Superior cervical ganglionectomy caused a marked decrease in noradrenaline concentrations in major cerebral arteries (−77%), although the reduction was less pronounced (−34%) in small pial vessels. Sympathectomy decreased by 33% 5-HT concentrations in the major cerebral arteries but was without effect on 5-HT levels in the small pial vessels.
Journal of Neurochemistry
Volume 56 Issue 2, Pages 681 - 689
Published Online: 5 Oct 2006
Received March 28, 1990 revised manuscript received July 12, 1990; accepted August 14, 1990.
Experimental study of progressive facial hemiatrophy: effects of cervical sympathectomy in animals
Progressive facial hemiatrophy (Romberg's syndrome) is of unknown cause and uncertain pathogenesis. The main pathogenetic hypotheses are: sympathetic system alterations, localized scleroderma, trigeminal changes, possibly of genetic origin. To test the hypothesis of sympathetic system alterations, we designed an experimental model with ablation of the superior cervical sympathetic ganglion in rabbits, cats and dogs. All the animals were operated upon when 30 days old and were examined monthly for 1 year. During this period localized alopecia, corneal ulceration, keratitis, strabismus, enophthalmos, ocular atrophy, hemifacial atrophy and slight bone atrophy on the side of the sympathectomy were observed. Thus, cervical sympathectomy reproduces in animals the principal clinical alterations of Romberg's syndrome. Our data suggest that the sympathetic system is involved in the pathogenesis of this syndrome.
Rev Neurol (Paris). 1991;147(8-9):609-11.
Rev Neurol (Paris). 1991;147(8-9):609-11.
sympathectomy causes qualitative alterations in bone modeling and remodeling
The results further support that a regional sympathectomy causes qualitative alterations in bone modeling and remodeling, leading to bone resorption.
J Auton Nerv Syst. 2000 Jan 14;78(2-3):113-6.
J Auton Nerv Syst. 2000 Jan 14;78(2-3):113-6.
noradrenaline loss in the sympathetic nervous system of the heart
Symptoms or signs of abnormal autonomic nervous system function occur commonly in several neurological disorders.
Clinical evaluations have depended on physiological, pharmacological, and neurochemical approaches. Recently, imaging of sympathetic noradrenergic innervation has been introduced and applied especially in the heart. Most studies have used the radiolabeled sympathomimetic amine, (123)I-metaiodobenzylguanidine. Decreased uptake or increased "washout" of (123)I-metaiodobenzylguanidine-derived radioactivity is associated with worse prognosis or more severe disease in hypertension, congestive heart failure, arrhythmias, and diabetes mellitus. This pattern may reflect a high rate of postganglionic sympathetic nerve traffic to the heart. Many recent studies have agreed on the remarkable finding that all patients with Parkinson's disease and orthostatic hypotension have a loss of cardiac sympathetic innervation, whereas all patients with multiple system atrophy, often difficult to distinguish clinically from Parkinson's disease, have intact cardiac sympathetic innervation. Because Parkinson's disease entails a postganglionic sympathetic noradrenergic lesion, the disease appears to be not only a movement disorder, with dopamine loss in the nigrostriatal system of the brain, but also a dysautonomia, with noradrenaline loss in the sympathetic nervous system of the heart. As new ligands are developed, one may predict further discoveries of involvement of components of the autonomic nervous system in neurological diseases.
Semin Neurol. 2003 Dec;23(4):423-33.
Clinical evaluations have depended on physiological, pharmacological, and neurochemical approaches. Recently, imaging of sympathetic noradrenergic innervation has been introduced and applied especially in the heart. Most studies have used the radiolabeled sympathomimetic amine, (123)I-metaiodobenzylguanidine. Decreased uptake or increased "washout" of (123)I-metaiodobenzylguanidine-derived radioactivity is associated with worse prognosis or more severe disease in hypertension, congestive heart failure, arrhythmias, and diabetes mellitus. This pattern may reflect a high rate of postganglionic sympathetic nerve traffic to the heart. Many recent studies have agreed on the remarkable finding that all patients with Parkinson's disease and orthostatic hypotension have a loss of cardiac sympathetic innervation, whereas all patients with multiple system atrophy, often difficult to distinguish clinically from Parkinson's disease, have intact cardiac sympathetic innervation. Because Parkinson's disease entails a postganglionic sympathetic noradrenergic lesion, the disease appears to be not only a movement disorder, with dopamine loss in the nigrostriatal system of the brain, but also a dysautonomia, with noradrenaline loss in the sympathetic nervous system of the heart. As new ligands are developed, one may predict further discoveries of involvement of components of the autonomic nervous system in neurological diseases.
Semin Neurol. 2003 Dec;23(4):423-33.
Psychoneurological applications of endoscopic sympathetic blocks
In addition to more widely and longer known indications of ETS, various neurological disorders and psychologically stressful situations in their worst expressions might be alleviated by the reversible ESB procedure. The patients with social phobia, especially those who have also blushing and/or stage fright type of heart racing, benefit from the ESB. The disturbances of the sympathetic nervous system, e. g. in Parkinson's disease and multiple system atrophy might be alleviated with sympathetic block, especially the extrapyramidal symptoms in these diseases. In migraine, sympathetic surgery has been noted to give some help. The unilateral left-sided block has been effective in long QT-syndrome type arrhythmias. In schizophrenia, the phobic, paranoic or confusional reactions have been tentatively treated by the sympathetic block.Clin Auton Res. 2003 Dec;13 Suppl 1:I20-1; discussion I21.
