Autonomic Homeostasis Research Articles

Modulating Sympathetic Nervous System with the use of SGLT2 Inhibitors: Where There is Smoke, There is Fire?

Heart failure (HF) has become even more prevalent in recent years, as a result of improved diagnostics and an increase in the risk factors predisposing to its pathology. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) emerged as one of the key pharmacotherapy options for both reduced and preserved ejection fraction, providing cardio- and renoprotection and improving mortality and cardiovascular (CV) outcomes. The pleiotropism of SGLT2i has led to multiple efforts to understand their distinct pathophysiological interactions with various pathways, including microcirculation, endothelial dysfunction, and inflammation. More recently, the role of SGLT2i on the sympathetic nervous system (SNS) is starting to be recognized, especially as observations of retained or reduced heart rate (HR) despite volume contraction have been noted by investigators in the large clinical trials testing the safety and efficacy of these agents. Both preclinical and clinical studies have been performed, with conflicting results. Interestingly, in both settings, whilst there are indications of SNS modulation by SGLT2i, other studies contradict such findings, without showing, however, worsening of the autonomic homeostasis. Given the importance of neuromodulation in HF, in both pharmacological and interventional therapies, in this review, we aim to describe the role of SNS in CV disease, focusing on HF, analyse preclinical and clinical data regarding the efficacy of SGLT2i in modulating autonomic dysfunction by examining various markers of SNS activation, as well as provide the most plausible theoretical backgrounds on the mechanism of benefit of SNS from the inhibition of SGLT2 receptors.

Noninvasive Assessment of Temporal Dynamics in Sympathetic and Parasympathetic Baroreflex Responses.

The baroreflex system is crucial for cardiovascular regulation and autonomic homeostasis. A comprehensive assessment requires understanding the simultaneous temporal dynamics of its multiple functional branches, which traditional methods often overlook. To develop and validate a noninvasive method for simultaneously assessing the temporal dynamics of sympathetic and parasympathetic baroreflexes using pulse contour analysis and the sequence method. Beat-to-beat blood pressure and ECG recordings were analyzed from 55 preoperative cardiothoracic surgery patients in the supine position and 21 subjects from the EUROBAVAR dataset in both supine and standing positions. Systolic arterial pressure (SAP), interbeat interval (IBI), cardiac output (CO), myocardial contraction (dP/dt max ), and systemic vascular resistance (SVR) were estimated using pulse contour analysis. Baroreflex sensitivity (BRS) was calculated via the sequence method and correlated with hemodynamic and heart rate variability (HRV) parameters. Parasympathetic BRS for IBI was correlated with the root mean square of successive differences of ECG RR intervals (RMSSD-HRV) at 0-beat delay. Sympathetic BRS for SVR strongly correlated with SVR, CO, and RMSSD-HRV, particularly at 3-beat delay, and was uniquely associated with SAP at 1-beat delay. Sympathetic BRS for dP/dt max correlated with dP/dt max at 1-beat delay. In contrast, BRS for CO correlated with CO and SVR at 0- and 3-beat delays. Postural changes mainly affected parasympathetically-mediated BRS for IBI and, to a lesser extent, the sympathetic vascular and myocardial branches. This method effectively captures multiple baroreflex responses and their temporal dynamics, revealing distinct autonomic mechanisms and the impact of postural changes. Further validation is warranted.

