Disorders Of Autonomic Nervous System Research Articles

Arterial hypertension in the Arctic: the role of stress and autonomic dysfunction, gender differences

Introduction. Psychological stress and autonomic dysfunction are recognized as risk factors for cardiovascular diseases, but they affect cardiovascular risk differently in men and women.Aim: To study gender differences in factors influencing the probability of detecting arterial hypertension (AH) from the perspective of the role of stress, autonomic dysfunction and nonspecific inflammation in rotational shift workers in the Arctic region.Material and Methods. In the medical unit of the gas production company “Gazprom dobycha Yamburg” (polar settlement of Yamburg, 68°21’40”N) we simultaneously examined 99 men and 81 women with AH 1,2 degree of AH and normotensive persons comparable in age (p = 0.450), work experience in the Arctic (p = 0.956), number of years of rotational shift work (p = 0.824), level of office systolic (SBP) (p = 0.251) and diastolic blood pressure (DBP) (p = 0.579). Questionnaires were used to determine the level of general stress (PSM25 scale), occupational stress (Vaisman questionnaire); assessment of autonomic nervous system (ANS) function (Wayne A.M. questionnaire); 24-hour blood pressure monitoring was performed; biochemical blood test for biomarkers of inflammation, cortisol, brain natriuretic peptide precursor, homocysteine, folliclestimulating hormone was carrued out.Results. Vegetative manifestations (asthenization, increased fatigue, meteorological dependence, headaches) were significantly more often observed in women. Among men with AH, individuals with high levels of neuropsychological tension predominated, every fifth M had a high level of occupational stress. The median scores on the Wayne A.M. questionnaire were significantly higher in women, regardless of BP, and moderate ANS disorders were significantly more prevalent. According to logistic regression data, a significant effect on the probability of AH in men was the number of stress scores (OR = 1.050; 1.029–1.171, p = 0.001), indicators of nocturnal DBP variability (OR = 1.295; 1.109–1.511, p = 0.001) and nonspecific inflammation: rise in high-sensitivity C-reactive protein (hs-CRP) increased the probability of AH by 1.5 times (OR = 1.532; 1.212–1.937, p = 0.001), IL-1β – by 7 times (OR = 7.275; 3.235–16.361, p = 0.001). The probability of AH in women increased by the values of the daily variability of SBP (OR = 1.154; 1.019–1.306, p = 0.024), hs-CRP by 1.5 times (OR = 1.479; 1.226–1.783, p = 0.001), tumor necrosis factor-alpha (TNF-α) (OR = 1.111; 1.001–1.244, p = 0.044), level of IL-6 increased the probability of AH by 1.7 times (OR = 1.676; 1.149–2.958, p = 0.035), the number of scores on ANS questionnaire had a significant effect (OR = 1.055; 1.006–1.107, p = 0.026).Conclusion. In the conditions of the rotational shift work in the Arctic, gender differences were revealed in the stress perception and the severity of ANS dysfunction with a clear relationship between stress, inflammation and AH in men. ANS dysfunction in women was a trigger of nonspecific inflammation and AH. The identified gender differences will help to reveal vulnerable groups among men and women and develop targeted interventions for individuals in the Arctic region.

The Clinical Characteristics of Heart Rate Variability After Stroke: A Systematic Review.

The autonomic nervous system dysfunction has been reported in up to 76% of stroke patients 7 days after an acute stroke. Heart rate variability (HRV) is one of the important indicators reflecting the balance of sympathetic and parasympathetic nerves. Therefore, we performed a systematic literature review of existing literature on the association between heart rate variability and the different types of stroke. We included studies published in the last 32 years (1990 to 2022). The electronic databases MEDLINE and PubMed were searched. We selected the research that met the inclusion or exclusion criteria. A narrative synthesis was performed. This review aimed to summarize evidence regarding the potential mechanism of heart rate variability among patients after stroke. In addition, the association of clinical characteristics of heart rate variability and stroke has been depicted. The review further discussed the relationship between post-stroke infection and heart rate variability, which could assist in curbing clinical infection in patients with stroke. HRVas a noninvasive clinical monitoring tool can quantitatively assess the changes in autonomic nervous system activity and further predict the outcome of stroke. HRV could play an important role in guiding the clinical practice for autonomic nervous system disorder after stroke.

