However, compensatory sweating (CS) developed in 97.1% of the patients, and 82.9% answered that they were disturbed because it was more than they had expected. This result makes us realize further the importance of preoperative informed consent for CS. The problem of palmar hyperhidrosis is very serious for patients, and hence it is important to give treatment with a thorough understanding of the effectiveness and problems of ETS for palmar hyperhidrosis according to the analytical results of this questionnaire.
http://ci.nii.ac.jp/naid/110006980508/en
Monday, March 29, 2010
Tuesday, March 23, 2010
An Ultrastructural Study - effects of Preganglionic Sympathectomy
The ultrastructure of satellite cells of the rat superior cervical ganglion was studied following preganglionic sympathectomy. Several distinct morphological alterations were observed: (a) enlargement of the intercellular space between the ganglion cells and the satellite cells, (b) dilation of the granular endoplasmic reticulum and loss of attached ribosomes, and (c) swelling of the mitochondria with disorganization of the cristae mitochondriales. The presence of degenerating nerve fibers and synaptic boutons was also noted.
Journal of Neural Transmission 38, 43--57 (1976)
Results of elective procedure can be "devastating"
Surgery ofthe sympathetic system is performed for a variety ofindications,hyperhidrosis being a major one. Despite excellent results, sympathectomy for hyperhidrosis bears a number of sequels, some of which may be devastating.
Clin Auton Res (2003) 13 [Suppl 1]:I/83–I/88
Clin Auton Res (2003) 13 [Suppl 1]:I/83–I/88
lesser imbalance of the autonomic nervous system
Ramicotomy is a surgical procedure, with less adverse effects than conventional sympathectomy, however, it was abandoned due to the high recurrence rate.
With the purpose of using a less aggressive surgical approach and lesser imbalance of the autonomic nervous system, the ramicotomy was proposed.
Ramicotomy allows complete section of all rami communicantes of the sympathetic ganglia. The histological regeneration might be greater than the recurrence rates of clinical symptoms seen in a human being due to non-functional regenerations.
Interact CardioVasc Thorac Surg 2009;9:411-415.
With the purpose of using a less aggressive surgical approach and lesser imbalance of the autonomic nervous system, the ramicotomy was proposed.
Ramicotomy allows complete section of all rami communicantes of the sympathetic ganglia. The histological regeneration might be greater than the recurrence rates of clinical symptoms seen in a human being due to non-functional regenerations.
Interact CardioVasc Thorac Surg 2009;9:411-415.
increased blood supply is associated with decreased vascular permeability
The influence of the sympathetic nervous system on capillary permeability was studied in cats. The dye penetration from the blood through the synovial membrane was tested by perfusing the two knee joints, one of which was deprived of its sympathetic nerve supply by unilateral lumbosacral
sympathectomy.
In confirmation of previous experiments, it was found in a great majority of experiments that, in spite of marked vasodilatation, the dye excretion was considerably reduced on the sympathectomised side.
A permeability factor under the influence of the sympathetic nervous system has been postulated; its character and mechanism is still unknown.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.
Res Exp Med (Berl) 173, 1--8 (1978)
sympathectomy.
In confirmation of previous experiments, it was found in a great majority of experiments that, in spite of marked vasodilatation, the dye excretion was considerably reduced on the sympathectomised side.
A permeability factor under the influence of the sympathetic nervous system has been postulated; its character and mechanism is still unknown.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.
Res Exp Med (Berl) 173, 1--8 (1978)
lead to hyperfunction of the serotoninergic system and pathology
We studied the balance of activity of sympathetic, parasympathetic, and serotoninergic divisions of the autonomic nervous system in the regulation of the heart function in rabbits. High activities of the sympathetic and parasympathetic system are associated with antagonistic interactions between them. Moderation of activity of these systems could be accompanied by activation of the serotoninergic system. Physiological sympathectomy and parasympathectomy lead to hyperfunction of the serotoninergic system and pathology.
Bulletin of Experimental Biology and Medicine, Vol. 140, No. 5, 2005 PHYSIOLOGY
Bulletin of Experimental Biology and Medicine, Vol. 140, No. 5, 2005 PHYSIOLOGY
In all cases wrinkling was abolished after interruption of the hand sympathetic innervation
In the study, the effect ofcervical sympathectomy on water immersion wrinkling was examined in 12 patients treated for palmar hyperhidrosis.
