could be responsible for this intolerance in both healthy and pathophysiological conditions. This review discusses sex differences in hemodynamics, ventilation, autonomic control, and cerebral blood flow. Further, we discuss these phenomena and their potential exacerbations in postural orthostatic tachycardiac syndrome (POTS). After normalization for body size women have lower stroke volume and blood volume, and while upright women have reduced ventilation, reduced venous return likely from attenuated respiratory pump and skeletal muscle pump activity, augmented parasympathetic withdrawal, attenuated neurovascular transduction of sympathetic outflow, and increased vasodilatory capacity compared to age-matched men. Women have greater middle cerebral artery blood velocity, potentially impaired cerebral dynamic autoregulation (depending on the timing), yet similar cerebrovascular reactivity to carbon dioxide exists between the sexes. Thus, we suggest that the greater incidence of orthostatic intolerance in women is primarily due to hemodynamic control and autonomic function; however, the enhanced parasympathetic withdrawal while upright could theoretically influence cerebral vasodilatory capacity and is proposed as a possibility in need of further investigation. POTS physiology is described briefly due to its increasing prevalence via post-COVID infections. We summarize some potential physiological changes in POTS including hemodynamic and ventilatory control, and we highlight that cerebral blood flow control is impaired and likely plays a role in the symptomology of POTS.

年轻女性比男性更容易出现站立不耐受。在健康和病理生理条件下，许多生理途径可能导致这种不耐受。这篇综述讨论了血液动力学、通气、自主控制和脑血流的性别差异。此外，我们讨论了这些现象及其在体位性心动过速综合征（POTS）中的潜在恶化。在身体尺寸正常化后，女性中风量和血容量降低，而直立女性通气减少，静脉回流减少，可能是由于呼吸泵和骨骼肌泵活动减弱，副交感神经退出增强，交感神经血管传导减弱，与年龄匹配的男性相比，血管舒张能力增加。女性的大脑中动脉血流速度更快，这可能会损害大脑动态自动调节（取决于时间），但两性之间存在类似的脑血管对二氧化碳的反应。因此，我们认为女性直立不耐受发生率较高主要是由于血流动力学控制和自主神经功能；然而，直立时增强的副交感神经退缩在理论上可能影响脑血管舒张能力，这一可能性有待进一步研究。由于其通过covid - 19后感染而增加，因此简要描述了POTS生理学。我们总结了POTS的一些潜在生理变化，包括血流动力学和通气控制，并强调脑血流控制受损，可能在POTS的症状中起作用。

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引用次数: 0

Cardiovascular and sympathetic neural responses during acute vagus nerve stimulation and subsequent static handgrip exercise in healthy adults 急性迷走神经刺激和随后的静态握力运动对健康成人的心血管和交感神经反应

IF 3.2 4区医学 Q2 NEUROSCIENCES

Autonomic Neuroscience-Basic & Clinical

Pub Date : 2025-06-01 Epub Date: 2025-03-25 DOI: 10.1016/j.autneu.2025.103270

Takuro Washio , John D. Akins , Sarah L. Hissen , Anna K. Geib , Skyler A. Robles , Qi Fu

Purpose

This study aimed to investigate cardiovascular and sympathetic neural responses during acute cervical non-invasive vagus nerve stimulation (nVNS) and subsequent static handgrip (SHG) exercise with post-exercise circulatory occlusion (PECO) in healthy humans.

Methods

Ten healthy adults (5 men and 5 women, 33 ± 9 [standard deviation] yrs) participated in this double-blinded, randomized, crossover study. Each participant was studied twice on two separate days, with approximately 4 weeks apart: once during the actual cervical nVNS and once during sham stimulation for 4 min each. Mean arterial pressure (MAP), heart rate (HR), and muscle sympathetic nerve activity (MSNA) were measured during nVNS and sham stimulation. In addition, participants performed SHG at 40 % of maximal voluntary contraction until fatigue, followed by 2-min PECO to isolate muscle metaboreflex activation before and after each stimulation.

Results

During both nVNS and sham stimulation, HR decreased (△−4 ± 4 and △−4 ± 5 bpm; both P < 0.001), and MSNA increased (△4 ± 6 and △2 ± 3 bursts/min; both P < 0.001) in all participants, although MAP remained unchanged (P = 0.312). However, these responses did not differ between nVNS and sham stimulation (all P > 0.05). Additionally, there were no differences in cardiovascular and MSNA responses to fatiguing SHG and PECO between stimulations (all P > 0.05).

Conclusion

Compared to the sham condition, cervical nVNS had no significant impact on cardiovascular variables and MSNA during acute stimulation, nor on the responses to SHG or PECO. These findings suggest that cervical nVNS has no or minimal acute effect on sympathetic neural (re)activity in healthy adults.

目的本研究旨在探讨急性颈部无创迷走神经刺激（nVNS）和随后的静止握力（SHG）运动伴运动后循环闭塞（PECO）时的心血管和交感神经反应。方法10名健康成人（男5名，女5名，33±9[标准差]岁）参加了这项双盲、随机、交叉研究。每个参与者分别在两天进行两次研究，间隔约4周：一次在实际的颈椎nVNS期间，一次在假刺激期间，每次4分钟。在nVNS和假刺激期间测量平均动脉压（MAP）、心率（HR）和肌肉交感神经活动（MSNA）。此外，参与者以最大自愿收缩的40%进行SHG，直到疲劳，然后在每次刺激前后进行2分钟的PECO，以隔离肌肉代谢反射激活。结果nVNS和假性刺激时，心率降低（△−4±4和△−4±5 bpm）；P <；0.001)， MSNA增加(△4±6次和△2±3次/min；P <；0.001)，尽管MAP保持不变（P = 0.312）。然而，这些反应在nVNS和假刺激之间没有差异(所有P >；0.05)。此外，两种刺激对疲劳SHG和PECO的心血管和MSNA反应没有差异(所有P >；0.05)。结论与假手术相比，颈椎nVNS对急性刺激时的心血管变量和MSNA无显著影响，对SHG和PECO的反应无显著影响。这些发现表明，颈椎nVNS对健康成人交感神经（re）活动没有或只有很小的急性影响。

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引用次数: 0