Non-invasive ventral cervical magnetoneurography as a proxy of in vivo lipopolysaccharide-induced inflammation

Maintenance of autonomic homeostasis is continuously calibrated by sensory fibers of the vagus nerve and sympathetic chain that convey compound action potentials (CAPs) to the central nervous system. Lipopolysaccharide (LPS) intravenous challenge reliably elicits a robust inflammatory response that can resemble systemic inflammation and acute endotoxemia. Here, we administered LPS intravenously in nine healthy subjects while recording ventral cervical magnetoneurography (vcMNG)-derived CAPs at the rostral Right Nodose Ganglion (RNG) and the caudal Right Carotid Artery (RCA) with optically pumped magnetometers (OPM). We observed vcMNG RNG and RCA neural firing rates that tracked changes in TNF-α levels in the systemic circulation. Further, endotype subgroups based on high and low IL-6 responders segregate RNG CAP frequency (at 30-120 min) and based on high and low IL-10 response discriminate RCA CAP frequency (at 0-30 min). These vcMNG tools may enhance understanding and management of the neuroimmune axis that can guide personalized treatment based on an individual’s distinct endophenotype.

Role of exercise in reducing the risk of cardiovascular diseases associated with sleep disorders.

Cardiovascular diseases are the leading cause of death among urban and rural residents and have become a major global public health problem. The prevention and control of cardiovascular disease risk factors is crucial for preventing, stabilizing, and even reversing cardiovascular disease. Studies have found that certain sleep disorders are directly related to cardiovascular disease and may be induced through pathways such as endothelial dysfunction, dysregulation of autonomic homeostasis, inflammatory response, and metabolic dysfunction. Exercise helps improve sleep disorders and thus reduce the risk of cardiovascular disease, and has irreplaceable advantages over pharmacological treatments for improving sleep. Different types of sleep disorders should be adjusted by factors such as exercise mode, intensity, and duration of exercise. A good sleep state further reduces the risk of cardiovascular disease. Discussing the effect of exercise on the improvement of the risk of cardiovascular disease associated with sleep disorders, and elaborating the mechanism of action of exercise in reducing the risk of cardiovascular disease from the perspective of sleep, can lay a foundation for the treatment of sleep disorders by exercise and propose new directions for reducing cardiovascular disease risk.

Вегетативні розлади та адаптаційні поведінкові реакції при синдромі вегетативної дисфункції в дітей, які перехворіли на інфекцію COVID-19

Aim - to study the features of autonomic homeostasis as one of the markers of the body impaired adaptive mechanisms and the development of pathology in children after SARS-CoV-2 infection. Materials and methods. There are 95 children aged 7-14 years were included. The study group included the 75 children without chronic pathology who had a mild or moderate course of COVID-19 infection and had laboratory confirmation of the disease. The control group included 20 children who had no COVID-19 infection. The state of the autonomic nervous system was assessed by the Cardio-Spectrum rapid heart rate variability analysis system according to the conventional methodology with the calculation of the tension index (Baevsky Index), which reflects the balance of the sympathetic and parasympathetic divisions of the ANS. Statistical processing of the obtained data was performed with application package "Statistica 10.0 for Windows" by the method of variation statistics. Results. All children from both groups had symptoms of somatoform autonomic dysfunction. It was discovered that 54.7% of children with COVID-19 had vagotonia, 24% had sympathicotonia, and 21.3% had euthonia, what is significantly different from the distribution in the comparison group. After analyzing the wave structure of the variability of heart rhythm in children after COVID-19 it was noted a significant increasing of all components of the spectrum. These results characterize an increasing of the absolute level of activity of regulatory systems. Given into account the multidirectional nature of vegetative shifts in children after COVID-19, a comprehensive method of correction was proposed. This method include in addition to medications a rational diet, treatment of physical and mental stress, psychotherapy, and the elimination of factors supporting the presence of chronic stress. Conclusions. The COVID-19 infection leads to tension in the adaptive mechanisms of autonomic regulation with a shift towards the depletion of compensatory mechanisms. The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child and child's parents was obtained for the research. No conflict of interest was declared by the authors.