In all cases wrinkling was abolished after interruption of the hand sympathetic innervation. A separate study in patients with diabetic neuropathy noted that reduced or absent water immersion wrinkling was linked to autonomic dysfunction as indicated by diarrhea and orthostatic hypotension [3]. Two clinical studies on patients with leprosy further strengthened deficient water immersion wrinkling as an indicator ofperipheral sympathetic nerve damage [14,18]. Interestingly, central nervous system sympathetic dysfunction has also been shown to affect finger wrinkling.In a study of patients with unilateral Parkinsonism, wrinkling was significantly reduced on the side not affected by motor signs.
Clin Auton Res (2004) 14:125–131
In all cases wrinkling was abolished after interruption of the hand sympathetic innervation. A separate study in patients with diabetic neuropathy noted that reduced or absent water immersion wrinkling was linked to autonomic dysfunction as indicated by diarrhea and orthostatic hypotension [3]. Two clinical studies on patients with leprosy further strengthened deficient water immersion wrinkling as an indicator ofperipheral sympathetic nerve damage [14,18]. Interestingly, central nervous system sympathetic dysfunction has also been shown to affect finger wrinkling.In a study of patients with unilateral Parkinsonism, wrinkling was significantly reduced on the side not affected by motor signs.
Clin Auton Res (2004) 14:125–131
Autonomic neuropathy simulating the effects of sympathectomy
Autonomic neuropathy simulating the effects of sympathectomy as a complication of diabetes mellitus. Diabetes 1955;4:92-97. 112.
Sympathectomy = autonomic neuropathy
A number of papers have been published which
stressed [22-24] the high failure rate of sympathecto-
my operations in diabetics. We believe that the failure
of the operation is due to the fact that diabetic auto-
nomic neuropathy has already sympathectomized the
patient. The results of the present study are compati-
ble with this idea. It is also of interest that the histolog-
ical abnormalities found in the present study are simi-
lar to those described in the bladder [15], in the corpo-
ra cavernosa [16] and in the myocardium [17], all of
which are typical sites of diabetic autonomic neuro-
pathy. Thus, autonomic neuropathy is a very com-
mon feature in diabetes and an important back-
ground to the development of other complications.
For example, although the chronic dryness of the skin
is rarely troublesome for the patient, it may lead to
skin shrinkage and cracking which may, in turn, pre-
dispose to infection.
stressed [22-24] the high failure rate of sympathecto-
my operations in diabetics. We believe that the failure
of the operation is due to the fact that diabetic auto-
nomic neuropathy has already sympathectomized the
patient. The results of the present study are compati-
ble with this idea. It is also of interest that the histolog-
ical abnormalities found in the present study are simi-
lar to those described in the bladder [15], in the corpo-
ra cavernosa [16] and in the myocardium [17], all of
which are typical sites of diabetic autonomic neuro-
pathy. Thus, autonomic neuropathy is a very com-
mon feature in diabetes and an important back-
ground to the development of other complications.
For example, although the chronic dryness of the skin
is rarely troublesome for the patient, it may lead to
skin shrinkage and cracking which may, in turn, pre-
dispose to infection.