Comorbid pathology of the mammary glands and endometriosis: risk factors and prognosis

Aim: based on a retrospective analysis, the relationship between external genital endometriosis and comorbid breast pathology was established and risk factors were identified, their comparison and the formation of a prognostic risk criterion were determined. Materials and Methods: to address the objectives of the study, a retrospective analysis of 470 cases of patients treated for external genital endometriosis after surgical treatment and comorbid breast pathology was conducted. The control group included 30 healthy non-pregnant women. Statistical processing was performed on a personal computer using the statistical software package Statistica 10. Results: As a result of the analysis, the age of the patients ranged from 23 to 40 years. The average age of patients in the study group was (32.2}1.18) years, and in the control group (31.1}1.35) (p>0.05). The groups were homogeneous in terms of age (p>0.05), marital status (p>0.05) and level of education (p>0.05). Close relatives in 208 (44.25}2.18) % (OR=8.86; 95 % CI: (0.68-10.53); p<0.002) cases suffered from benign (hormone-dependent) tumours and tumour-like diseases of the uterus and appendages in isolation or in various combinations (fibroids, adenomyosis, endometrial hyperplasia). It was also found that 102 (21.70}1.67) % of patients had endometriosis, which may indicate a genetic predisposition to this disease. In the closest relatives of EM patients: in 118 (25.10}2.01) % of the examined parents, breast problems were noted, in 66 (14.04}1.12) % – diabetes mellitus, and in 98 (20.85}1.22) % thyroid diseases were detected, which in total amounted to (60.00}2.23) % (OR=9.12; 95 % CI: (0.58-11.54); p<0.002). Early menarche almost tripled the risk of EM (OR=2.72; 95% CI: (1.02-5.11); p<0.002), and menstrual irregularities doubled it (OR=2.04; 95% CI: (1.09-3.14); p<0.05), higher education, urban residents – 2.2 times higher (OR= 2.27; 95 % CI: (1.11-3.63); p<0.05), diseases of the gastrointestinal tract and hepatobiliary complex – 5.2 times higher (OR=5.27; 95 % CI: (1.89-12.03); p<0.05), frequently recurrent inflammatory diseases of the appendages – 3 times higher (OR=3.14; 95 % CI: (0.91-5.14); p<0.05), dysmetabolic manifestations (thyroid dysfunction) – 5 times higher (OR=5.11; 95 % CI: (1.61-9.503); p<0.002). Conclusions: Thus, in endometriosis and dyshormonal diseases of the mammary glands, menstrual and generative function disorders, along with clinical symptoms of pelvic pain, dysmenorrhoea, autonomic nervous system disorders and sexual dysfunction, are significant components of this problem, initiating comorbidity processes in target organs in the setting of hormonal maladaptation. Therefore, these comorbidities become a trigger for the activation of systemic hormonal imbalance and become an urgent interdisciplinary problem that requires further study.

The COVID-19 pandemic and neurology: A survey on previous and continued restrictions for clinical practice, curricular training, and health economics.

The COVID-19 pandemic has significantly impacted health systems worldwide. Here, we assessed the pandemic's impact on clinical service, curricular training, and financial burden from a neurological viewpoint during the enforced lockdown periods and the assumed recovery by 2023. An online 18-item survey was conducted by the European Academy of Neurology (EAN) NeuroCOVID-19 Task Force among the EAN community. The survey was online between February and March 2023. Questions related to general, demographic, clinical, work, education, and economic aspects. We collected 430 responses from 79 countries. Most health care professionals were aged 35-44 years, with >15 years of work experience. The key findings of their observations were as follows. (i) Clinical services were cut back in all neurological subspecialties during the most restrictive COVID-19 lockdown period. The most affected neurological subspecialties were services for patients with dementia, and neuromuscular and movement disorders. The levels of reduction and the pace of recovery were distinct for acute emergencies and in- and outpatient care. Recovery was slow for sleep medicine, autonomic nervous system disorders, neurorehabilitation, and dementia care. (ii) Student and residency rotations and grand rounds were reorganized, and congresses were converted into a virtual format. Conferences are partly maintained in a hybrid format. (iii) Affordability of neurological care and medication shortage are emerging issues. Recovery of neurological services up to spring 2023 has been incomplete following substantial disruption of neurological care, medical education, and health economics in the wake of the COVID-19 pandemic. The continued limitations for the delivery of neurological care threaten brain health and call for action on a global scale.