Clinical Characteristics of Vegetative Manifestations in Young Children with Acute Pneumonia

60 sick children with acute pneumonia aged from 1 to 3 years were examined. The control group consisted of 30 healthy children of the same age. The experience of the clinic has shown that all children with acute pneumonia have disorders of the autonomic nervous system, which aggravates the course of this disease. The author found that children with acute pneumonia showed characteristic changes in autonomic regulation, manifested by a predominance of hypersympathicotonic initial autonomic tone, which generally indicates a state of overstrain of the body's adaptive capabilities. High tension and disruption of adaptation increase the risk of an unfavorable outcome of the disease. In patients with acute pneumonia who received vegetotropic drugs and a multivitamin complex as part of complex therapy, more pronounced positive dynamics in indicators of autonomic homeostasis were noted.

Valor diagnóstico de análises lineares e não lineares da variabilidade da frequência cardíaca para diferenciação da homeostase em estado de saúde, doença e risco de óbito em cães

ABSTRACT The autonomic nervous system is closely linked to heart rate and is characterized as a chaotic deterministic system. As the heart is therefore controlled by a non-linear system, these analyzes are being used more and more. The aim of this study was to evaluate nonlinear indices of recurrence graphs and linear indices in healthy, sick and at risk of death dogs and to demonstrate whether these indices have good diagnostic accuracy to identify dogs at risk of death. Sixty-six dogs underwent heart rate variability analysis using a frequency meter. The results showed that the SDNN, RMSSD, PNN50% and DET% indices showed a significant difference between all groups, helping to differentiate the health status in terms of autonomic homeostasis. Greater sensitivity (96.67%) was observed for linear indices (SDNN, RMSSD and PNN50%) and greater specificity (100%) for non-linear indices (DET%, REC% and LAM%) in the recognition of dogs at risk of death. Linear indices (SDNN, RMSSD and PNN50%) and non-linear indices (DET% and ShanEnt) showed greater diagnostic accuracy for identifying healthy or dying dogs. It is concluded that the studied indices of heart rate variability help to differentiate the health status in healthy dogs and are excellent predictors of prognosis.

Influence of visceral fat on cardio-respiratory homeostasis depending on sex, age and presence of arterial hypertension

Introduction. The study of vegetative homeostasis requires the accounting of sensitive, non-invasive parameters of multidimensional ambulatory metabolic and cardiorespiratory monitoring, including bioimedansometry, heart rate variability (HRV) and respiratory function (RF).Aim. To determine concomitant changes in HRV, RF, depending on the level of visceral fat (VF) and the presence of arterial hypertension (AH), associated with gender, age to determine the targets of preventive effects.Materials and methods. 215 boys and girls aged 18 to 30 years and 93 men and women with hypertension aged 45 to 59 years underwent, bioimpedancometry, HRV monitoring using ten-minute recordings, and the study of respiratory function.Results and discussion. In young people with a BMI over 25 kg/m2, a high level of HF was associated with an increase in LF/ HF and SDANN values, which reflected a reduction in parasympathetic activity and an increase in sympathetic activity, as well as changes in RF with a decrease in the Tiffno index and maximum half-expiratory flow (MHF). In middle-aged individuals with AH and BMI exceeding 25 kg/m2, a direct correlation was found between the value of VF and age, waist circumference, diastolic blood pressure, with a higher stress index of cardiac rhythm regulation and more pronounced sympathetic activity in terms of the LF/HF parameter. A lower total HRV, low parasympathetic activity and tension in the regulation of the heart rhythm in persons with AH were detected even with an intermediate value of VF.Conclusions. The study of autonomic homeostasis required the accounting of the individual dynamics of the parameters of HRV and the RF even within normal values. Changes in HRV associated with an intermediate increase in VF should be monitored with an emphasis on SDANN, LF/HF, stress index and vegetative index, and changes in RF – with an emphasis on the Tiffno index and MHF.

Effect of hypoglycemia on baroreflex sensitivity in individuals with type 2 diabetes: implications for autonomic control of cardiovascular function in diabetes.

