Vegetative System Research Articles

Sex Differences in the Neuroendocrine Stress Response: A View from a CRH-Reporting Mouse Line

Corticotropin-releasing hormone (CRH) neurons within the paraventricular hypothalamic nucleus (PVH) play a crucial role in initiating the neuroendocrine response to stress and are also pivotal in coordination of autonomic, metabolic, and behavioral stress reactions. Although the role of parvocellular CRHPVH neurons in activation of the hypothalamic–pituitary–adrenal (HPA) axis is well established, the distribution and function of CRH-expressing neurons across the whole central nervous system are less understood. Stress responses activate complex neural networks, which differ depending on the type of stressor and on the sex of the individual. Because of the technical difficulties of localizing CRH neurons throughout the rodent brain, several CRH reporter mouse lines have recently been developed. In this study, we used Crh-IRES-Cre;Ai9 reporter mice to examine whether CRH neurons are recruited in a stressor- or sex-specific manner, both within and outside the hypothalamus. In contrast to the clear sexual dimorphism of CRH-mRNA-expressing neurons, quantification of CRH-reporting, tdTomato-positive neurons in different stress-related brain areas revealed only subtle differences between male and female subjects. These results strongly imply that sex differences in CRH mRNA expression occur later in development under the influence of sex steroids and reflects the limitations of using genetic reporter constructs to reveal the current physiological/transcriptional status of a specific neuron population. Next, we compared the recruitment of stress-related, tdTomato-expressing (putative CRH) neurons in male and female Crh-IRES-Cre;Ai9 reporter mice that had been exposed to predator odor. In male mice, fox odor triggered more c-Fos in the CRH neurons of the paraventricular hypothalamic nucleus, central amygdala, and anterolateral bed nucleus of the stria terminalis compared to females. These results indicate that male mice are more sensitive to predator exposure due to a combination of hormonal, environmental, and behavioral factors.

Could piano music therapy alleviate high sinus rhythm in subjects with controlled hypertension?

Abstract Background/Introduction With a millenary tradition, music is rediscovered nowadays, as adjuvant therapy. The number of beats per minute (bpm) is the common factor of cardiology – representing heart rate (HR), and music – reprezentative for tempo. Purpose Our goal was the HR modulation in patients (pts) with moderate tachycardia using three piano kits: K1 – Adagio by Albinoni, K2 – Piano Concerto nr. 21 by Mozart, second part; and K3 – Liebestraum by Liszt. Methods During 1st January – 31st December 2023, we identified by ambulatory screening 288 pts adequate for our goal. As exclusion criterion, we considered any type of rhythm or conduction dysturbances. All selected pts were controlled with antihypertensive agents not altering HR, usually thiazide/thiazide-like diuretics and/or ACEis/ARBs. The study group consisted in 144 hypertensive pts controlled at least six months, without any other cardiac diseases. The control group consisted in 144 pts with normal cardiologic examination. Both groups were demographically balanced. The HR at admission was between 84 and 120 bpm, the pts being stratified in three bpm subcategories. All pts have done three visits consisting in: physical examination, ECG, lab markers, TTE for V1 at initiation and EoS at six months, and respectively, physical exam and ECG for V2 at 3 months. Results (in bpm): Inside the group with HR 84-96 treated with K1, the Controlled HTN group (CHG) and the Normal Cardiac group (NCG) alleviated HR from 85,8 +/- 12,6 to 82,6 +/- 12,2; and from 85,7 +/- 12,6 to 80,8 +/- 11,9, respectively. For pts inside the interval 97-108 treated with K1, the CHG group and the NCG alleviated HR from 94,3 +/- 14,1 to 90,9 +/- 13,7 and, respectively, from 94,4 +/- 14,1 to 89,7 +/- 13,6. In pts from HR spectrum 97-108 treated with K2, the CHG and the NCG alleviated HR from 98,4 +/- 14,6 to 95,7 +/- 14,1; and from 98,5 +/- 14,6 to 94,1 +/- 13,8; respectively. Inside the group with HR spectrum 109-120 treated with K1, the CHG and the NCG alleviated HR from 97,1 +/- 14,3 to 94,8 +/- 13,9; and, respectively, from 97,0 +/- 14,3 to 93,9 +/- 13,7. For pts inside the interval 109-120 treated with K2, the CHG and the NCG alleviated HR from 101,7 +/- 14,6 to 99,3 +/- 14,2; and from 101,8 +/- 14,6 to 97,3 +/- 14,1; respectively. In pts from HR spectrum 109-120 treated with K3, the CHG and the NCG alleviated HR from 106,1 +/- 14,7 to 103,8 +/- 14,6; and from 106,5 +/- 14,4 to 103,6 +/- 14,4; respectively. Conclusions The effect of piano music on HR seems favorable in controlled hypertensive pts without major comorbidities, probably by interfering the sympathetic vegetative nervous system. In this regard, it could be used as adjuvant in optimizing this cardiac parameter. However, a multicentered randomized clinical study will be needed.

