J. J. M. Askenasy1 
| (1) | Sleep Medicine Institute, Sheba Medical Centre (affiliated to Sackler School of Medicine, Tel Aviv University), Israel |
| (2) | Department of Internal Medicine E, Asaf Harofeh Medical Centre, Israel |
| (3) | Sleep Medicine Institute, Sheba Medical Centre, 52621 Tel Hashomer, Israel |
Received: 15 November 1995 Accepted: 26 April 1996
F. B. Axelrod1
| (1) | Departments of Pediatrics and Neurology, New York University Medical Center, 530 First Avenue, Suite 3A, 10016 New York, NY, USA |
| (2) | Clinical Neuroscience Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 20892 Bethesda, MD, USA |
| (3) | Department of Pediatrics, New York University Medical Center, 10016 New York, NY, USA |
Received: 20 November 1995 Accepted: 12 April 1996
Neuropeptide Y plasma levels and serum dopamine-beta-hydroxylase activity in MS patients with and without abnormal cardiovascular reflexes. |
| 1994, N° 1 (Vol. 94/1) |
| Gallai V, Sarchielli P, Firenze C, Trequattrini A, Paciaroni M, Usai F, Franceschini M, Palumbo R |
| Abstract: |
| An impairment in the autonomic function has been demonstrated in patients with multiple sclerosis (MS) using electrophysiological, pupillary and biochemical tests. Particularly evident were alterations in the cardiovascular reflexes, cutaneous sympathetic response and lymphomonocyte adrenergic binding. Electrophysiological and biochemical findings in MS patients have only occasionally been compared. Among the peripheral markers of the autonomic system, Neuropeptide Y (NPY) and dopamine-beta-hydroxylase (DBH) have been singled out as reliable indices of sympathetic function. The former is a peptide with a strong vasoconstrictive action, which is released from adrenergic endings together with noradrenaline following sympathetic activation. The latter is the enzyme which catalyses the conversion of dopamine to norepinephrine. It is located both in sympathetic endings and the chromaffin granules of adrenal medulla. To verify a failure in autonomic function in the course of MS, a battery of cardiovascular tests (assessing sympathetic and parasympathetic functions) was performed on 25 MS patients. The results were compared with a group of 20 age- and sex-matched control individuals. The plasma levels of NPY and the serum DBH activity were also determined in both groups. 52% of patients showed an impairment in sympathetic function in one or more tests (sustained handgrip, postural hypotension, cold face test). 48% of the patients had abnormal values in deep breathing test, indicating a failure of the parasympathetic function. 44% of patients showed also a paroxysmal tachycardia after cold face test, indicating an abnormal function of the vagal-cardiac and sympathetic-vascular smooth muscle pathways of the trigeminal nerve. |
R. Freeman1, 2, 8
| (1) | The Division of Neurology, Deaconess Hospital, Suite 7H, 110 Francis Street, 02215 Boston, MA, USA |
| (2) | The Department of Neurology, Beth Israel Hospital, Boston, MA, USA |
| (3) | The Department of Medicine, Shadyside Hospital, Boston, MA, USA |
| (4) | The Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA |
| (5) | The Department of Medicine, Pulmonary and Critical Care Division, Beth Israel Hospital, Boston, MA, USA |
| (6) | The Department of Veterans Affairs Outpatient Clinic, Normative Aging Study, Boston, MA, USA |
| (7) | University of Pittsburgh, Pennsylvania, USA |
| (8) | Harvard Medical School, Boston, MA, USA |
Received: 8 March 1995 Accepted: 19 July 1995
-Adrenoceptor responsiveness in dorsal foot veins is increased in patients with tetraplegia. Hypersensitivity of vascular -adrenoceptors may contribute to autonomic dysreflexia in patients with high spinal cord injury.", Q. -P. Feng1, G. A. Delaney2 and R. W. Teasell3| (1) | Victoria Hospital, University of Western Ontario, 375 South Street, N6A 4G5 London, Ontario, Canada |
| (2) | Parkwood Hospital, University of Western Ontario, London, Ontario, Canada |
| (3) | University Hospital, University of Western Ontario, London, Ontario, Canada |
F. Costa1, P. Lavin1, D. Robertson1 and I. Biaggioni1
| (2) | Clinical Research Center, Room AA3228 Medical Center North, Vanderbilt University, 37232-2195 Nashville, TN, USA |
Received: 6 July 1995
L. L. Thomsen1
| (1) | Department of Neurology, Glostrup Hospital, University of Copenhagen, Nordre Ringvej 57, DK-2600 Glostrup, Denmark Clinical Autonomic Research |
Received: 17 March 1995 Accepted: 24 July 1995
H. J. Romijn1
| (1) | Present address: Department of Electron Microscopy, Netherlands Central Institute for Brain Research, Amsterdam, The Netherlands |