severe compensatory sweating was experienced in 90% of patients
Postsurgery, severe compensatory sweating was experienced in 90% of patients (P <>
Pulmonary Functional Abnormalities after Upper Dorsal Sympathectomy
Results of pulmonary function studies were compared in two groups of 12 patients each, in whom upper dorsal sympathectomy was performed by the supraclavicular or by the fransaxillary approach. Patients were evaluated clinically, radiologically and functionally before operation and again three weeks, three months and six months after denervation. Findings suggest that an increase in small airway resistance concomitant with some degree of paeumoconstricfion occurred after upper dorsal sympathectomy by both routes. Muscular transection and possible phrenic nerve retraction dam-
age due to the operative procedure could not be the cause of the above abnormalities because the Iuspiratory and expiratory forces, inspiratory peak flow and diaphragmatic movement were not significantly reduced after operation by both approaches. (Adar)
1980;77;651-655 Chest
age due to the operative procedure could not be the cause of the above abnormalities because the Iuspiratory and expiratory forces, inspiratory peak flow and diaphragmatic movement were not significantly reduced after operation by both approaches. (Adar)
1980;77;651-655 Chest
Gustatory Phenomena After Upper Dorsal Sympathectomy
In a series of 100 bilateral upper dorsal sympathectomies performed for palmar hyperhidrosis, gustatory sweating and other gustatory phenomena were reported by 68 of 93 patients (73%), followed up for an average of 11/2 years. These gustatory phenomena were quite different from physiologic gustatory sweating: a wide range of gustatory stimuli caused a variety of phenomena in varied locations. There was a negative correlation between the incidence of these phenomena and the occurrence of Horner's syndrome after sympathectomy. Analysis of our observations, and of clinical and experimental work of others, leads to the conclusion that gustatory phenomena after upper dorsal sympathectomy are the result of preganglionic sympathetic regeneration or collateral sprouting with aberrant synapses in the superior cervical ganglion. (Adar)
Arch Neurol. 1977;34(10):619-623.
The effect of cervical sympathectomy on retinal vessel responses to systemic autonomic stimulation
The retinal vessel calibre responses to systemic sympathetic stimulation, were studied in nine patients (eight male; mean age: 31.7 years; range: 19-58 years) with unilateral disruption of their cervical sympathetic tract. All patients had ipsilateral decreased/absent facial sweating and a Horners syndrome, evidence of unilateral sympathetic denervation. Both eyes of each patient were studied and the results were analysed in two groups: the group of nine sympathectomised eyes and the control group of unaffected fellow eyes. During handgrip contraction there was a significant difference in the mean retinal arteriolar constriction (mean +/- SEM) between the group of sympathectomised eyes (4.6 +/- 0.89%) and control eyes (7.1 +/- 1.13%), p less than 0.01. Similarly, there was a significant difference in mean venule constriction during sustained handgrip contraction between the group of sympathectomised eyes (1.5 +/- 0.67%) and control eyes (4.9 +/- 0.98%), p less than 0.05.
Eye (Lond). 1990;4 ( Pt 1):181-9.
PMID: 2323469 [PubMed - indexed for MEDLINE]
Neuromodulation Of Cerebral Blood Flow
After the demonstration that spinal cord stimulation (SCS) can improve peripheral blood flow, Hosobuchi in 1986 first studied the effect of SCS on cerebral blood flow (CBF) in human beings. The group found that SCS could produce either an increase of CBF, a reduction, or no effect at all. A reduction of CBF is very rare and occurs when electrodes are place in a more caudal location, while cervical stimulation produces, more frequently, an increase in CBF (61% of cervical stimulations). The effect of SCS on CBF in rabbits suggests that a reversible functional sympathectomy occurs during SCS.
Neuromodulation; Jul2003, Vol. 6 Issue 3, p192-192, 1p
Neuromodulation; Jul2003, Vol. 6 Issue 3, p192-192, 1p
Complications of sympathectomy
The excision of axillary sweat glands can cause unsightly scarring and transthoracic sympathectomy (either open or endoscopic) can be associated with complications of compensatory and gustatory hyperhidrosis, Horner syndrome and neuralgia, some of which patients may find worse than the condition itself.
American Journal of Clinical Dermatology; 2003, Vol. 4 Issue 10, p681-697, 17p
American Journal of Clinical Dermatology; 2003, Vol. 4 Issue 10, p681-697, 17p
Effect of sympathetic denervation on the rate of protein synthesis in rat skeletal muscle
Soleus isolated after 2 and 4 days of chemical sympathectomy or after 3 days of lumbar denervation showed a 17–20% statistically significant decrease in in vitro rates of protein synthesis.
American Journal of Physiology: Endocrinology & Metabolism; Apr2004, Vol. 49 Issue 4, pE642-E647, 6p
American Journal of Physiology: Endocrinology & Metabolism; Apr2004, Vol. 49 Issue 4, pE642-E647, 6p
sweat response often to emotional stimuli in body regions influenced by the anterior cingulate cortex
A common link among these disorders is an excessive, nonthermoregulatory sweat response often to emotional stimuli in body regions influenced by the anterior cingulate cortex as opposed to the thermoregulatory sweat response regulated by the preoptic-anterior hypothalamus.