Overgeneralization of autonomic defensive reactions in obesity

Generalizing defensive responses to new stimuli resembling learned threats is an adaptive process within an ever-changing environment. However, evaluation mechanisms excessively biased toward generalization (i.e., overgeneralization) may underlie anxiety-related symptoms. In the context of obesity, fear memory and fear generalization processes have never been investigated. In this study, participants with obesity and healthy participants as controls underwent a single-cue auditory fear conditioning paradigm and recognition memory tasks. We analyzed the autonomic reactions evoked by threat-predictive and new stimuli, as well as the recognition performance towards the same cues. We found that participants with obesity displayed similar autonomic defensive responses to a learned fearful stimulus, but enhanced reactions to new stimuli, when compared with the controls. We detected no significant differences between groups in recognition abilities. Our results provided the first evidence that obesity may widen fear generalization patterns. This alteration may encourage future research in investigating the link between emotional dysregulation and clinical anxiety-related symptoms in obesity.

Perioperative Use of Intravenous Lidocaine Infusion to Decrease Postoperative Opioids in Colorectal Surgery: A Randomized Prospective Study

Pain is defined as an unpleasant sensory and emotional sensation provoked by real tissue damage and manifested by autonomic, psychological, and behavioral reactions. Improvement of postoperative pain control remains a significant challenge among clinicians. 40 patients aged 30-60 years, ASA 1-2 scheduled for colorectal surgery, were divided into two groups 20 patients each. Lidocaine group: (n= 20) received bolus intravenous lidocaine 20 min before incision with a dose of 1.5mg/kg followed by lidocaine infusion with a dose of 1.5mg/kg/h. Control group: (n= 20) receive intravenous lidocaine only. After premedication with a bolus dose of lidocaine at induction, the heart rate was lower in the interventional group compared with the control one until 12 hours post-operatively, then returned to be equal by 24 hours. Between recovery and one hour postoperative, intraoperative serial differences were significant only for the intervention group. After premedication and during the operation until 24 hours, postoperative mean blood pressure was significantly higher among controls. This returns to be equal by 48 hours and beyond. The postoperative VAS score and analgesic requirements were significantly lower in the lidocaine infusion group. Perioperative lidocaine infusion provides analgesia, low pain score, and decreases postoperative opioid consumption in laparoscopic colorectal surgery.

Heart Rate Variability and Global Longitudinal Strain for Prognostic Evaluation and Recovery Assessment in Conservatively Managed Post-Myocardial Infarction Patients.