Lower heart rate variability is associated with loss of muscle mass and sarcopenia in community-dwelling older Chinese adults

Autonomic nervous system (ANS) disorders may occur in skeletal muscle disease, but the link between them has not been fully established. Studying the relationship between them may yield insights into the mechanisms and treatment of disease. This study aimed to explore the association between heart rate variability (HRV), sarcopenia, and subscales of sarcopenia (muscle mass, muscle strength, and physical mobility). 2514 community-dwelling older Chinese participants were included in this study. The Asian Working Group for Sarcopenia guidelines were used to define sarcopenia. HRV was measured by 90-s electrocardiogram RR interval data. All HRV parameters were transformed using natural logarithms. Multiple regression analysis and multivariate linear regression was performed using potential correlates. The overall prevalence of sarcopenia was 15.1% (18.5% in males and 12.6% in females). In the logistic regression analysis model, there was a significant association between log-transformed standard deviation of RR interval (lnSDNN) (OR=0.736, p=0.019), log-transformed coefficient of variation of RR intervals (lnCVRR) (OR=0.751, p=0.020), log-transformed low-frequency power (lnLF) (OR=0.861, p=0.008), log-transformed high-frequency power (lnHF) (OR=0.864, p=0.003) and sarcopenia in the general population after adjusting for age, sex, body mass index (BMI), daily activity levels, hypertension, heart disease and cardiac drugs. In addition, in multivariate linear regression, lnSDNN (β=0.146, p=0.001), lnCVRR (β=0.120, p=0.010), lnLF (β=0.066, p=0.002) and lnHF (β=0.065, p<0.001) remained significantly positively associated with muscle mass, but there were no significant differences in grip strength and walking speed. Sarcopenia was independently associated with lower heart rate variability in a community-dwelling elderly Chinese population. In addition, muscle mass was positively associated with heart rate variability in the elderly.

Effects of autonomic nervous system disorders on male infertility.

The male reproductive functions are largely regulated by the autonomic nervous system. Male sexual behavior and fertility primarily depend on the normal function of the higher neural centers related to the autonomic nervous system, the hypothalamic-pituitary-gonadal axis, the autonomic nervous components within the spinal cord and spinal nerves, and certain somatic nerves in the pelvic floor. In this review article, we will summarize the role of the autonomic nervous system in regulating male reproductive capabilities and fertility, its impact on male infertility under abnormal conditions, including the role of drug-induced autonomic nervous dysfunctions on male infertility. The main purpose of this article was to provide an overview of the effects of autonomic nervous dysfunction on male reproductive function and shed light on the potential therapeutic target for male infertility.

