Central Nervous System Management of Autonomic Cardiovascular Control

Ruffinazzi, Marta; Dusi, Veronica

doi:10.1007/978-3-319-90305-7_65-1

Cited by 3 publications

(2 citation statements)

References 196 publications

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“…72 The brain regions important for cardiovascular functions include the following (ordered rostral to caudal): medial prefrontal cortex (MPFC), insular cortex, paraventricular nucleus of the hypothalamus (PVN), dorsomedial nucleus of the hypothalamus (DMH), amygdala, locus coeruleus (LC), PBN, PAG, and NTS. 73 While pregnancy alters the activity of neurones in several of these brain regions, there are significant pregnancy-associated changes in the hypothalamus. Interestingly, inhibiting the activity of PVN neurones during pregnancy reduced the arterial blood pressure, heart rate and sympathetic nerve activity in pregnant rats.…”

Section: Cardiovascular Changes During Pregnancymentioning

confidence: 99%

The role of maternal hormones in regulating autonomic functions during pregnancy

Georgescu

2023

J Neuroendocrinology

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Offspring development relies on numerous physiological changes that occur in a mother's body, with hormones driving many of these adaptations. Amongst these, the physiological functions controlled by the autonomic nervous system are required for the mother to survive and are adjusted to meet the demands of the growing foetus and to ensure a successful birth. The hormones oestrogen, progesterone, and lactogenic hormones rise significantly during pregnancy, suggesting they may also play a role in regulating the maternal adaptations linked to autonomic nervous system functions, including respiratory, cardiovascular, and thermoregulatory functions. Indeed, expression of pregnancy hormone receptors spans multiple brain regions known to regulate these physiological functions. This review examines how respiratory, cardiovascular, and thermoregulatory functions are controlled by these pregnancy hormones by focusing on their action on central nervous system circuits. Inadequate adaptations in these systems during pregnancy can give rise to several pregnancy complications, highlighting the importance in understanding the mechanistic underpinnings of these changes and potentially identifying ways to treat pregnancy‐associated afflictions using hormones.This article is protected by copyright. All rights reserved.

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Section: Cardiovascular Changes During Pregnancymentioning

confidence: 99%

The role of maternal hormones in regulating autonomic functions during pregnancy

Georgescu

2023

J Neuroendocrinology

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“…Within the brainstem, the nucleus tractus solitarius (NTS) receives most afferent information from the heart and serves as a relay point for cardiovascular reflexes. In contrast, input from spinal afferents is received by centers in the thalamus, brainstem, and hypothalamus 107 . Through interaction between the NTS and other brainstem nuclei, reflexive autonomic motor responses are generated 108 .…”

Section: Cardiac Autonomic Nervous Systemmentioning

confidence: 99%

The function of the autonomic nervous system in type 1 diabetes and in response to physiological and pharmacological modulations