Background: Heart rate variability (HRV) is the fluctuation in the time intervals between adjacent heartbeats. HRV is a measure of neurocardiac function that is produced by dynamic autonomic nervous system (ANS) processes and is a simple measure that estimates cardiac autonomic modulation. Methods: The study included 108 patients admitted to the Coronary Intensive Care Unit with acute myocardial infarction (AMI) who did not undergo primary percutaneous transluminal coronary angioplasty (PTCA) or systemic thrombolysis and followed conservative management. All patients underwent detailed clinical, biological, and paraclinical assessments, including evaluation of HRV parameters and echocardiographic measurements. The analysis of RR variability in both time and frequency domains indicates that the negative prognosis of patients with AMI is associated with an overall imbalance in the neuro-vegetative system. The HRV parameters were acquired using continuous 24 h electrocardiogram (ECG) monitoring at a baseline, after 1 month, and 6 months. Results: Our analysis reveals correlations between alterations in HRV parameters and the increased risk of adverse events and mortality after AMI. The study found a significant improvement in HRV parameters over time, indicating better autonomic regulation post-AMI. The standard deviation of all RR intervals (SDNN) increased significantly from baseline (median 75.3 ms, IQR 48.2-100) to 1 month (median 87 ms, IQR 55.7-111) and further to 6 months (median 94.2 ms, IQR 67.6-118) (p < 0.001 for both comparisons). The root mean square of successive difference of RR (RMSSD) also showed significant increases at each time point, from baseline (median 27 ms, IQR 22-33) to 1 month (median 30.5 ms, IQR 27-38) and from 1 month to 6 months (median 35 ms, IQR 30-42) (p < 0.001 for all comparisons), indicating enhanced parasympathetic activity. Moreover, changes in HRV parameters have been associated with impaired left ventricle ejection fraction (LVEF) and global longitudinal strain (GLS), indicating a relationship between autonomic dysfunction and myocardial deformation. GLS values improved from a baseline median of -11% (IQR 5%) to -13% (IQR 4%) at 6 months (p < 0.001), reflecting better myocardial function. Conclusions: HRV parameters and cardiac performance analysis, especially using GLS, offer a solid framework for evaluating recovery and predicting adverse outcomes post-MI.

The Physical Sensation of Precordial Pain as a Signal of Psychiatric Relevance of Anguish

Anguish is a sensation of precordial chest tightness or oppression that has an emotional origin. Unlike anxiety which is focused on the future, anguish is experienced in the present as a state of pain and mental agony. Furthermore, distress is supposed to have different autonomic, physiological and biochemical reactions when compared to anxiety and depression. The main objective of this work is to investigate whether depression is more related to anguish than anxiety, and also to identify which variables or symptoms are most predictive of the state of anguish. A binomial logistic regression model was adjusted and statistically significant evidence was found that depression may be more related to distress than anxiety. An important depression diagnostic variable (MINI Depression) was selected in the model (at the 10% level) and its interpretation corroborates the central hypothesis of the study mentioned above. Correspondence analysis also points to clues in the direction of the research hypothesis. As for the second objective, under the same logistic model, the following variables were shown to be related to the state of distress: Gender, Reduced Hamilton Score, BSI Somatization, BSI Hostility, BSI Obsession Compulsion, Age and MINI Depression.

Pupil contagion variation with gaze, arousal, and autistic traits

Pupillary contagion occurs when one’s pupil size unconsciously adapts to the pupil size of an observed individual and is presumed to reflect the transfer of arousal. Importantly, when estimating pupil contagion, low level stimuli properties need to be controlled for, to ensure that observations of pupillary changes are due to internal change in arousal rather than the external differences between stimuli. Here, naturalistic images of children’s faces depicting either small or large pupils were presented to a group of children and adolescents with a wide range of autistic traits, a third of whom had been diagnosed with autism. We examined the extent to which pupillary contagion reflects autonomic nervous system reaction through pupil size change, heart rate and skin conductance response. Our second aim was to determine the association between arousal reaction to stimuli and degree of autistic traits. Results show that pupil contagion and concomitant heart rate change, but not skin conductance change, was evident when gaze was restricted to the eye region of face stimuli. A positive association was also observed between pupillary contagion and autistic traits when participants’ gaze was constrained to the eye region. Findings add to a broader understanding of the mechanisms underlying pupillary contagion and its association with autism.

Eye Movements and Autonomic Regulation of Cognitive Activity during Reading in Adolescence. Part I. Functional “Cost” of Cognitive Activity when Reading Text from the Screen in Adolescence