Hypoglycemia is associated with increased mortality, though the mechanisms underlying this association are not established. Hypoglycemia impairs the counterregulatory hormonal and autonomic responses to subsequent hypoglycemia. It is unknown whether hypoglycemia elicits a generalized impairment in autonomic control of cardiovascular function in individuals with type 2 diabetes. We tested the hypothesis that in individuals with type 2 diabetes, hypoglycemia impairs a key measure of cardiovascular autonomic homeostasis, baroreflex sensitivity. Sixteen individuals with well-controlled type 2 diabetes and without known cardiovascular disease were exposed to two 90-min episodes of experimental hypoglycemia (2.8mmol/L, 50mg/dL) on the same day. All individuals experienced a hypoglycemic-hyperinsulinemic clamp in the morning (AM clamp) and again in the afternoon (PM clamp). Baroreflex sensitivity was assessed using the modified Oxford method before the initiation of each hypoglycemic-hyperinsulinemic clamp, during the last 30min of hypoglycemia, and the following morning. A mixed effects model adjusting for sex, age, BMI, and insulin level, demonstrated a significant effect of hypoglycemia on baroreflex sensitivity. The study is registered at ClinicalTrials.gov (NCT03422471). Baroreflex sensitivity during PM hypoglycemia was reduced compared to baseline, during AM hypoglycemia, and the next day. Insulin levels positively correlated with baroreflex sensitivity at baseline and during AM hypoglycemia. Exposure to hypoglycemia impairs a key measure of autonomic control of cardiovascular function and, thus, may increase the risk of cardiac arrhythmias and blood pressure lability in individuals with type 2 diabetes. This effect is attenuated in part by increased insulin levels.

Effectiveness of Osteopathic Manipulative Treatment in Treating Symptoms of Irritable Bowel Syndrome: A Literature Review.

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects a patient for their entire life. Effective treatments for IBS are scarce, leading to an increased interest in alternative treatmentssuch as osteopathic manipulative treatment (OMT). OMT uses hands-on treatment to reduce pain through various methods. By focusing on visceral techniques, OMT can restore autonomic homeostasis and increase lymphatic flow. This literature review aims to investigate the efficacy of visceral OMT in reducing the severity of IBS symptoms. Five primary research studies were evaluated in this analysis. The concluding results show that visceral OMT effectively reduces the symptoms of IBS and improves patients' quality of life. Therefore, OMT should be considered an alternative therapy for treating IBS.

Autonomic Nervous System Regulation Effects of Epipharyngeal Abrasive Therapy for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Associated With Chronic Epipharyngitis.

To evaluate the autonomic nerve stimulation effect of epipharyngeal abrasive therapy (EAT) on myalgic encephalomyelitis/chronic fatigue syndrome (CFS) associated with chronic epipharyngitis. Heart rate variability analysis was performed. The study was conducted by analyzing heart rate variability. A total of 29 patients with chronic epipharyngitis who underwent EAT from July 2017 to April 2018 were classified into two groups: 11 patients in the CFS groupand 18 patients in the control group without CFS. The patients were classified as phase 1 during bed rest, phase 2 during nasal endoscopy, phase 3 during nasal abrasion, and phase 4 during oral abrasion. Electrocardiographic recordings were made, and autonomic function was compared and evaluated by measuring heart rate, coefficient of variation on R-R interval (CVRR), coefficient of component variance high frequency (ccvHF), and low frequency/ccvHF ratio (L/H) for each of the four phases.The Shapiro-Wilk test was performed to confirm the normality of the two groups, and the parametric test was selected. A repeated measures analysis of variance was performed to assess changes over time between the four events in the two groups. Multiple comparisons were corrected by the Bonferroni method. Comparisons between resting data and three events within each group were performed by paired t-test. The CFS group had an increased baseline heart rate compared to the control group, and the CFS group had a greater increase in parasympathetic activity and a decrease in heart rate with nasal abrasion. Oral abrasion elicited a pharyngeal reflex and increased heart rate and both sympathetic and parasympathetic activity. The CFS group was in a state of dysautonomia due to autonomic overstimulation, with an elevated baseline heart rate. The CFS group was considered to be in a state of impaired autonomic homeostasis, with an increased likelihood that overstimulation would induce a pathological vagal reflex and the Reilly phenomenon would develop. The direct effects of EAT on the autonomic nervous system were considered to be vagus nerve stimulation and the regulation of autonomic function by opposing stimulation input to sympathetic and parasympathetic nerves. As an indirect effect, bleeding from the epipharyngeal mucosa due to abrasion was thought to restore the function of the cerebral venous and lymphatic excretory systems and the autonomic nerve center.

