Gravity in the brain: how compressive ischemic changes in the weight-bearing brainstem autonomic nuclei may contribute to vascular endothelial dysfunction elsewhere in the body following sleep deprivation

Jaster, J. Howard

doi:10.1152/ajpheart.00059.2021

Cited by 5 publications

(12 citation statements)

References 9 publications

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“…These two additional factors are vasoconstriction in the brain related to carbon dioxide (CO2) levels [8,9], and gravity in the brain [10][11][12][13][14][15]. These possibly have several clinical effects, but the one applicable here is sudden unexpected death, related to both cardiac arrhythmias and neurogenic pulmonary edema [10][11][12][13][14][15]-and possibly responsible for significant mortality in patients discharged from the hospital following acute heart failure.…”

Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

“…In contrast, the heart and lungs are continuously in motion-and they are surrounded to a significant degree by soft tissues. 'Gravitational ischemia in the brain' results from the mass effect of one part of the brain upon another in a gravitational field [10][11][12][13][14][15]. In any given head position, the 'top' half of the brain (farthest from the center of the earth) is sitting on the 'bottom' half as a weight-burden.…”

Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

“…In healthy individuals, the horizontal supine body positioning associated with sleep helps to redistribute both gravitational ischemia and blood flow-after a 16-hour period of vertical head positioning during the waking hours of the day. Restoration of blood flow by reopening of capillary vascular beds follows repositioning (unloading of ischemic regions) of the brain relative to gravity-by head tilting, which is significant through the 24hour sleep/wake cycle [10][11][12][13][14][15].…”

Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

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Acute Heart Failure, 90-day Mortality—and Gravitational Ischemia in the Brain

Jaster¹,

Ottaviani²

2022

Preprint

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During the 90 days following hospitalization for acute heart failure, ejection fraction and type of discharge medications have been shown in clinical trials to have little effect on mortality. We examined the recent literature addressing brain-related etiologies of sudden death following heart failure. Two mechanisms of sudden unexpected death have been suggested to possibly result from 4 significant influences on pathophysiology in the brain. The two causes of death are severe cardiac arrhythmia, and neurogenic pulmonary edema. They are both mediated through the brainstem autonomic nuclei generally, and executed specifically through the dorsal motor nucleus of the vagus nerve. The four significant influences on pathophysiology in the brainstem autonomic nuclei are: 1) Hyper-stimulation of neurons in the solitary tract nucleus, increasing their metabolic requirements; 2) Inadequate blood flow at a vascular watershed terminus; 3) Additionally decreased blood flow following vasoconstriction related to relative hyperventilation and decreased pCO2 levels; 4) Gravitational ischemia in the brain—caused by the weight of the brain mass sitting above the brainstem. Changes in head tilt release gravitational ischemia in the brain. There is no specific head position (relative to gravity) that is considered favorable or unfavorable for an extended period of time (i.e. more than 24 hours). Even a small degree of head elevation, used in managing pulmonary congestion, may increase gravitational ischemia in the posterior fossa and brainstem. In this paper we suggest a new and important research avenue for intervening in cardiac arrhythmias, and preventing their occurrence, through the non-invasive use of head-tilting, and other head repositioning maneuvers. This could potentially help many geriatric patients with heart failure, who have decreased mobility in bed, and who tend to stay in one position longer, thereby increasing gravitational ischemia in the brain.

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Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

Section: Carbon Dioxide Gravity-and Thinking Like a Skin Nursementioning

confidence: 99%

See 1 more Smart Citation

Acute Heart Failure, 90-day Mortality—and Gravitational Ischemia in the Brain

Jaster¹,

Ottaviani²

2022

Preprint

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“…Its metabolism (and resulting size and strength) may be regulated directly by cortisol and testosterone levels-but it may be regulated indirectly by cortisol and testosterone releasing factors in the brain, active along the hypothalamic-pituitary axis. And this may be influenced significantly by gravitational ischemia in the brain (Jaster, 2021b(Jaster, , 20212020).…”

Section: Gravity In the Brain-how It May Regulate Skeletal Muscle Metabolism By Balancing Compressive Ischemic Changes In The Weight-bearmentioning

confidence: 99%

Gravity in the brain—how it may regulate skeletal muscle metabolism by balancing compressive ischemic changes in the weight‐bearing pituitary and hypothalamus

Jaster

2021

Physiol Rep

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“…'Gravitational ischemia in the brain', results from the mass effect of one part of the brain upon another in a gravitational field [2][3][4][5]. In any given head position, the 'top' half of the brain (farthest from the center of the earth) is sitting on the 'bottom' half as a weight-burden.…”

mentioning

confidence: 99%