Reading from the screen of an electronic device (ED) is a significant cognitive activity for adolescences, and its complexity affects visceral functions. We conducted an analysis of the heart rate variability (HRV) and eye movements (EM) in adolescents while they were reading complex text on an ED screen. The aim was to assess the functional state characteristics under these conditions and reveal the intensity (“cost”) associated with this activity The study involved 22 adolescences with an average age of 15 years (М = 15.46, SD = 0.44). Reading text from an ED screen in adolescents was associated with a high functional “cost,” characterized by a decrease in overall HRV, an increase in the tension index and heart rate. These changes indicate the functional tension of regulatory systems during cognitive activity. The study revealed varying levels of parafoveal processing involvement. For the majority of adolescents (86.4%), word-by-word reading and a low percentage of regressions (12.0%) were observed, suggesting developed average reading skill. However, a qualitative analysis of individual EM tracks indicated varying level of reading skill development among adolescents, possibly due to a limited vocabulary and a lack of understanding of syntax. Additionally, 40.9% of adolescents demonstrated poor text comprehension. Our results showed that reading remains a complex cognitive task for adolescents, despite the expectation that their reading skills should be well-developed and automated by this age. Individual analysis of HRV and EM in adolescents with varying levels of text comprehension during reading demonstrated different strategies of adaptive behavior and autonomic reactions when performing a complex cognitive task. The functional “cost” of information processing when reading text from the ED screen results from a combination of age-related and individual adaptation characteristics, language competence and the psycholinguistic complexity of the text.

Brain Perception of Different Oils on Appetite Regulation: An Anorectic Gene Expression Pattern in the Hypothalamus Dependent on the Vagus Nerve.

(1) Background: We examined the effect of the acute administration of olive oil (EVOO), linseed oil (GLO), soybean oil (SO), and palm oil (PO) on gastric motility and appetite in rats. (2) Methods: We assessed food intake, gastric retention (GR), and gene expression in all groups. (3) Results: Both EVOO and GLO were found to enhance the rate of stomach retention, leading to a decrease in hunger. On the other hand, the reduction in food intake caused by SO was accompanied by delayed effects on stomach retention. PO caused an alteration in the mRNA expression of NPY, POMC, and CART. Although PO increased stomach retention after 180 min, it did not affect food intake. It was subsequently verified that the absence of an autonomic reaction did not nullify the influence of EVOO in reducing food consumption. Moreover, in the absence of parasympathetic responses, animals that received PO exhibited a significant decrease in food consumption, probably mediated by lower NPY expression. (4) Conclusions: This study discovered that different oils induce various effects on parameters related to food consumption. Specifically, EVOO reduces food consumption primarily through its impact on the gastrointestinal tract, making it a recommended adjunct for weight loss. Conversely, the intake of PO limits food consumption in the absence of an autonomic reaction, but it is not advised due to its contribution to the development of cardiometabolic disorders.

#1972 Changes in vegetative hemodynamic relationship in the comorbid state of patients with respiratory pathology

Abstract Background and Aims The parameters of the vegetative nervous system (VNS) and its relationship with the function of the central and renal vessels in patients with bronchial asthma (BA) in comorbidity with glomerular filtration dysfunction of the kidneys were studied and the above-mentioned indicators of complex treatment regimens were determined. Since the tension of neuropsychiatric predictors negatively affects the state of hemodynamics and internal organs directly of the VNS. The constant hyperactivity of this system due to chronic inflammatory processes is the starting point of vegetative imbalance. Method 68 patients with comorbidity with glomerular filtration dysfunction of the kidneys and 30 healthy individuals were examined. Studies were conducted in 36 patients with BA grade II-III (group 1, in which the level of glomerular filtration rate of the kidneys was determined by eGFRCKD-EPI ≥6 ml/min/1.73 m2) and 32 patients with BA grade IV (group 2, they were determined by eGFRCKD-EPI ≥60 ml/min/1,73m2). The functional state of the peripheral VNS was studied by cardiointervalography (CIG) using methods of mathematical analysis of indicators: Mode (Mo, sec.) and mode amplitude (AMo, %); Vasodilation of dependent endothelium (VDE) was determined by hyperreactive brachial artery Dopplerography test: maximum systolic velocity (Vmax) and vascular resistance index (IR). Results On the first day of admission to the hospital, patients were examined by the VNS meth, where eitonia and vagotonia were detected in practically healthy people, and hypersympathicotonia was determined in patients with BA with disorders of central and renal hemodynamics. A significant decrease in Mo parameters and an increase in AMo levels were analyzed when compared with the reference parameters of healthy individuals. This reflects the tension of the sympathetic department, and parasympathicotonia, on the contrary, decreased. There is a decrease in the ability of PA vessels to actively vasodilate due to an imbalance in the tone of the VNS. In the results of the hyperemic test, it was analyzed that in patients with BA in comorbidity with glomerular filtration dysfunction of the kidneys, the Vmax of blood flow decreases, and IR increases in parallel with the severity of the disease. All patients underwent complex therapy with halotherapy for 20 minutes daily and resonance therapy for the area of both kidneys for 5 minutes of exposure, once a day, for 10 days. After the course of treatment, there was a positive dynamics in the functional parameters of the state of the VNS. The indicators of CIG were analyzed, where hypaticotonia decreased by 6.7%, and the parameters of the parasympathetic system improved to 5.3%. Conclusion At the heart of the elevation of maladaptive processes of chronic respiratory inflammation, hypoxia of brain structures and dysfunctions of glomerular filtration of the kidneys, vegetovisceral imbalance develops. The regimens of complex therapy have a positive effect, both anti-inflammatory at the visceral level and a calming effect on the VNS.

