Our previous study demonstrated that oral treatment with simvastatin (SIM) suppressed renal sympathetic nerve activity (RSNA) in the rabbits with chronic heart failure (CHF). The purpose of this experiment was to determine the effects of direct application of SIM to the central nervous system on RSNA and its relevant mechanisms. Experiments were carried out on 21 male New Zealand White rabbits with pacing-induced CHF. The CHF rabbits received infusion of vehicle, SIM, or SIM ϩ N -nitro-L-arginine methyl ester into the lateral cerebral ventricle via osmotic minipump for 7 days. We found that 1) in CHF rabbits, intracerebroventricular infusion of SIM significantly suppressed basal RSNA (1st day 69.5 Ϯ 8.9% maximum; 7th day 26.0 Ϯ 6.0% maximum; P Ͻ 0.05, n ϭ 7) and enhanced arterial baroreflex function starting from the 2nd day and lasting through the following 5 days; 2) statin treatment significantly up-regulated neuronal nitric-oxide synthase (nNOS) protein expression in the rostral ventrolateral medulla (RVLM) (control, n ϭ 6, 0.12 Ϯ 0.04; SIMtreated, n ϭ 7, 0.31 Ϯ 0.05. P Ͻ 0.05); 3) in CATH.a neurons, incubation with SIM significantly up-regulated the nNOS mRNA expression, which was blocked by coincubation with mevalonate, farnesyl-pyrophosphate, or geranylgeranyl-pyrophosphate; and 4) incubation with Y-27632 [(R)-(ϩ)-trans-N-(4-pyridyl)-4-(1-aminoethyl)-cyclohexanecarboxamide] significantly up-regulated nNOS mRNA expression in these neurons. These results suggest that central treatment with SIM decreased sympathetic outflow in CHF rabbits via up-regulation of nNOS expression in RVLM, which may be due to the inhibition of 3-hydroxy-3-methylglutaryl-CoA reductase and a decrease in Rho kinase by SIM.Chronic heart failure (CHF) is characterized by both sympatho-excitation (Packer, 1992) and blunted arterial baroreflex function (DiBona and Sawin, 1995). Our previous studies demonstrated that oral treatment with the HMG-CoA reductase inhibitor, simvastatin (SIM), improved baroreflex function and normalized sympathetic outflow in the rabbits with CHF (Pliquett et al., 2003). In previous experiments, we have demonstrated that these therapeutic effects of SIM correlated with changes in several important signaling molecules in the rostral ventrolateral medulla (RVLM) of rabbits with CHF (Gao et al., 2005a). These experiments were based on systemic (oral) administration of SIM. Therefore, it is difficult to determine whether these effects were mediated by central or peripheral mechanisms following oral administration of SIM. Because SIM has been demonstrated to permeate the blood-brain barrier (Saheki et al., 1994), we postulated that the above effects of oral SIM were mediated, at least partially, by central mechanisms. Our first hypothesis in the current experiment was that direct administration of SIM into the brain would reduce sympathetic nerve activity in the CHF state.There is considerable evidence suggesting that nitric oxide (NO) in the central nervous system, especially in the brain stem, plays an imp...