ВЕГЕТАТИВНАЯ ДИСФУНКЦИЯ ПРИ ХРОНИЧЕСКОМ ОПИСТОРХОЗЕ

Introduction. Altai Krai is one of the most significant natural foci of opisthorchiasis not only in Western Siberia, but also on the territory of the Russian Federation as a whole, where the incidence of opisthorchiasis ranges from 44 to 34 per 100,000 people. The primary habitat of opisthorchiasis is the hepatobiliary system; the polymorphism of long-term invasion polymorphism is characterized by a violation of the functions of many organs and systems: liver, immune and cardiovascular systems, digestive organs, etc. The control center responsible for these vital functions of the body is the autonomic nervous system, which regulates them in the body. Analysis of heart rate variability can give an idea of sympathetic-parasympathetic vegetative balance. The purpose of the study. A comprehensive study of the state of autonomic regulation by analyzing heart rate variability in patients with chronic opisthorchiasis. Materials and methods. During the course of the study, 31 patients with chronic opisthorchiasis (CO) were observed, a comparison was made with 30 healthy individuals of similar age and gender. When studying the function of the autonomic nervous system, the method of mathematical analysis of the heart rate according to R.M. Baevsky was used with the help of the original program "CORVEG". The level of critical significance of the null statistical hypothesis was assumed to be 0.05. Results and Discussion. In the study of the nature of vegetative changes, methods of frequency and spectral analysis of heart rate were used. Changes in heart rate regulation indicators were statistically significantly (p<0.05) indicated an increase in sympathetic regulation at rest and orthostasis in patients with SC, their autonomic homeostasis was shifted toward the sympathetic nervous system both at rest and under load, and in some patients (31%) dysregulation of the central type was detected. Conclusions. Dysregulation of autonomic nervous system in patients with chronic opisthorchiasis was revealed at all levels of its regulation and was characterized by increased sympathetic tone and a decrease in parasympathetic and humoral regulation, as well as vasoreflective and baroreflective mechanisms.

Состояние вегетативной адаптации у пациентов с хроническим описторхозом

Aim: to assess autonomic regulation by analyzing heart rate variability in patients with chronic opisthorchiasis (CO). Patients and Methods: the study involved 31 patients with CO and 30 healthy volunteers (control group). Clinical parameters of the biliary system and autonomic nervous system were as-sessed in all participants. The Baevsky method of mathematical analysis of heart rhythm was used to study autonomic nervous system functions. Parameters characterizing the activity of various branches of the autonomic nervous system were calculated. The results obtained were processed using the original CORVEG program. Results and Discussion: frequency analysis in patients with CO revealed significant deviations of SD, AMo, and CV in the supine position and EV, MSD, Mo, and AMo in active orthostatic position, thereby illustrating an increase in the effect of the sympathetic branch and a reduction in the effect of the parasympathetic branch of the autonomic nervous system (a decrease in heart rate variability in the CO group). Values of the HF and LF waves were significantly higher in the CO group (p<0.05) in the supine position, thereby illustrating an impairment of humoral regulation and a decrease in the activity of intersystem regulation. Changes in the parameters of heart rate regulation significantly (p<0.05) showed increased sympathetic regulation at rest and orthostasis in CO. Their autonomic homeostasis shifted toward the sympathetic nervous system both at rest and during exercise. Moreover, in some patients (31%), central dysregulation was detected. Autonomic tone and autonomic reactivity in CO were also significantly (p<0.05) shifted toward sympathicotonia and hypersympathicotonia. Conclusion: in CO, deviations at all levels of autonomic regulation were detected, which manifested as increased activity of the sympathetic branch and decreased parasympathetic regulation, vasoreflex and baroreflex mechanisms, and humoral regulation. KEYWORDS: chronic opisthorchiasis, Opisthorchis felineus, autonomic nervous system, parasympathetic nervous system, sympathetic nervous system, heart rate variability, cardiointervalography. FOR CITATION: Plotnikova E.Yu., Karbysheva N.V., Nikonorova M.A., Beskhlebova O.V., Ivanova M.E., Sinkov M.A., Kanner E.V., Kanner I.D. Vegetative adaptation in patients with chronic opisthorchiasis. Russian Medical Inquiry. 2023;7(11):725–732 (in Russ.). DOI: 10.32364/2587- 6821-2023-7-11-4.