Received: 3 March 1975
The pineal gland was originally believed to be a "vestigial remnant" of a larger organ (much as the appendix was thought to be a vestigial digestive organ). Aaron Lerner and colleagues at Yale University discovered that melatonin, the most potent compound then known to lighten frog skin, was present in the highest concentrations in the pineal.[8] Melatonin is a derivative of the amino acid tryptophan, which also has other functions in the central nervous system. The production of melatonin by the pineal gland is stimulated by darkness and inhibited by light.[9] Photosensitive cells in the retina detect light and directly signal the suprachiasmatic nucleus (SCN), entraining it to the 24 hour clock. Fibers project from the SCN to the paraventricular nuclei (PVN), which relay the circadian signals to the spinal cord and out via the sympathetic system to superior cervical ganglia (SCG), and from there into the pineal gland. The function(s) of melatonin in humans is not clear; it is commonly prescribed for the treatment of circadian rhythm sleep disorders.
In his book DMT: The Spirit Molecule, Dr. Rick Strassman hypothesized that the pineal gland produces the psychedelic chemical DMT,[10] but there is no data to support this speculation.
The pineal gland is large in children, but shrinks at puberty. It appears to play a major role in sexual development, hibernation in animals, metabolism, and seasonal breeding. The abundant melatonin levels in children is believed to inhibit sexual development, and pineal tumors have been linked with precocious puberty. When puberty arrives, melatonin production is reduced. Calcification of the pineal gland is typical in adults.
Studies suggest that in rodents the pineal gland may influence the actions of recreational drugs, such as cocaine,[13] and antidepressants, such as fluoxetine (Prozac),[14] and its hormone melatonin can protect against neurodegeneration.[15]
The secretory activity of the pineal gland has only relatively recently become understood. Historically, its location deep in the brain suggested to philosophers that it possessed particular importance. This combination led to its being a "mystery" gland with myth, superstition and metaphysical theories surrounding its perceived function.
René Descartes, who dedicated much time to the study of the pineal gland,[16] called it the "seat of the soul".[17] He believed that it was the point of connection between the intellect and the body.[18] This was in part because of his belief that it is unique in the anatomy of the human brain in being a structure not duplicated on the right and left sides. This observation is not true, however; under a microscope one finds the pineal gland is divided into two fine hemispheres. Another theory was that the pineal operated as a valve releasing fluids, thus the position taken during deep thought, with the head slightly down meeting the hand, was an allowance for the opening of these 'valves'.
The pineal gland is occasionally associated with the sixth chakra (also called Ajna or the third eye chakra in yoga) or sometimes the Seventh (Crown) chakra. It is believed by some to be a dormant organ that can be awakened to enable telepathic communication.[citation needed]
Copyright © 1971 by the National Academy of Sciences
Melatonin Metabolism: Neural Regulation of Pineal Serotonin: Acetyl Coenzyme A N-acetyltransferase Activity
There is a diurnal rhythm in the activity of serotonin N-acetyltransferase in the rat pineal gland. In the normal rat, the nocturnal enzyme activities are 15- to 30-fold greater than are daytime activities. This rhythm is abolished by decentralization or removal of the superior cervical ganglia, procedures that interrupt the only source of central neural input to the pineal gland. This effect of superior cervical sympathectomy on the N-acetyltransferase rhythm cannot be attributed to changes occurring in the denervated pineal parenchymal cells. When chronically denervated glands are placed in organ culture with norepinephrine, the neurotransmitter normally located in sympathetic terminals in the gland, N-acetyltransferase activity increases 10- to 20-fold. These data indicate that superior cervical sympathectomy abolishes the N-acetyl-transferase rhythm by elimination of the input of central signals to the gland. These signals appear to regulate the N-acetyltransferase rhythm in the normal rat by regulation of the release of norepinephrine from the sympathetic terminals within the pineal gland.