Mayo Clinic Proceedings; May2005, Vol. 80 Issue 5, p657-666, 10p
Mayo Clinic Proceedings; May2005, Vol. 80 Issue 5, p657-666, 10p
- Eisenach, John H.1 eisenach.john@mayo.edu
Atkinson, John L. D.2
Fealey, Robert D.3
Immunoglobulin producing cells in the rat dental pulp after unilateral sympathectomy.
Sympathectomy results in recruitment of cells expressing κ and λ light chains into the dental pulp (P=0.005). Electron microscopy revealed these cells to be mainly plasma cells and Mott cells. We conclude that neural imbalance caused by unilateral sympathectomy recruits immunoglobulin producing cells in the dental pulp. Our results are in agreement with a model of immune regulation in which the sympathetic nervous system exerts a tonic regulatory effect over lymphocyte proliferation and migration. [Copyright &y& Elsevier]
Neuroscience; Jan2006, Vol. 136 Issue 2, p571-577, 7p
Neuroscience; Jan2006, Vol. 136 Issue 2, p571-577, 7p
- Haug, S.R. sivakami.rethnam@biomed.uib.no
Heyeraas, K.J.1
Severe Bronchospasm Following Bilateral T2-T5 Sympathectomy
We describe a case report of a 32-year-old woman who suffered severe bronchospasm following a bilateral T2-T5 video assisted thoracoscopic sympathetic ganglion ablation. The patient required overnight sedation, mechanical ventilation, nebulized albuterol and a prednisone taper prior to extubation. The combination of the patient's asthma, and the bilateral sympathectomy, enhanced the risk and severity of this complication. A heightened awareness for bronchospasm should be considered when planning surgical therapy and anesthesia in patients being treated for hyperhydrosis, and special consideration be given to the risk benefit ratio of performing bilateral versus staged surgery in patients with reactive airway disease.
Internet Journal of Anesthesiology, 1092406X, 2007, Vol. 12, Issue 2
Internet Journal of Anesthesiology, 1092406X, 2007, Vol. 12, Issue 2
Anti-inflammatory role of sympathetic nerves in chronic intestinal inflammation
Sympathectomy reduced acute DSS colitis but increased chronic DSS colitis. Sympathectomy also increased chronic colitis in II10-/- mice. Conclusions: This study demonstrated a loss of sympathetic and an increase of SP+ nerve fibres in Crohn's disease. SEMA3C, a sympathetic nerve repellent factor, is highly expressed in the epithelium of Crohn's disease patients. In chronic experimental colitis, the sympathetic nervous system confers an anti-inflammatory influence. Thus, the loss of sympathetic nerve fibres in the chronic phase of the disease is most probably a pro-inflammatory signal, which might be related to repulsion of these fibres by SEMA3C and other repellents.
Straub, R. H.1 rainer.straub@klinik.uni-regensburg.de
Gut; Jul2008, Vol. 57 Issue 7, p911-921,
Straub, R. H.1 rainer.straub@klinik.uni-regensburg.de
Gut; Jul2008, Vol. 57 Issue 7, p911-921,
Similar pathological effects of sympathectomy and hypercholesterolemia on arterial smooth muscle cells and fibroblasts
Summary: In a previous study, we showed that after sympathectomy, the femoral (FA) but not the basilar (BA) artery from non-pathological rabbits manifests migration of adventitial fibroblasts (FBs) into the media and loss of medial smooth muscle cells (SMCs). The aim of the present study was to verify whether similar behaviour of arteries occurred in the pathological context of atherosclerosis. Thus, similar experiments were conducted on hypercholesterolemic rabbits, which were chemically sympathectomized with 6-hydroxydopamine (n=4) or treated with vehicle for control (n=5).