RESEARCH ARTICLE: Heart Rate Variability Biofeedback: Managing Disorders of Gut-Brain Interaction by Improving Autonomic Homeostasis

Disorders of gut-brain interaction, previously called functional gastrointestinal disorders, are prevalent, disabling, expensive, and difficult to treat. In this review, I trace the available scientific knowledge on the pathophysiology of these disorders and describe how the proposed pathways are integrated into treatment approaches. A novel treatment approach, heart rate variability biofeedback (HRVB), is described, and outcome literature is reviewed. It is concluded that an approach such as HRVB offers benefits beyond more traditional treatment approaches.

Peculiarities of the relationship between aggressive and protective factors of the gastric mucosa in patients with esophagogastroduodenal pathology with impaired adaptive potential and autonomic homeostasis (according to PRECISE-diagnostics)

Background. An imbalance of interaction between the sympathetic and parasympathetic links of the autonomic nervous system leads to autonomic dysregulation of the heart rate resulting in insufficient stress resistance, impaired adaptation and depletion of the protective mechanisms of the gastric mucosa. Therefore, the purpose of our research was to study adaptive potential of the body depending on the aggressive and protective factors of the gastric juice. Materials and methods. Seventy-one patients with esophagogastroduodenal pathology were examined using the method of PRECISE-diagnostics. The level of pH, pepsin, glycoproteins, fucose and sialic acids in the gastric contents was determined. The patients were divided into 3 representative groups: I— 30 individuals with hiatal hernia; II— 20 patients with achalasia cardia; III— 21 people with duodenal ulcer disease complicated by stenosis. Results. An imbalance of sympathetic and parasympathetic links of autonomic system was detected in 85.2% of patients. The sympathetic mechanisms dominated in 71.3% of cases. At the same time, most patients with achalasia cardia had vagotonia. The adaptive and compensatory mechanisms were identified after studying the relationship between the aggressive and protective factors of the gastric mucosa. When analyzing the correlation of aggressive and protective factors of gastric juice, the following adaptive and compensatory options were revealed: 1) hyperreactive, with simultaneous increase in the factors of both aggression and protection; 2)compensatory (an increase in the level of aggressive factors against the background of normal protective indicators); 3) decompensatory (an increase in the level of aggressive factors simultaneously with a decrease in protective factors). Conclusions. The adaptive potential of the body in 85.2% of surgical patients, mostly those with hiatal hernia and achalasia cardia, according to PRECISE-diagnostics was defined as reduced, in the form of impaired adaptation in decompensatory type of the relationship between aggressive and protective factors of gastric juice.