,
,,,,
Contributed by Rita Levi-Montalcini, December 29, 2000
In postnatal tissues, angiogenesis occurs in nontumoral conditions on appropriate stimuli. In the nervous tissue, hypoxia, neural graft, increased neural function, and synaptic activity are associated with neoangiogenesis. We have investigated the occurrence of neoangiogenesis in the superior cervical ganglia (scg) of newborn rats treated for 8-21 days with 6-hydroxy-dopamine (6-OHDA), nerve growth factor (NGF), or 6-OHDA + NGF. The two latter treatments induced a significant increase in scg size. However, the increase after combined treatment far exceeded that of NGF alone. Similarly, histological and histochemical analysis revealed neuronal hypertrophy and endothelial cell hyperplasia associated with stromal hypertrophy (as described by laminin immunostaining) and increased vascular bed (as revealed by platelet/endothelial cell adhesion molecule-1 immunostaining) in 6-OHDA + NGF-treated pups. NGF, either alone or associated with 6-OHDA, also induced a significant up-regulation of NADPH diaphorase, neuronal nitric oxide synthase, and vascular endothelial growth factor expression in scg neurons. The present investigation suggests that the increase of scg size induced by NGF and 6-OHDA + NGF is associated with neoangiogenesis, and that the induction of vasoactive and angiogenic factors in neurons represents a further and previously undisclosed effect of NGF.
Copyright © 1989 by the National Academy of Sciences
Thoracic ganglia in humans were studied after electrical, preganglionic stimulation using in situ hybridization with synthetic oligonucleotide probes against the catecholamine-synthesizing enzymes tyrosine hydroxylase (EC 1.14.16.2) and dopamine ß -hydroxylase (EC 1.14.17.1) and neuropeptide tyrosine. Immunohistochemical analysis was also performed. Following short peroperative stimulation a severalfold increase in all three mRNAs was found in principal ganglion cells, whereas no definite changes could be detected in enzyme or peptide levels with immunohistochemistry. The results suggest a very rapid and sensitive regulation of genes involved in signal transmission in the sympathetic nervous system of humans. Moreover, they indicate that electrical stimulation of neurons and/or pathways combined with in situ hybridization may be used as a method to define neuronal projections by visualizing increases in mRNAs for transmitter enzymes and/or peptide in target cells.
The apparent apposition of epidermal nerves with Langerhans cells suggests a possible locus of interaction between the nervous system and the immune system within the skin. (J ALLERGY CLIN IMMUNOL 1995;96:1178-82.)
During the first test in the complex environment following the start of drug injections, the guanethidine-treated females, in comparison to saline-treated females, displayed a lower frequency of lordotic behavior during coital contacts. The changes in behavior produced by the sympathetic drug, guanethidine, implicate the autonomic nervous system in the regulation of copulatory pacing in the female rat.
Three series of experiments were undertaken to determine whether the residual catecholamine (CA) terminals or intrinsic neurons of ventral tegmentum (VT) in rats given 6-hydroxydopamine (6-OHDA) after desmethylimipramine (DMI) in the lateral ventricles at birth, mediated VT self-stimulation (SS). In Experiment I, male pups were injected bilaterally on days 3 and 5 with 6-OHDA (total dose 200 micrograms) or with the vehicle after pretreatment with DMI (50 mg/kg, IP) 30 min earlier. Each subject, 150 days old, was implanted bilaterally in the VT with electrode-cannula units. Both the dopamine (DA)-depleted and control groups yielded similar percentages of self-stimulators. The rate of responding was, however, slightly but significantly lower in the DA-depleted group than in the controls.
Authors: Hamner M.B.1; Gold P.B.
