Pathology-Dependent Histological Changes of the Left Stellate Ganglia: A Cadaveric Study

Abstract

Sympathetic hyperinnervation due to nerve sprouting generated by the left stellate ganglion has been noted following cardiopulmonary disease processes. Sympathetic hyperinnervation seems to be limited to cardiopulmonary diseases in the experimental and clinical settings. However, histological changes of the left stellate ganglion following cardiopulmonary diseases in humans have yet to be observed. This study intends to investigate the histological changes of cadaveric sympathetic nervous tissue of left stellate ganglia (n = 32) and their relationship to noted pathology. Our study found fibrotic changes of the left stellate ganglion are not significantly dependent upon pathological processes, however, changes in the number of nerve cell bodies seems to be pathology dependent A relationship between respiratory (mean = 33.3; P = 0.023) and cardiovascular pathologies (mean = 29.6; P = 0.199) and an increase in nerve cell bodies of the left stellate ganglion was noted when compared to other pathologies (mean = 25.7). The link between cardiopulmonary disease and sympathetic hyperinnervation may be the increase in the number of nerve cell bodies of the left stellate ganglion. Our results are clinically significant considering sympathetic hyperinnervation is associated with arrythmogenesis and an increase in morbidity and mortality in patients with pulmonary disease. Such findings may warrant investigation into the use of ganglion blockade in cardiopulmonary diseases.

Inflammation, oxidative stress, and glial cell activation characterize stellate ganglia from humans with electrical storm

“…The decrease in intensity of TH staining in soma of SGNs from CMY patients may appear counterintuitive; however, it likely represents mobilization of enzyme to the nerve terminals to support catecholamine generation and release. In addition to reported structural changes to neurons (25)(26)(27), the findings of the present study support enhanced activity in SGNs in patients with CMY and arrhythmias.…”

Cardiovascular Disease and its Association with Histological Changes of the Left stellate Ganglion

“…Our previous research14 demonstrated an increased number of nerve cell bodies within the left stellate ganglia of cadavers with cardiopulmonary disease, in comparison to other pathologies. In the present study, we attempted to present a definite link between an increased number of nerve cell bodies and evidence of previous myocardial infarction.…”

Extracardiac Neural Remodeling in Humans With Cardiomyopathy

“…Since neurons in peripheral ganglia do not replicate (unlike glial cells), this suggests no significant neuronal loss under cardiac pathologic conditions compared to normal. Fibrosis within the stellate ganglia was reported to differ in cadavers with cardiopulmonary disease compared to cadavers without (17). Another study from the same group showed greater neuronal density in stellate ganglia from cadavers with fibrosis detected within the inter-ventricular septum (18).…”

“…Patients with cardiopulmonary disease have been reported to have greater fibrosis and neuron density within their stellate ganglia than those without such conditions, although the differences were marginal (17, 18). Whether extra-cardiac neurons undergo physical remodeling due to cardiac pathology remains unknown in man.…”