Psychological defenses in patients with autonomic nervous system disorder

In order to identify psychosocial characteristics of individuals with autonomic nervous system disorder (ANSD), 104 patients of the organized population of Petrozavodsk (n=104; mean age 36.8±10.7 years; gender index 1:1) were examined. The control group included healthy individuals (n=30; mean age 36.1±5.5 years; gender index 1:1; p=0.761). The ANSD diagnosis was confirmed by means of the Questionnaire for identifying signs of vegetative changes and the Study scheme for detecting signs of vegetative disorders (Vein A.M. et al., 2003), as well as by palpatory examination using the Markelov-Naryshkin method. The calculation of the Kerdo index in the patients with ANSD showed a predominance of sympathicotonia (40.38% and 50.0% of cases among men and women, respectively) over parasympathicotonia (21.15% of the patients without gender differences). In addition, psychological defenses (PD) were investigated using the method of the Life Style Index (LSI) (R. Plutchik, H. Kellerman, R. Conte, 1979). It was found that the patients with ANSD were characterized by an increase in the overall stress index of psychological defense mechanisms due to “regression” (22.28±15.45 (0) / 35.57±14.6 (9.33±5.31)), “projections” (23.97±17.61 (10.78±3.59) / 31.23±18.05 (12.83±6.11)), and “substitutions” (20.43±12.74 (5.65±1.15) / 16.29±10.85 (6.67±3.98)), with statistically rarer use of “denial” (36.71±15.42 (47.68±13.98) / 34.18±17.64 (51.8±14.37) percentiles among men with ANSD (healthy individuals) / women with ANSD (healthy individuals); p=0.001). Gender specificity was noted only in relation to the PD “reactive education”, with its predominant use by women 37.88±23.71 (compared with 23.27±19.37 percentiles in men; p&lt;0.01). The identified psychosocial predictors are aimed at timely diagnosis and optimization of medical and psychological rehabilitation of patients with ANSD.

Quality of life in patients with autonomic nervous system disorder

The paper studied the quality of life (QOL) in individuals of an organized population of Petrozavodsk with autonomic nervous system disorder (ANSD) (n=104; mean age 37.64±5.8 years; gender index 1:1). The control group included healthy individuals (n=30; mean age 37.64±5.8 years; gender index 1:1; p=0.761). The Short Form-36 Quality of Life Scale was used, and a medical assessment of signs of autonomic nervous system disorders was carried out according to the method by A.M. Vein. It was found that patients with ANSD were characterized by a lower level of QOL compared to healthy individuals without gender differences (indicators in men/women: “Physical component of health (Physical health)” (PH) 44.7±5.41/40.72±6.28 (patients) and 58.37±1.8/57.25±1.96 points (control); “Psychological component of health (Mental health)” (MH) 36.69±5.56/35.48±6.94 (patients) and 56.53±2.67/54.78±1.98 points (control); p=0.001). The first ranking places in the decline of QOL were the decrease in “role physical functioning” (in the treatment of PH) and the reduction of “mental health” (in the treatment of MH). Moderate vegetative imbalance in men/women with ANSD (36.86±8.58/42.96±10.62 points according to the method by A.M. Vein, compared with the results of healthy individuals of 2±0.29/2.13±0.97 points; p=0.001) correlates with a decrease in PH (R = – 0.368) and MH (R = –0.572). The revealed patterns are aimed at optimizing the medical and psychological rehabilitation of patients with ANSD.

Congenital Central Hypoventilation Syndrome (Ondine’s Curse): Clinical Case

Background. Congenital central hypoventilation syndrome (CCHS), or Ondine’s Curse, is rare, incurable and life-threatening disease characterized by autonomic nervous system disorders, it manifests with disability to maintain ventilation function during sleep. Sensitivity to hypoxia and hypercapnia is reduced in case of CCHS, thus, it leads to recurrent episodes of deep apnea. The world literature describes just over 1000 cases of this disease. Clinical case description. An infant born at 37th week of gestation, weight of 3330 g, had episodes of apnea and hypercapnia from the first day of life. CCHS was suspected by the 28th day of life after excluding other causes of respiratory disorders, and it was genetically confirmed by the 43rd day of life — pathogenic variant of PHOX2B gene was revealed. Mechanical ventilation has been initiated by the age of 1 month after disease worsening. Analysis of CCHS cases published in Russian-language medical literature was performed. Typical symptoms and timing of their manifestation, as well as the time before correct diagnosis were mentioned. Conclusion. Symptoms that can be suggestive of CCHS presence early after birth and can urge to perform all the necessary genetic testing that are crucial for timely treatment onset and for minimizing the negative effect of hypoxemia and hypercapnia on the child are described.