Source: Psychiatry Research, Volume 77, Number 3, 27 February 1998 , pp. 175-181(7)
Recognition and treatment of comorbid chronic psychotic symptoms in post-traumatic stress disorder (PTSD) has become of increasing clinical interest. Altered dopamine beta-hydroxylase (DBH) activity has been reported in mood disorders. Plasma DBH is reduced in major depression with psychosis and elevated in bipolar disorder with psychosis compared with their respective non-psychotic diagnostic groups. DBH is likely a trait marker with interindividual variations secondary to genetic polymorphism. We therefore evaluated DBH activity in PTSD patients with and without psychotic features and compared these groups with age- and gender-matched control subjects. Vietnam combat veterans with PTSD (n=19) (including patients with and without psychotic features) and normal control subjects (n=22) had plasma DBH enzyme activity assayed photometrically. DBH was significantly higher in patients with PTSD with psychotic features than in patients without psychotic features (80.6±13.4 vs. 42.1±7.3 mM/min, P<0.01)>P<0.01).>
Chronic idiopathic anhidrosis (Mia: one of the side-effects of sympathectomy)
Chronic idiopathic anhidrosis is an acquired generalized loss of sweating without other autonomic features.
|
Since norepinephrine and its receptor sites have long been postulated to play a role in a number of psychiatric disorders, the essentially normal mood and mental status of adult DBH-deficiency subjects so far encountered has elicited great interest among investigators in the area of depression and schizophrenia. http://www.mc.vanderbilt.edu/root/vumc.php?site=adc&doc=4792
This view has changed with recognition of a congenital syndrome of severe orthostatic hypotension, noradrenergic failure, and ptosis of the eyelids in two young adults. The syndrome differs from familial dysautonomia and various other autonomic disorders seen in adults in that the defect can be localized to the noradrenergic and adrenergic tissues. There is virtual absence of norepinephrine, epinephrine, and their metabolites. However, there is greatly increased dopamine in plasma, cerebrospinal fluid, and urine.
As children, DBH deficient patients have had a markedly reduced ability to exercise, perhaps because of hypotension engendered by the physical exertion. Because of occasional syncope, anticonvulsive medications have been given in some patients, even though no abnormality was seen on the electroencephalogram. Symptoms have generally worsened in late adolescence and by early adulthood, patients complain of profound orthostatic hypotension, especially early in the day and during hot weather or after alcohol ingestion. In addition to ptosis of the eyelids, there is reduced exercise tolerance, a tendency for nasal stuffiness to occur, especially in the supine posture. A male patient had appropriate erectal function, but retrograde rather than antegrade ejaculation. Presyncopal symptoms in these patients have included dizziness, blurred vision, dyspnea, nuchal discomfort, and occasionally chest pain.
Friedhelm Lamprecht1, Michael H. Ebert1, Ibrahim Turek1, 2 and Irwin J. Kopin1
| (1) | Laboratory of Clinical Science, NIMH, 20014 Bethesda, Maryland |
| (2) | Maryland Psychiatric Research Center, Catonsville, Maryland |
Received: 18 June 1974
Key words Electroconvulsive Shock Treatment - Serum Dopamine-Beta-Hydroxylase - Depression - Catecholamines - Sympathetic Nervous System
| Journal | Psychopharmacology |
| Publisher | Springer Berlin / Heidelberg |
| ISSN | 0033-3158 (Print) 1432-2072 (Online) |
| Issue | Volume 40, Number 3 / September, 1974 |
(Dbh-/-), the enzyme responsible for synthesizing norepinephrine and epinephrine from dopamine,
Copyright © 1970 by the National Academy of Sciences
Neurally Mediated Increase in Dopamine-ß -hydroxylase Activity
The development of a sensitive and specific enzymatic assay for dopamine-ß -hydroxylase has enabled us to measure the activity of this enzyme in several tissues where it has not previously been measured. The administration of reserpine leads to an increase in dopamine-ß -hydroxylase activity in the rat adrenal, heart, salivary gland, and in sympathetic ganglia. The increase in the heart is preceded by a small but significant fall. We have confirmed the increase in tyrosine hydroxylase which follows the administration of reserpine and have found that the activity of phenylethanolamine-N-methyltransferase also increases after administration of this drug. The activities of two enzymes not involved in the synthesis of catecholamines, monoamine oxidase and lactate dehydrogenase, are not affected by reserpine treatment. The rise of dopamine-ß -hydroxylase activity in the sympathetic ganglia is blocked by surgical decentralization.
