Asymmetry of Sympathetic Consequences of Experimental Stroke

Hachinski, Vladimir; Oppenheimer, Stephen; Wilson, John X.; Guiraudon, C; Cechetto, David F.

doi:10.1001/archneur.1992.00530310039010

Cited by 137 publications

(75 citation statements)

References 24 publications

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“…Th e heart rate increased or decreased aft er the inactivation of either the left or the right hemisphere, respectively suggesting the existence of anatomical or functional asymmetries in the central and peripheral nervous system. Also, occlusion of the left or right middle cerebral artery in normotensive rats reduces BP only in animals with left occlusion (Hachinski et al 1992). In these experiments, renal sympathetic nerve discharge increased aft er left occlusion (suggesting RAS activation) whereas plasma norepinephrine increased aft er right occlusion.…”

Section: Asymmetry In the Neuroendocrine Interaction For The Cardiovamentioning

confidence: 57%

Bidirectional asymmetry in the neurovisceral communication for the cardiovascular control: New insights

Prieto

Segarra

Martı́nez-Cañamero

et al. 2017

Endocrine Regulations

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Th e cardiovascular control involves a bidirectional functional connection between the brain and heart. We hypothesize that this connection could be extended to other organs using endocrine and autonomic nervous systems (ANS) as communication pathways. Th is implies a neuroendocrine interaction controlling particularly the cardiovascular function where the enzymatic cascade of the renin-angiotensin system (RAS) plays an essential role. It acts not only through its classic endocrine connection but also the ANS. In addition, the brain is functionally, anatomically, and neurochemically asymmetric. Moreover, this asymmetry goes even beyond the brain and it includes both sides of the peripheral nervous and neuroendocrine systems. We revised the available information and analyze the asymmetrical neuroendocrine bidirectional interaction for the cardiovascular control. Negative and positive correlations involving the RAS have been observed between brain, heart, kidney, gut, and plasma in physiologic and pathologic conditions. Th e central role of the peptides and enzymes of the RAS within this neurovisceral communication, as well as the importance of the asymmetrical distribution of the various RAS components in the pathologies involving this connection, are particularly discussed. In conclusion, there are numerous evidences supporting the existence of a neurovisceral connection with multiorgan involvement that controls, among others, the cardiovascular function. Th is connection is asymmetrically organized.

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Section: Asymmetry In the Neuroendocrine Interaction For The Cardiovamentioning

confidence: 57%

Bidirectional asymmetry in the neurovisceral communication for the cardiovascular control: New insights

Prieto

Segarra

Martı́nez-Cañamero

et al. 2017

Endocrine Regulations

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“…Differences in outcomes between left and right insular cortex strokes arise because of the laterality of autonomic representation in the brain, 10 although there is disagreement whether the right or left insula is the one most associated with poor prognosis. 2,5,[11][12][13][14] We therefore examined the associations between insular involvement, its laterality, and outcome at 6 months after stroke in the large prospective data set provided by the IST-3 study (Third International Stroke Trial).…”

mentioning

confidence: 99%

Effect of Right Insular Involvement on Death and Functional Outcome After Acute Ischemic Stroke in the IST-3 Trial (Third International Stroke Trial)

Sposato¹,

Cohen²,

Sandercock³

et al. 2016

Stroke

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Background and Purpose-In patients with acute ischemic stroke, whether involvement of the insular cortex influences outcome is controversial. Much of the apparent adverse outcome may relate to such strokes usually being severe. We examined the influence of right and left insular involvement on stroke outcomes among patients from the IST-3 study (Third International Stroke Trial) who had visible ischemic stroke on neuroimaging. Methods-We used multiple logistic regression to compare outcomes of left versus right insular and noninsular strokes across strata of stroke severity, on death, proportion dead or dependent, and level of disability (ordinalized Oxford Handicap Score) at 6 months, with adjustment for the effects of age, lesion size, and presence of atrial fibrillation. Results-Of 3035 patients recruited, 2099 had visible ischemic strokes limited to a single hemisphere on computed tomography/magnetic resonance scans. Of these, 566 and 714 had infarction of right and left insula. Six months after randomization, right insular involvement was associated with increased odds of death when compared with noninsular strokes on the left side (adjusted odds ratio, 1.83; 95% confidence interval, 1.33−2.52), whereas the adjusted odds ratio comparing mortality after insular versus noninsular strokes on the left side was not significant. Among mild/moderate strokes, outcomes for right insular involvement were worse than for left insular, but among more severe strokes, the difference in outcomes was less substantial. Conclusions-We found an association between right insular involvement and higher odds of death and worse functional outcome. The difference between right-and left-sided insular lesions on outcomes seemed to be most evident for mild/ moderate strokes. Clinical Trial Registration-URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518.

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“…25 Many studies have shown that MCAO leads to an increase in renal sympathetic nerve discharge, an increase in circulating norepinephrines, and associated myocardial ischemia, subendocardial congestion, or subendocardial hemorrage. [25][26][27][28] Indeed, the sympathetic activation is more marked after right MCAO, with involvement of the insular cortex and amygdala. 26 Because the latter mediates cardiovascular responses to stress, the neurochemical changes in the amygdala may thus be responsible for stroke-induced cardiovascular disturbances.…”

mentioning

confidence: 99%

“…[25][26][27][28] Indeed, the sympathetic activation is more marked after right MCAO, with involvement of the insular cortex and amygdala. 26 Because the latter mediates cardiovascular responses to stress, the neurochemical changes in the amygdala may thus be responsible for stroke-induced cardiovascular disturbances. 27 Human studies have also attempted to determine the influence of stroke subtype, the topographical location, the extent and laterality of the infarction or hemorrhage, and the involvement of structures such as the insular cortex on sympathetic nervous system activation.…”

mentioning

confidence: 99%