Posterior cingulate epilepsy: Seizure semiology and intracranial electrical stimulation using SEEG

PurposeThis study aimed to explore seizure semiology and the effects of intracerebral electrical stimulation on the human posterior cingulate cortex (PCC) using Stereoelectroencephalography (SEEG) to deepen our comprehension of posterior cingulate epilepsy (PCE). MethodsThis study examined the characteristics of seizures through video documentation, by assessing the outcomes of intracranial electrical stimulation (iES) during SEEG. We further identified the connection between the observed semiology and precise anatomical locations within the PCC subregions where seizure onset zones (SOZ) were identified. ResultsAnalysis was conducted on 59 seizures from 15 patients recorded via SEEG. Behavioural arrest emerged as the predominant manifestation across the PCC subregions. Where ictal activity extended to both the mesial and lateral temporal cortex, automatism was predominantly observed in seizures originating from the ventral PCC (vPCC). The retrosplenial cortex (RSC) is associated with complex motor behaviour, with seizure discharges spreading to the temporal lobe. Seizures originating from the PCC include axial tonic and autonomic seizures. Only one case of positive clinical seizures was documented. High frequencies of iES within the PCC induced various clinical responses, categorised as vestibular, visual, psychological, and autonomic, with vestibular reactions primarily occurring in the dorsal PCC (dPCC) and RSC, visual responses in the left RSC, and autonomic reactions in the vPCC and RSC. ConclusionThe manifestations of seizures in PCE vary according to the SOZ and the patterns of seizure propagation. The occurrence of seizures induced by iES is exceedingly rare, indicating that mapping of the PCC could pinpoint the primary sector of PCC.

Autonomic Activities in Cases of Post-traumatic Stress Disorder Through Virtual Reconstruction of Trauma

Background: In Iran, one of the main duties of forensic psychiatrists is to accurately diagnose post-traumatic stress disorder (PTSD). In order to achieve a more accurate diagnosis and reduce the possibility of deception, the autonomic reactions of patients with PTSD were investigated through virtual reconstructed trauma. Methods: The autonomic activities of 80 patients who were diagnosed with PTSD by psychiatric interview based on the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) and PTSD checklist for DSM-5 (PCL-5) checklists, were recorded by an electronic wristband through virtual trauma exposure. Data were collected and analyzed by SPSS software, version 16. Results: The galvanic skin response, heart rate, and body temperature can be the most reliable automatic reactions to diagnose true cases of PTSD. Conclusion: The findings of this study along with psychometric tests can be used to distinguish between true cases of PTSD and fake cases.

Psychophysiological Responses to High-Intensity Interval Training Exercise over Menstrual Cycle Phases: An Exploratory Study.