Parameters of the autonomic nervous system and their interpretation in patients after acute myocardial infarction

In cardiovascular diseases, including coronary heart disease (CHD) and myocardial infarction (MI), there are pronounced changes in the myocardium and the associated reconfiguration of the autonomic nervous system (ANS) of the heart. This leads to the damage to both sympathetic and parasympathetic regulatory influences. Great attention is paid to activation of the sympathoadrenal system and a decrease in the activity of the parasympathetic division of the ANS, associated both with an increase in the general adaptation syndrome and with a major restructuring of the myocardium, which indicates an increase in electrical instability, a tendency to dangerous cardiac arrhythmias and an increased risk of cardiac death. ANS disorders lead to the damage to the parasympathetic and sympathetic systems. A disorder in the latter causes such complications as orthostatic tachycardia, changes in heart rate, anxiety disorders, panic attacks resembling, and sleep disturbance. Coronary heart disease is one of the predisposing factors for the occurrence of autonomic dysfunction.

Bidirectional thermo-regulating hydrogel composite for autonomic thermal homeostasis

Thermal homeostasis is an essential physiological function for preserving the optimal state of complex organs within the human body. Inspired by this function, here, we introduce an autonomous thermal homeostatic hydrogel that includes infrared wave reflecting and absorbing materials for improved heat trapping at low temperatures, and a porous structure for enhanced evaporative cooling at high temperatures. Moreover, an optimized auxetic pattern was designed as a heat valve to further amplify heat release at high temperatures. This homeostatic hydrogel provides effective bidirectional thermoregulation with deviations of 5.04 °C ± 0.55 °C and 5.85 °C ± 0.46 °C from the normal body temperature of 36.5 °C, when the external temperatures are 5 °C and 50 °C, respectively. The autonomous thermoregulatory characteristics of our hydrogel may provide a simple solution to people suffering from autonomic nervous system disorders and soft robotics that are susceptible to sudden temperature fluctuations.

Autonomic nervous system disorders in multiple sclerosis.

Multiple sclerosis (MS) is a chronic progressive demyelinating disease of the central nervous system (CNS), which also affects the autonomic nervous system (ANS). Manifestations of MS in the ANS include urological, sexual, gastrointestinal, cardiovascular, and thermoregulatory disorders as well as increased fatigue. These problems are common yet are often underestimated due to the non-specificity of the symptoms and the limited evaluation of the ANS in the usual clinical practice. Most of these symptoms seem to be related to localized lesions in the CNS. However, the mechanisms by which these disorders are caused in MS have not been fully investigated, thus preventing any focused etiological treatment. The most common disorders of the ANS in MS represent a challenge for clinicians due to the variability of the clinical picture and our minimal data on their diagnosis and treatment. Early diagnosis and initiation of individualized treatment regimens, often in need of multiple approaches, seem to yield the best results in managing ANS dysfunction in MS patients.

Синдром вегетативной дисфункции пациентов, перенесших COVID-19, на 3 этапе медицинской реабилитации

At the moment, post-COVID-19 syndrome is a poorly studied aspect of the past pandemic, the clinical signs of which largely coincide with the symptoms of autonomic dysfunction. When examining patients who underwent COVID-19, symptoms of the autonomic nervous system disorder are often revealed. The use of vegetative status assessment methods will allow detecting, confirming and adjusting a rehabilitation program for such patients. The purpose — to analyze the results of the vegetative status assessment in patients who underwent COVID-19, admitted to post-COVID rehabilitation. Material and methods. We examined 100 patients with a confirmed history of COVID-19 infection who were admitted for post- COVID-19 rehabilitation as part of stage 3 of medical rehabilitation. Results. Autonomic dysfunction was observed in two thirds of patients and corresponded to the complaints without correlation with clinical manifestations. The most common symptoms were asthenia and shortness of breath during exercise. After a comprehensive rehabilitation, positive dynamics was observed; however, residual phenomena requiring further correction persisted in patients with autonomic dysfunction. Conclusions. The data obtained confirmed that patients who underwent COVID-19 have chronic symptoms of post-COVID-19 syndrome associated with the autonomic system disorder.