Nielsen

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Type 1 diabetes is a chronic autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic beta cells, whereas type 2 diabetes is characterized by insulin resistance alone or combined with insufficient insulin production. Both types result in hyperglycemia. Prolonged hyperglycemic exposure can lead to several life-impairing microvascular complications, such as diabetic nephropathy, neuropathy, and retinopathy.Diabetic neuropathy is the most common complication of diabetes and can affect both peripheral and autonomic nerves and cause, e.g., distal symmetrical polyneuropathy (DSPN) and diabetic autonomic neuropathy (DAN). Whereas DSPN affects sensorimotor neurons in a "glove and stocking" pattern, DAN results in dysfunction and impaired regulation of several organ systems and autonomically innervated muscles. Diabetic neuropathies can be painful as well as non-painful.Glucagon-like peptide 1 receptor agonists (GLP-1 RA's) are used in the treatment of type 2 diabetes by stimulating insulin secretion and inhibiting glucagon secretion, resulting in a reduction of glucose levels. GLP-1 RA's have several extra-pancreatic effects, including anti-inflammatory, cardioprotective, and neuroprotective effects. In mice, topical administration of a GLP-1 RA has shown to prevent thinning of the neuroretina and promote neurogenesis in retinal cells. In humans, GLP-1 RA's are known to increase heart rate through autonomic stimulation mechanisms not yet fully understood. In this thesis, we investigate the effects of the GLP-1 RA liraglutide in individuals with long-term type 1 diabetes to assess the anti-inflammatory and neuroprotective effects, independently of the anti-hyperglycemic effects.The overall aims of this thesis were to study:1) The effects of long-term type 1 diabetes on autonomic nerves involved in neurocardiac regulation (Study I, III, and IV) 2) The effects of long-term type 1 diabetes on sympathetic nerves innervating the superior and inferior tarsal muscles (Study I) 3) The effects of the GLP-1 RA liraglutide on heart rate variability (HRV) and the retinal nerve fiber layer thickness in individuals with long-term type 1 diabetes and confirmed DSPN (Study II and IV)Paper I investigated the relationship between the sympathetically innervated tarsal muscles' response to phenylephrine (assessed as changes in palpebral fissure height) and HRV measures. The study aimed to examine if the phenylephrine-induced response in palpebral fissure height was associated with HRV measures and thus could be a potential marker of autonomic dysfunction in individuals with type 1 diabetes and DSPN. The phenylephrine-induced changes in palpebral fissure height were associated with autonomic function, diabetic retinopathy stage, and disease duration.

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Vagal nerve stimulation in myocardial ischemia/reperfusion injury: from bench to bedside

Giannino,

Nocera,

Andolfatto

et al. 2024

Bioelectron Med

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The identification of acute cardioprotective strategies against myocardial ischemia/reperfusion (I/R) injury that can be applied in the catheterization room is currently an unmet clinical need and several interventions evaluated in the past at the pre-clinical level have failed in translation. Autonomic imbalance, sustained by an abnormal afferent signalling, is a key component of I/R injury. Accordingly, there is a strong rationale for neuromodulation strategies, aimed at reducing sympathetic activity and/or increasing vagal tone, in this setting. In this review we focus on cervical vagal nerve stimulation (cVNS) and on transcutaneous auricular vagus nerve stimulation (taVNS); the latest has the potential to overcome several of the issues of invasive cVNS, including the possibility of being used in an acute setting, while retaining its beneficial effects. First, we discuss the pathophysiology of I/R injury, that is mostly a consequence of the overproduction of reactive oxygen species. Second, we describe the functional anatomy of the parasympathetic branch of the autonomic nervous system and the most relevant principles of bioelectronic medicine applied to electrical vagal modulation, with a particular focus on taVNS. Then, we provide a detailed and comprehensive summary of the most relevant pre-clinical studies of invasive and non-invasive VNS that support its strong cardioprotective effect whenever there is an acute or chronic cardiac injury and specifically in the setting of myocardial I/R injury. The potential benefit in the emerging field of post cardiac arrest syndrome (PCAS) is also mentioned. Indeed, electrical cVNS has a strong anti-adrenergic, anti-inflammatory, antioxidants, anti-apoptotic and pro-angiogenic effect; most of the involved molecular pathways were already directly confirmed to take place at the cardiac level for taVNS. Pre-clinical data clearly show that the sooner VNS is applied, the better the outcome, with the possibility of a marked infarct size reduction and almost complete left ventricular reverse remodelling when VNS is applied immediately before and during reperfusion. Finally, we describe in detail the limited but very promising clinical experience of taVNS in I/R injury available so far.

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Central Nervous System Management of Autonomic Cardiovascular Control

Cited by 3 publications

References 196 publications

The role of maternal hormones in regulating autonomic functions during pregnancy

The role of maternal hormones in regulating autonomic functions during pregnancy

The function of the autonomic nervous system in type 1 diabetes and in response to physiological and pharmacological modulations

Vagal nerve stimulation in myocardial ischemia/reperfusion injury: from bench to bedside

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