Although there is potential for the menstrual cycle to impact psychophysiological responses to exercise, there has been a paucity of studies investigating this aspect, specifically in the context of high-intensity interval training (HIIT). This exploratory study aimed to examine the psychophysiological responses to HIIT over the menstrual cycle. Twenty-three healthy and physically active young women were recruited. Each woman completed a cycle ergometer HIIT session in the menstrual, follicular, and luteal phases of the menstrual cycle in a random order. Psychophysiological variables of interest were collected at baseline, and during and after exercise. Primary variables of interest were anxiety, mood, motivation, enjoyment, arousal, affect, and menstrual distress. Higher pain, water retention, behavior change (related to social interactions, eating habits, and self-performance), and autonomic reactions (consisting of nausea, dizziness, hot flashes, and cold sweats) were observed before HIIT during the menstrual phase compared with the follicular phase ( P < 0.05). Participants exhibited worse psychological responses to HIIT sessions during the menstrual phase, followed by the luteal phase. Findings also noted participants arrived to the laboratory with lower motivation to initiate HIIT sessions during the luteal and menstrual phases compared with the follicular phase. This difference was observed before and during HIIT. Motivation and depressive symptoms showed a significant reduction from pre-HIIT to post-HIIT ( P < 0.05), regardless of menstrual phase. The findings revealed that the menstrual cycle had a significant impact on psychophysiological responses. Moreover, HIIT could be adopted to improve motivation and depressive symptoms; however, further research is needed to explore the effects of HIIT across the menstrual cycle in women with clinical depression.

75 Inflammation and post-tx sickness syndrome as an explanation for late effects

The changing epidemiology of head and neck cancer, with an increase in HPV-positive oropharyngeal cancers and the refinement of a multidisciplinary approach, has led to an increase in the prevalence of long-term survivors after treatment. Consequently, a higher proportion of patients are suffering from late effects of the treatments, temporally defined as effects occurring or persisting more than 3 months after the end of the treatments. These late toxicities consist both of locoregional problems and systemic syndromes, with an impact on patients’ quality of life.There is still limited knowledge about the precise causes of these late toxicities, and at the same level, we lack predictive factors able to identify patients at higher risk of late effects. Treatment combinations with surgery followed by (chemo)radiation or with chemotherapy added to radiation with a radiosensitizing effect increase the probability of suffering from the late consequences of the same therapies. Pain, swallowing difficulties, trismus, osteonecrosis, dental disorders, mucositis, xerostomia or sticky saliva, hoarseness, lymphedema, and fibrosis are the most reported symptoms and signs, while fatigue, anxiety, depression, and cognitive impairment are the counterparts at the systemic level.There is growing evidence for the role of inflammation in the progression of cancer and treatment-related side effects. However, for head and neck cancer patients, there are still a lot of unanswered questions related to the role of inflammation as being both related to cancer disease and to the consequences of the intensive treatments carried out for this disease. In particular, it is well known that pro-inflammatory cytokines have been shown to be activated by malignant tumors and cancer treatment, and that their level during treatment is linked to higher acute toxicities. Also, the level of pro-inflammatory cytokines such as interleukin (IL)-1 beta (IL-1β), IL-6, IL-8, and tumor necrosis factor (TNF) has been correlated to higher mucositis, dysphagia, and pain due to the acute toxic effect of chemoradiation. However, researchers have not yet proven the association between the level of proinflammatory cytokines in the acute phase of the treatment and the development of late toxicities. Even the role of the same pro-inflammatory mediators in the follow-up period has a conflicting correlation with the late toxicities reported by the patients. Chronic inflammation may cause fibrosis, one of the key pathological features of radiation-induced late effects such as dysphagia and transforming growth factor beta (TGF-β) and TNF are involved in the formation of fibrosis in irradiated tissue. There is even more debate about the cause of systemic symptoms after cancer treatment. Head and neck cancer patients may develop the post-treatment sickness syndrome, consisting of chronic fatigue, mood alteration, cognitive impairment, and sleep problems, among the most frequently reported symptoms. The neuro-behavioral sickness model recapitulates all these symptoms as being related to the stress induced by the treatment, causing alterations in mood, cognition, nutritional intake, and the neurovegetative system. One of the hypotheses is that activation of peripheral pro-inflammatory cytokine networks transmits signals to the brain, which promote sickness behavior. The tissue damage induced by the oncological treatments would result in a self-perpetuating activation of biological processes, leading to a persistent inflammation condition that results in worsening systemic late effects over time. However, this theory needs to be carefully validated with prospective studies exploring patient-reported outcomes and their correlation with inflammatory mediators. According to this model, if inflammation recapitulates the locoregional and systemic late toxicities induced by the treatments, research should lead efforts to find ways to counteract it. From one side, it is possible to define de-escalating treatments that could offer the same level of cancer control with a reduced burden of acute and late toxicities. This is particularly awaited in HPV-positive cancer patients, who are usually younger patients, obtaining higher survival rates and thus a higher impact of toxicities on quality of life. On the other hand, it is important to define specific protocols to reduce the impact of inflammation in the long-term. In this regard, the role of physical exercise has been clearly underestimated, and recent research has shown benefits for the survival and quality of life of head and neck cancer patients. Also, even with less scientific evidence, nutrition could offer a less inflamed systemic status that could help minimize the late effects of cancer treatment. It is clear that research in this field is in its infancy, and we need to put more efforts into defining the translational correlates of late toxicities and exploring new ways to counteract the post-treatment sickness syndrome.