New biomarkers for the assessment of fatigue evoked by long-term sleep deprivation based on pupillary light reflex using rheological models

BackgroundThe pupillary reflex (PLR) can be used to describe the function of individual segments of the visual pathway. It is modulated by the autonomic nervous system (ANS) and clinical disorders. The results of the research on the PLR parameterization methods presented in the article show that it is possible to use the phenomenon of pupil contraction as a result of light stimulation to assess the level of sleepiness. Currently, the PLR reflex is mainly used as the primary tool to study the integrity of the sensory and motor functions of the eye. Emergency medicine physicians routinely test the pupil light reflex to assess brainstem function. MethodsThe study utilized a method for estimating the fatigue level caused by 48-hour sleep deprivation under standardized and controlled conditions through the development and implementation of the Kelvin-Voigt rheology model (KV), explaining the dynamics of the pupillary light reflex. The baseline parameters for the model were as follows: parasympathetic force (fp), sympathetic force (fs), pupil radius in rest conditions (r0), onset time: parasympathetic system (tp), onset time: sympathetic system (ts), product fp × tp and product fs × ts. These parameters were subject to a statistical analysis of variance and compared with the parameters determined by the pupillographic assessment system by AmTech, such as contraction velocity (CV), relative amplitude (RA), pupil diameter (DDil1-fast), pupil diameter (DDil2-slow), latency (Lat), time of minimum diameter (TMD), contraction time (CT), redilation time (RT). ResultsThe statistical analysis involved the data obtained in the research experiment on a group of 18 healthy volunteers enrolled in our study (range 26–32 years, fifty percent of the study group were female). Based on the parameters from the KV model developed, the statistical significance for the model indicators was determined, i.e, fp, r0, tp, ts and fp × ts, compared at different levels of sleep deprivation of 48 h. In addition, analysis of the determined indicators, via the AmTech pupillographic system, demonstrated that an increased level of sleep deprivation does not only result in a change in the slope and amplitude of the curve of the pupil diameter in the contraction phase, which is visualized by the CV, RA, CT parameters, but also in the pupil dilation curve shape (Dil1-fast, Dil2-slow, RT). Sleep deprivation was observed to cause an increase of TMD and Lat. Correlation analysis presented the strongest correlations between fp and the contraction velocity r = 0.73 (p < 0.05) and the minimum pupil diameters as expressed by the RA values: 0.66 (p < 0.05). The force fp, originating from the parasympathetic system, was correlated with redilation time – i.e., the larger the force, the shorter the time: −0.52 (p < 0.05). It also affected the value of the pupil diameter at the end of dilatation (DDil2-slow) r = 0.49 (p < 0.05).The delay in the force tp, originating from the parasympathetic nervous system (PNS), increased the duration of pupil contraction time. In this case, the correlation coefficient was r = 0.73 (p < 0.05). This was also facilitated by a delay (ts) on the part of the sympathetic nervous system (SNS), leading to a delay in dilatation and thus facilitating unrestrained pupil constriction. The correlation coefficient was r = 0.7 (p < 0.05).The controlled level of sleepiness, assessed via the Stanford Sleepiness Scale (SSS) test, had increased by about 150% by the end of the experiment. ConclusionThe results of the studies indicate that the fatigue biomarkers, as determined during the pupil dilation phase (DDil1-fast, DDil2-Slow), as well as the new method for describing the dynamics of the PLR, can provide an effective and specific indicator of sleepiness levels. These results are also confirmed by an analysis of the Stanford Sleepiness Scale assessment results.In addition, the use of the KV rheological model to describe the curve of the pupillary reflex makes it possible, through the designated parameters of the model, to independently assess the sympathetic (fs, ts) and parasympathetic (tp, tp) activation of the autonomic nervous system.

Clinical autonomic nervous system laboratories in Europe: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies: A joint survey of the European Academy of Neurology and the European Federation of Autonomic Societies.