The susceptibility of cardiac arrhythmias after spinal cord crush injury in rats

High-level spinal cord injury (SCI) often interrupts supraspinal regulation of sympathetic input to the heart. Although it is known that dysregulated autonomic control increases the risk for cardiac disorders, the mechanisms mediating SCI-induced arrhythmias are poorly understood. Here, we employed a rat model of complete spinal cord crush injury at the 2nd/3rd thoracic (T2/3) level to investigate cardiac rhythm disorders resulting from SCI. Rats with T9 injury and naïve animals served as two controls. Four weeks after SCI, rats were implanted with a radio-telemetric device for electrocardiogram and blood pressure monitoring. During 24-h recordings, heart rate variability in rats with T2/3 but not T9 injury exhibited a significant reduction in the time domain, and a decrease in power at low frequency but increased power at high frequency in the frequency domain which indicates reduced sympathetic and increased parasympathetic outflow to the heart. Pharmacological blockade of the sympathetic or parasympathetic branches confirmed the imbalance of cardiac autonomic control. Activation of sympatho-vagal input during the induction of autonomic dysreflexia by colorectal distention triggered various severe arrhythmic events in T2/3 injured rats. Meanwhile, intravenous infusion of the β1-adrenergic receptor agonist, dobutamine, caused greater incidence of arrhythmias in rats with T2/3 injury than naïve and T9 injured controls. Together, the results indicate that high-level SCI increases the susceptibility to developing cardiac arrhythmias likely owing to compromised autonomic homeostasis. The T2/3 crush model is appropriate for studying abnormal cardiac electrophysiology resulting from SCI.

Elp1 is required for development of visceral sensory peripheral and central circuitry.

ABSTRACTCardiovascular instability and a blunted respiratory drive in hypoxic conditions are hallmark features of the genetic sensory and autonomic neuropathy, familial dysautonomia (FD). FD results from a mutation in the gene ELP1, the encoded protein of which is a scaffolding subunit of the six-subunit Elongator complex. In mice, we and others have shown that Elp1 is essential for the normal development of neural crest-derived dorsal root ganglia sensory neurons. Whether Elp1 is also required for development of ectodermal placode-derived visceral sensory receptors, which are required for normal baroreception and chemosensory responses, has not been investigated. Using mouse models for FD, we here show that the entire circuitry underlying baroreception and chemoreception is impaired due to a requirement for Elp1 in the visceral sensory neuron ganglia, as well as for normal peripheral target innervation, and in their central nervous system synaptic partners in the medulla. Thus, Elp1 is required in both placode- and neural crest-derived sensory neurons, and its reduction aborts the normal development of neuronal circuitry essential for autonomic homeostasis and interoception. This article has an associated First Person interview with the first author of the paper.

Characteristic of disorders of motor-evacuator activities of the stomach and intestinal in chronic duodenal insufficiency

To assess the psychoemotional status and the state of the autonomic nervous system and their importance in the violation of the motor-evacuation function of the gastrointestinal tract in chronic duodenal insufficiency (CDI). A prospective study of 40 patients with CDI was carried out. The control group consisted of 30 healthy individuals. Anamnestic and physical data, results of X-ray and endoscopic studies, and intracavitary manometry were used to verify CDI. The study of the gastrointestinal tract was carried out using the "Gastroscan-GEM". Assessment of autonomic homeostasis was carried out using cardiac rhythmographic research and analysis of heart rate variability using the "Varicard 2.51" complex. To assess personal and situational anxiety test questionnaire SpielbergerKhanin. Eysenck's test questionnaire was used to determine the type of temperament. We revealed a postprandial decrease in the contribution of the frequency spectrum of the duodenum (Pi/Ps 1.70.07; p=0.000) and the colon (Pi/Ps 39.622.45; p=0.000) in the total spectrum in comparison with the starving study, at the same time there is an aberrant significant increase in the contribution of the stomach to the total spectrum (46.55.8%; p=0.00). In patients with CDI, the prevalence of the sympathetic division of the autonomic nervous system AMo was noted 94.0 [92.5; 97.5]% with an asymptotic type of autonomic reactivity (IN2/IN1=1.1 [1.05; 1.17]) and insufficient adaptation reserve coefficients (0.32 [0.2; 0.4]) in relation to the control group. The psychoemotional state in patients with chronic duodenal stasis is in direct correlation with changes in the postprandial ratio of the electrical activity of the stomach and duodenum (r=0.7, p=0.021), and in reverse with the coefficient of the ratio of intraduodenal pressure to intragastric pressure (r=-0,8, p=0.000). In patients with CDI, changes in the functional state of the stomach and duodenum are of a systemic nature, which is due to stimulating (parasympathetic) and inhibitory (sympathetic) effects. The relationship between the motor-evacuation activity of the stomach and duodenum and the psychoemotional state in patients with CDI was revealed.