Comparative multimodal sensory testing in multifocal motor neuropathy and multifocal variant of chronic inflammatory demyelinating polyradiculoneuropathy

Comparative multimodal sensory testing in multifocal motor neuropathy and multifocal variant of chronic inflammatory demyelinating polyradiculoneuropathy

Effectiveness of osteopathic manipulative applications on hypothalamic-pituitary-adrenal (HPA) axis in youth with major depressive disorder: a randomized double-blind, placebo-controlled trial.

Osteopathic treatments regulate the neurovegetative system through joint mobilizations and manipulations, and myofascial and craniosacral techniques. Despite the growing body of research, the precise impact of osteopathic medicine on the autonomic nervous system (ANS) is not yet fully elucidated. As to Kuchera's techniques, the stimulation of the sympathetic trunk and prevertebral ganglia contributed to harmonization of the sympathetic activity. However, potential relationships between the harmonization of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis largely remain uncertain and warrant further exploration. This study was designed to evaluate the effectiveness of the osteopathic sympathetic harmonization (OSH) on the SNS and the HPA axis in youth with major depressive disorder (MDD). The study included 39 youths aged 15-21 years and diagnosed with MDD. The participants were randomly assigned into either the OSH or the placebo group. Stimulation was performed on the sympathetic truncus and prevertebral ganglia in the OSH group. The stimulation of the placebo group was performed with a lighter touch and a shorter duration in similar areas. Each participant completed the Beck Depression Inventory (BDI) and the State and Trait Anxiety Inventory (SAI and TAI) before the application. Blood pressure (BP) and pulse measurements were made, and saliva samples were taken before, immediately after, and 20 min after application. The baseline BDI (p=0.617) and TAI (p=0.322) scores were similar in both groups. Although the SAI scores decreased in both groups postintervention, no statistically significant difference was found between the two groups. Subjects who received OSH had a decrease in α-amylase level (p=0.028) and an increase in cortisol level (p=0.009) 20 min after the procedure. Following OSH application in depressed youth, SNS activity may decrease, whereas HPA axis activity may increase. Future studies may examine the therapeutic efficacy of repeated OSH applications in depressed individuals.

Exploring machine learning approaches for transcriptome-based diagnosis and subgrouping of multiple system atrophy✰

Multiple system atrophy (MSA) is a rare adult-onset neurodegenerative disease, where the cause of the disease is not well understood yet. This disease affects the nervous system and then gradually damages the nerve cells in the brain. The consequences of the disease are very serious such as affecting the body balance, body movements and involuntary nervous system, which are closely connected to many crucial body functions including breathing, digestion and bladder control. Even though this disease starts between the age of 50 and 60, it can begin any time after 30 years. This disease can be presented as two main subtypes, one is predominating parkinsonian called as MSA-parkinsonian (MSA-P) and the other one is predominating cerebellar ataxia called as MSA-cerebellar (MSA-C). For such a complicated disease, on-time diagnosis and subgrouping is very crucial. However, there are no specific tests or diagnosis methods so far for the on time identification. Hence, this study checks the possibility of using transcriptome data of MSA patients in the diagnosis and subgrouping of MSA. Mutual information is used in the feature selection and the selected features are used with three different machine learning algorithms to select the model with the highest accuracy. Results show that random forest classifier performs comparably better in both of the classifications with the accuracy value of 0.8 ± 0.20 for subgrouping and 0.86 ± 0.16 for diagnosis.