Disorders of the autonomic nervous system (ANS) are common conditions, but it is unclear whether access to ANS healthcare provision is homogeneous across European countries. The aim of this study was to identify neurology-driven or interdisciplinary clinical ANS laboratories in Europe, describe their characteristics and explore regional differences. We contacted the European national ANS and neurological societies, as well as members of our professional network, to identify clinical ANS laboratories in each country and invite them to answer a web-based survey. We identified 84 laboratories in 22 countries and 46 (55%) answered the survey. All laboratories perform cardiovascular autonomic function tests, and 83% also perform sweat tests. Testing for catecholamines and autoantibodies are performed in 63% and 56% of laboratories, and epidermal nerve fiber density analysis in 63%. Each laboratory is staffed by a median of two consultants, one resident, one technician and one nurse. The median (interquartile range [IQR]) number of head-up tilt tests/laboratory/year is 105 (49-251). Reflex syncope and neurogenic orthostatic hypotension are the most frequently diagnosed cardiovascular ANS disorders. Thirty-five centers (76%) have an ANS outpatient clinic, with a median (IQR) of 200 (100-360) outpatient visits/year; 42 centers (91%) also offer inpatient care (median 20 [IQR 4-110] inpatient stays/year). Forty-one laboratories (89%) are involved in research activities. We observed a significant difference in the geographical distribution of ANS services among European regions: 11 out of 12 countries from North/West Europe have at least one ANS laboratory versus 11 out of 21 from South/East/Greater Europe (p= 0.021). This survey highlights disparities in the availability of healthcare services for people with ANS disorders across European countries, stressing the need for improved access to specialized care in South, East and Greater Europe.

Non-invasive diagnostic methods for fatal familial insomnia

&#x0D; Fatal familial insomia (FFI) is a dominant autosomal genetic prion disease characterised by progressive sleep impairment, autonomic nervous system disorders and motor symptoms associated with significant loss of nerve cells in the medial thalamic nuclei.&#x0D; &#x0D; &#x0D; Making a diagnosis of FFI requires the presence of a certain or probable recognised first-degree relative of the patient, together with neuropsychiatric disorders present. In turn, the detection of the PrP mutation allows the diagnosis to be definitively established. In addition, three other tests - polysomnography, brain imaging and cerebrospinal fluid examination - can be helpful. &#x0D; &#x0D; &#x0D; Fatal familial insomnia is not a fully understood disease. Diagnosis is based on the presence of symptoms of the disease. An important step in diagnosis will be the development of non-invasive diagnostic tests that are reliable in the early and presymptomatic stages of the disease. Polysomnography, imaging studies (PET, SPECT) and cerebrospinal fluid examination should be improved and widely accepted.&#x0D;

Preterm birth: the impact of risk factors on pregnancy outcomes

BACKGROUND: Despite the achievements of modern obstetrics and neonatology, the problem of preterm birth remains one of the most pressing.&#x0D; AIM: The aim of this study was to evaluate the influence of risk factors on the outcome of threatened preterm birth.&#x0D; MATERIALS AND METHODS: This prospective cohort study included the analysis of clinical and anamnestic data of 130 patients delivered at various gestational ages. The main group comprised 68 women with preterm delivery, with the control group consisting of 62 women with timely delivery.&#x0D; RESULTS: The outcome of preterm birth is adversely affected by overweight in the group of modifiable risk factors, by history of premature birth in the immediate family in the group of non-modifiable risk factors, and by a previous COVID-19, anemia and autonomic nervous system disorders in the group of potentially modifiable risk factors. The most reliable prognostic marker for the development of preterm labor was the shortening of the cervical length of less than 2.5 cm according to ultrasound.&#x0D; CONCLUSIONS: The formation of risk groups based on the analysis of clinical, anamnestic, medical, and social data, as well as somatic and gynecological diseases can help avoid the development of adverse outcomes of preterm birth.

Indicators of Immune and Neurohumoral Profile in Women of Fertile Age with Functional Disorders of the Autonomic Nervous System Associated with Polymorphic Variants of the HTR2A (rs7997012) and TP53 (rs1042522) Genes.