Supplemental aerobic, anaerobic and strength training positively affects autonomic functioning, anaerobic capacity, and immune cell homeostasis of male judo athletes

The present study aimed to investigate the effect of additional package of aerobic, anaerobic and strength training (AAS training), along with the conventional judo specific training, on autonomic nervous system balance, anaerobic capacity, exercise adaptation, phenotype of different blood mononuclear cells and cellular inflammatory signalling of university judo athletes. Thirty male judokas were randomly allocated to a control group/conventional judo specific training group (performing Uchi-komi, Nage komi, and Randori) or to an experimental group/conventional judo specific training + additional AAS training group. Physiological data including recovery ANS variables and anaerobic capacity were obtained by using wireless heart rate variability and anaerobic cycle ergometer, respectively, at two different time points (T1-pre, T3-post). Serum and primary mononuclear cells were prepared at three different time points (T1-pre, T2-acute, T3-post) and processed further as per the experimental requirement. For measuring the expression level of genes, and proteins biomarkers related to immune health, we have performed advanced qPCR array technique, flow cytometry, ELISA and zymosan-fluorescein assays. The additional training modality enhanced athletes’ anaerobic performance, parasympathetic functioning, and exercise adaptation. On the other hand, it decreased fatigue index, stress index, number of reactive immune cells, and intensity of inflammatory signalling. Overall, the present study, for the very first time, exhibited the positive effect of four weeks long additional AAS training on autonomic functioning, anaerobic capacity, and immune cell homeostasis of male judo athletes. This additional training package might also help the judo coaches to optimise training schedule for the competitive session.

Effects of renal denervation on sleep apnea and arrhythmia in rats with myocardial infarction

BackgroundSympathetic hyperactivity and poor sleep quality have been reported in patients with myocardial infarction (MI). Sleep is an important modulator of cardiovascular function. We aimed to evaluate the effects of renal denervation (RDN) on cardiac autonomic activity and disordered sleep patterns in rats with MI. MethodsWireless transmission of polysomnographic recordings was performed in sham and left coronary artery (LCA) ligation male rats during normal daytime sleep before and after RDN. Spectral analyses of electroencephalogram and electromyogram (EMG) recordings were performed to define active waking, quiet sleep, and paradoxical sleep. Cardiac autonomic activity was measured by analyzing the power spectrum of heart rate variability. Central sleep apnea events were measured by analyzing the EMG recordings of the diaphragm. ResultsIn the LCA ligation group, there was a higher low-frequency (LF)/high-frequency (HF) power ratio during sleep; the LF/HF ratio decreased significantly in the rats that underwent RDN in all sleep stages when compared with that in the rats that did not. The frequency of sleep interruptions increased without RDN in the LCA ligation group when compared with that in the sham group. This change was ameliorated and prevented with RDN in the LCA ligation group. ConclusionsOur results demonstrate significant sleep fragmentation with sympathetic hyperactivity after MI and that RDN prevents autonomic dysfunction and disordered sleep. RDN may then reduce sleep apnea and sleep-related sudden cardiac death after MI by restoring autonomic homeostasis.