Does the Brain Noradrenaline Network Mediate the Effects of the CO2 Challenge?

Bellodi, Laura; Caldirola, Daniela; Bertani, Angelo

doi:10.1177/02698811030173002

Cited by 69 publications

(68 citation statements)

References 61 publications

(66 reference statements)

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“…There was, however, a striking difference between the two groups with respect to the heart rate response. The expected response, as determined from previous studies of the CO 2 challenge in healthy volunteers, includes initial bradycardia followed by a noradrenaline-mediated increase in total peripheral resistance and a pressor response [15,18]. Although all of the DAN− subjects had a bradycardic response, this was not seen in any of the DAN+ patients.…”

Section: Discussionmentioning

confidence: 90%

A new test for autonomic cardiovascular and neuroendocrine responses in diabetes mellitus: evidence for early vagal dysfunction

2004

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Aims/hypothesis: Diabetic autonomic neuropathy affects many physiological systems, producing a variety of important clinical manifestations. It is associated with high morbidity and mortality, particularly during times of stress. This is thought to be due to an increased risk of cardiac arrhythmias, although the exact mechanisms involved have yet to be fully elucidated. The aim of the present study was to investigate the endocrine, cardiac autonomic and psychological responses of diabetic patients with and without autonomic neuropathy to a single breath of 35% CO 2 . Methods: The 35% CO 2 challenge was performed in 20 male diabetic subjects, 11 of whom had autonomic neuropathy. Results: Baseline and stimulated cortisol, prolactin, systolic blood pressure and emotional arousal were similar in the two groups. However, subjects with autonomic neuropathy failed to demonstrate the expected CO 2 -induced bradycardia seen in the non-neuropathic patients (p<0.0001). Conclusions/ interpretation: The CO 2 challenge can be safely and easily administered to produce hypothalamic-pituitary-adrenal axis and cardiac autonomic activation, as well as emotional arousal. The test clearly distinguishes between subjects with and without cardiac autonomic neuropathy and could be an important adjunct to the methods currently available for the investigation and diagnosis of diabetic autonomic neuropathy.

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Section: Discussionmentioning

confidence: 90%

A new test for autonomic cardiovascular and neuroendocrine responses in diabetes mellitus: evidence for early vagal dysfunction

2004

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“…This noradrenergic innervation of the BNST arises probably from the A1 and A2 medullary cell groups (Ungerstedt, 1971;Moore, 1978). These two cell groups are activated by threatening stimuli (Zhu and Onaka, 2002;Bailey et al, 2003). Thus, they might also be activated by predator odors.…”

Section: Discussionmentioning

confidence: 99%

Noradrenaline Transmission within the Ventral Bed Nucleus of the Stria Terminalis Is Critical for Fear Behavior Induced by Trimethylthiazoline, a Component of Fox Odor

Fendt¹,

Siegl²,

Steiniger‐Brach³

2005

J. Neurosci.

104

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The bed nucleus of the stria terminalis (BNST) is involved in the mediation of fear behavior in rats. A previous study of our laboratory demonstrated that temporary inactivation of the BNST blocks fear behavior induced by exposure to trimethylthiazoline (TMT), a component of fox odor. The present study investigates whether noradrenaline release within the BNST is critical for TMT-induced fear behavior. First, we confirmed previous studies showing that the ventral BNST is the part of the BNST that receives the densest noradrenaline innervation. Second, using in vivo microdialysis, we showed that noradrenaline release within the BNST is strongly increased during TMT exposure, and that this increase can be blocked by local infusions of the ␣ 2 -receptor blocker clonidine. Third, using intracerebral injections, we showed that clonidine injections into the ventral BNST, but not into neighboring brain sites, completely blocked TMTinduced potentiation of freezing behavior. The present data clearly show that the noradrenergic innervation of the ventral BNST is important for the full expression of behavioral signs of fear to the predator odor TMT.

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“…Nevertheless, a study carried out in healthy volunteers reported that a single inhalation of 35% CO 2 increased blood pressure and subjective fear, and activated the HPA axis (Bailey et al 2003).…”

Section: Carbon Dioxide (Co 2 )mentioning

confidence: 97%

Does the panic attack activate the hypothalamic-pituitary-adrenal axis?

Graeff

Garcia-Leal

Del-Ben

et al. 2005

An. Acad. Bras. Ciênc.

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A bibliographic search has been performed in MEDLINE using cortisol and panic as key-words, occurring in the title and/or in the abstract. Human studies were selected, with no time limit. The following publications were excluded: review articles, case reports, panic attacks in disorders other than panic disorder, and studies on changes that occurred in-between panic attacks. The results showed that real-life panic attacks as well as those induced by selective panicogenic agents such as lactate and carbon dioxide do not activate the hypothalamicpituitary-adrenal (HPA) axis. Agonists of the colecystokinin receptor B, such as the colecystokinin-4 peptide and pentagastrin, increase stress hormones regardless of the occurrence of a panic attack and thus, seem to activate the HPA axis directly. The benzodiazepine antagonist flumazenil does not increase stress hormones, but this agent does not reliably induce panic attacks. Pharmacological agents that increased anxiety in both normal subjects and panic patients raised stress hormone levels; among them are the α 2 -adrenergic antagonist yohimbine, the serotonergic agents 1-(m-chlorophenyl) piperazine (mCPP) and fenfluramine, as well as the psychostimulant agent caffeine. Therefore, the panic attack does not seem to activate the HPA axis, in contrast to anticipatory anxiety.

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Does the Brain Noradrenaline Network Mediate the Effects of the CO2 Challenge?

Cited by 69 publications

References 61 publications

A new test for autonomic cardiovascular and neuroendocrine responses in diabetes mellitus: evidence for early vagal dysfunction

A new test for autonomic cardiovascular and neuroendocrine responses in diabetes mellitus: evidence for early vagal dysfunction

Noradrenaline Transmission within the Ventral Bed Nucleus of the Stria Terminalis Is Critical for Fear Behavior Induced by Trimethylthiazoline, a Component of Fox Odor

Does the panic attack activate the hypothalamic-pituitary-adrenal axis?

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