1 Department of Ophthalmology, Tulane University School of Medicine, New Orleans, La.
Histofluorometric techniques have confirmed that topical ocular application of 6-hydroxydopamine, a norepinephrine congener, causes a selective and reversible destruction of sympathetic nerve terminals in the anterior segment. An investigation of the effects of "chemical sympathectomy" on the pupil, intraocular pressure, and facility of outflow showed: the pupil underwent a sequence of changes characteristic of surgical sympathetic denervation, but with a different time course; the intraocular pressure .was significantly lowered, transiently in rabbits and of longer duration in monkeys; the facility of outflow was transiently increased in monkeys and probably in rabbits; the episcleral venous pressure was unchanged in both species. It was concluded that the lowered intraocular pressure and lowered outflow pressure were the result of a reduction of aqueous inflow. There was no unequivocal experimental demonstration of supersensitization to topical norepinephrine or isoproterenol following chemical sympathetic denervation; however, the experiments were not conclusive on this important point. It was concluded that chemical sympathectomy with 6-hydroxy-dopamine reproduces many of the ocular phenomena of surgical sympathectomy. 6-Hydroxy-dopamine is a useful drug for experimental ophthalmology, and may be useful clinically.
(Investigative Ophthalmology and Visual Science. 1971;10:120-143.)
© 1971 by The Association for Research in Vision and Ophthalmology, Inc.
| Wettervik C, Claes G, Drott C, Emanuelsson H, Lomsky M, Rådberg G et al. Endoscopic transthoracic sympathectomy for severe angina. Lancet 1995; 345: 97 - 8. | |
| 3. | Matsumoto Y, Ueyama T, Endo M, Sasaki H, Kasashima F, Abe Y et al. Endoscopic thoracic sympathectomy for Raynaud’s phenomenon. J Vasc Surg 2002; 36: 57 - 61. |
| 4. | Flørenes T. Torakoskopisk sympatektomi - operasjon for håndsvette og ansiktsrødming Tidsskr Nor Lægeforen 2003; 123: 463 - 4. |
| 5. | Drott C, Claes G, Rex L, Dalman P, Gothberg G, Fahlen T. Långtidsresultat efter operation mot handsvett och ansiktsrodnad. Patienterna nöyda trots besvärande biverkningar. Läkartidningen 2001; 98: 1766 - 72. |
| 6. | Telaranta T. Reversal surgery for reducing the side effects of ETS. (SIC!) A case report. Ann Chir Gynaecol 2001; 90: 175 - 6. |
| 7. | Furlan AD, Mailis A, Papagapiou M. Are we paying a high price for surgical sympathectomy? A systematic literature review of late complications. J Pain 2000; 1: 245 - 57. |
| 8. | Abraham P, Picquet J, Bickert S, Papon X, Jousset Y, Saumet J et al. Infra-stellate upper thoracic sympathectomy results in a relative bradychardia during exercise, irrespective of the operated side. Eur J Cardiothorac Surg 2001; 20: 1095 - 100. |
| 9. | DRUMMOND PD. A caution about surgical treatment for facial blushing. Br J Dermatol 2000; 142: 194 - 5. |
Authors: ANDREWS B.T.1; RENNIE J.A.1, *
Source: British Journal of Surgery, Volume 84, Number 12, December 1997 , pp. 1702-1704(3)
Publisher: John Wiley & Sons, Ltd.
Abstract:
Background Compensatory sweating is a common symptom following thoracic sympathectomy; however, the reported incidence of this complication varies greatly, and its severity has not been quantified.
Methods In this study changes in the distribution of sweating following bilateral T2-3 thoracoscopic sympathectomy for hyperhidrosis were assessed in 42 patients. Sweat production in the palms, axillae, face, trunk and feet was assessed using a linear analogue scale.
Results The operation was most successful in reducing sweat production in the palms, axillae and face (in descending order). The operation also reduced pedal sweat production in 12 of the 29 patients who suffered concomitant pedal hyperhidrosis. Compensatory truncal sweating occurred in 36 of the 42 patients; it was severe in ten, moderate in 16 and minimal in ten.
Conclusion Patients should be warned about compensatory sweating before thoracic sympathectomy.