In women of fertile age with functional disorders of the autonomic nervous system (ANS), a complex of indicators of the immune and neurohumoral profile associated with polymorphic variants of the HTR2A (rs7997012) and TP53 (rs1042522) genes was revealed. In patients with the diagnosis "G90.8. Other disorders of the autonomic nervous system", the neurohumoral profile is characterized by excessive content of cortisol and serotonin (p<0.05), which indicates the development of the hypersympathicotonic variant of autonomic regulation disorders. The cellular immune profile in the examined individuals was characterized by a significant decrease in the content of CD3+CD4+ and CD3+CD8+ lymphocytes (p<0.05). At the same time hyperactivation of the humoral immune response was observed. In particular, we revealed enhanced production of IgG and IgM antibodies accompanied by increased count of CD19+ lymphocytes (p<0.05), which characterized clinical and laboratory manifestations of the asthenic syndrome. The women with ANS disorders had increased frequency of the G allele (OR=3.00; 95%CI 1.20-7.47) and GG genotype (OR=3.91; 95%CI 1.00-15.24) of the HTR2A (rs7997012) serotonin receptor gene, as well as the G allele (OR=1.93; 95%CI 1.04-3.57), CG genotype (OR=2.38; 95%CI 1.02-5.53) and the GG genotype (OR=1.48; 95%CI 0.42-5.24) of the TP53 (rs1042522) oncosuppressor protein gene (p<0.05). The polymorphic G allele and GG genotype variants of candidate genes (HTR2A (rs7997012) and TP53 (rs1042522) genes) in women with ANS pathology are associated with an imbalance of the neurohumoral (excess of cortisol and serotonin) and immune regulation (deficiency of the CD3+CD4+ and CD3+CD8+, excess of CD19+, IgG and IgM). These parameters form a complex of the immune, neurohumoral, and genetic profile indicators in women of fertile age that characterize functional disorders of ANS manifestations by hypersympathicotonic type with an asthenic component.

Effects of Inhalation of Essential Oil From Pelargonium graveolens on the Autonomic Nervous System of Awake Mice

Autonomic nervous system disorders have many causes, and thus, no effective remedy for these disorders has been established. In this study, we conducted animal experiments with essential oil from Pelargonium graveolens (EOPG, geranium essential oil), which may regulate the autonomic nervous system. EOPG was administered to awake mice by inhalation. Heart rate variability (HRV) was analyzed from the pulse wave of the mice on an elevated platform, and the ratio of sympathetic to parasympathetic nerve activity was determined. The results showed that inhalation of EOPG did not affect the heart rate but made activity of the parasympathetic nervous system dominant. This effect was thought to be due to linalool, a component of EOPG that was transferred into the brain and body.

Pattern Changes in the Heart Rate Variability of Patients Undergoing Coronary Artery Bypass Grafting Surgery.

Introduction Coronary artery bypass grafting (CABG) with extracorporeal circulation is a key therapy for coronary artery disease (CAD). However, cardiovascular events and cardiac arrhythmias may still occur in these patients following surgery. Many studies have demonstrated a correlation between cardiac arrhythmias and heart rate variability (HRV). This study aimed to establish the temporal change pattern of HRV observed following CABG. Methods A prospective method was used to study 119 consecutive patients with stable CAD who were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months after the surgery at Hanoi Heart Hospital from June 2016 to August 2018. Main results: All the time-domain and frequency-domain parameters of HRV decreased precipitately after CABG and were mostly recovered 3 months postoperatively. The percentage of decreased HRV before surgery was 28.6% and 51.8% after 7 days, 19.6% after 3 months, and 12.7% after 6 months. ASDNN and SDNN before and after surgery had the highest rates of change. Conclusion The early decrease in HRV observed 7 days after CABG may be related to the acute effects of the surgery. The recovery of HRV at 3 months after surgery, regardless of the preoperative state of the patients, implies that the autonomic nervous system (ANS) disorder may be improved at this time. At 6 months after surgery, the autonomic nervous injury was recovered in combination with improvement of reperfusion, resulting in improvement in almost all HRV indices compared with those indices preoperatively.