Therapeutic exercise in fibromyalgia syndrome: a narrative review

Fibromyalgia syndrome (FMS) is characterised by the presence of distributed pain in different areas of the body accompanied by the alteration of some functions such as the activity of the neurovegetative system, the sleep quality, or the presence of fatigue. The present narrative review aims to evaluate some key studies regarding the effects of different therapeutic exercise (TE) modalities on clinical variables of interest in patients with FMS, as well as to discuss some of the possible mechanisms of action of TE in improving pain intensity in patients with FMS. All aerobic, strengthening, and body-mind exercises were shown to bring about changes in the improvement of clinical variables of interest in patients with FMS. In addition, with regard to the improvement of pain intensity, there are different arguments that could explain the hypoalgesic effect of TE (structured in physical, neurophysiological, and psychosocial mechanisms). In conclusion, TE is a clinical tool with great potential for patients with FMS as it may produce hypoalgesia through physical, neurophysiological, and psychosocial mechanisms. All these TE modalities have demonstrated in isolation a remarkable effectiveness in the overall improvement of patients with FMS. However, more research is needed in this field especially on the long-term effects and on the combination of the different training modalities.

Immediate effects of lavender soy wax candle on autonomic nervous system, stress, and reaction time in adolescents

Abstract Study aim: The study aimed to investigate the immediate effects of a lavender soy wax candle on the autonomic nervous system, stress, and reaction time in adolescents with moderate stress levels. Material and methods: Fifty-two males and females (mean age: 19.85 ± 0.78 years) with a moderate stress level determined by Suanprung Stress Test-20 (SPST-20) were enrolled. All participants were randomly assigned to either the control (n = 26) or experimental (n = 26) groups. The control group inhaled the lavender scent through a bowl filled with warm water, while the experimental group inhaled the scent from the lavender soy wax candle. In a peaceful environment, each participant was suggested to sit on a comfortable recliner chair in a private room while inhaling the scent for 20 minutes. Blood pressure, heart rate, respiratory rate, reaction time, and emotional states were assessed before and after the scent inhalation. The emotion states were based on the conceptual model proposed by the Geneva Emotion and Odor Scale (GEOS), consisting of 12 items. Results: The results indicated no significant differences between the two groups in all the parameters, except for the three items of emotion states (relax: p = 0.03, stress: p = 0.04, and calm: p = 0.04). Conclusions: This study suggested that the inhalation of lavender soy wax candles for 20 minutes can be used as adjuvant therapy for improving emotional states and enhancing cognitive function among adolescents with moderate stress levels.

«Selfish brain» theory: modern concept and practical use. (Literature review)

In the early 20th century, the term «selfish brain» appeared in scientific literature, around which theory was formed, finding its proof in the work of doctors and scientists. The basic principle of the theory is that the superior hierarchy of the brain, whose needs are prioritized, results in the primary satisfaction of one's own needs, often to the detriment of the functioning of other organs and systems. The origins of the theory of «selfish brain», according to researchers, lie in the work of neurosurgery pioneer Harvey Cushing, who discovered a reflex named after him and consisting in increasing arterial pressure at high intracranial pressure. Later, the field of action of this phenomenon was expanded by specialists who showed that an increase in arterial pressure can occur not only in critical situations and arise not only at high intracranial pressure, but also as a result of hypoxia of the brain. It was also found that the remodeling of intracranial vessels in hypertensive disease may be not only a consequence, but also a cause. Currently, similar patterns have been established in relation to other processes - exchange, immune and others. It was found that the priority of brain energy needs in different situations can affect insulin resistance and glucose tolerance. These effects can be realized through various mechanisms, but the advantage is through vegetative (autonomous) nervous system, mainly through sympathetic link, and also through simulation of the functioning of parasympathetic link. It is known that there is currently a rapidly increasing number of pathologies associated with degenerative-dystrophic processes of the spine, and other factors that disrupt the blood flow in the vertex-basilar zone of the Willis circle, Correction of these processes with the help of a set of manual techniques and physical methods (A. Yu. Shishonin's method with correction of aerobic-anaerobic energy balance in the reflex zones of the brain stem) Can have a good effect on the treatment of hypertensive disease and other chronic non-communicable diseases.