Both intact and sympathectomized BA and FA developed atherosclerotic plaques, but the thickening of the intima was more advanced in sympathectomized animals, as judged by increased plaque frequency and by the phenotypic modulation of SMCs in the intima. Our results show that in the media of FAs hypercholesterolemia induces changes similar to those observed in sympathectomized rabbits in non-pathological conditions, i.e., migration of adventitial FBs to the media and loss of medial SMCs. These latter changes, which can be ascribed to pathological events, were accentuated after sympathectomy in the hypercholesterolemic rabbits. The present study reveals that pathological events, including migration and phenotypic modulation of vascular FBs and loss of SMCs, may be under the influence of sympathetic nerves.
Acta Histochemica; Jul2008, Vol. 110 Issue 4, p302-313, 12p
Both intact and sympathectomized BA and FA developed atherosclerotic plaques, but the thickening of the intima was more advanced in sympathectomized animals, as judged by increased plaque frequency and by the phenotypic modulation of SMCs in the intima. Our results show that in the media of FAs hypercholesterolemia induces changes similar to those observed in sympathectomized rabbits in non-pathological conditions, i.e., migration of adventitial FBs to the media and loss of medial SMCs. These latter changes, which can be ascribed to pathological events, were accentuated after sympathectomy in the hypercholesterolemic rabbits. The present study reveals that pathological events, including migration and phenotypic modulation of vascular FBs and loss of SMCs, may be under the influence of sympathetic nerves.
Acta Histochemica; Jul2008, Vol. 110 Issue 4, p302-313, 12p
- Kacem, K.1 kamel.kacem@fsb.rnu.tn
Sercombe, R.2 r.sercombe@orange.fr
About 40% of ETS2 groups and 25% of ETS3 group patients were unsatisfied with their operation.
(Surgery 2008;143:784-9.)
Thoracoscopic Sympathectomy at the T2 or T3 Level Facilitates Bradykinin-Induced Protein Extravasation in Human Forearm Skin
The endogenous peptide bradykinin (BK) is an inflammatory mediator that induces nociceptor activation and sensitization as well as protein extravasation and vasodilation.
Conclusions. Forearm skin perfusion is increased after ETSC on the T2 or T3 level indicating decreased sympathetic activity while BK-induced protein extravasation was increased. These results show that preganglionic sympathectomy does not diminish bradykinin-induced protein extravasation as found for postganglionic sympathectomy in rats.
Stefan Leis, MD,*† Nicola Meyer, MD, † Andreas Bickel, MD, † Christoph H. Schick, MD, ‡§ Sophie Krüger, MD, § Martin Schmelz, MD, ¶ and Frank Birklein, MD**
Conclusions. Forearm skin perfusion is increased after ETSC on the T2 or T3 level indicating decreased sympathetic activity while BK-induced protein extravasation was increased. These results show that preganglionic sympathectomy does not diminish bradykinin-induced protein extravasation as found for postganglionic sympathectomy in rats.
Stefan Leis, MD,*
Pain Medicine
Published Online: 1 Mar 2010
© 2010 American Academy of Pain Medicine
Cerebral blood flow rose, while vascular resistance did not change after cervical sympathectomy
After bilateral cervical sympathectomy (n = 9), carotid chemoreceptor reflex stimulation induced significantly different (P less than 0.01) effects on cerebral blood flow, which rose by 42 +/- 8%, and cerebral vascular resistance, which did not change.
To determine whether the difference in effect was due to the sympathectomy or merely to the repetition of the stimulus, another group of dogs (sham; n = 6) that had intact sympathetic nerves were studied a second time. In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy.
Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;
http://ajpheart.physiology.org/cgi/content/abstract/238/4/H594
To determine whether the difference in effect was due to the sympathectomy or merely to the repetition of the stimulus, another group of dogs (sham; n = 6) that had intact sympathetic nerves were studied a second time. In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy.
Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;
http://ajpheart.physiology.org/cgi/content/abstract/238/4/H594
Melatonin levels markedly reduced after sympathectomy
In the patient with hyperhidrosis, a prominent melatonin rhythm was observed preoperatively in the CSF and plasma. After bilateral T1-T2 ganglionectomy, however, melatonin levels were markedly reduced, and the diurnal rhythm was abolished. These results provide direct evidence in humans for a diurnal melatonin rhythm in CSF and plasma as well as regulation of this rhythm by sympathetic innervation.
J Clin Endocrinol Metab 72: 819–823, 1991
J Clin Endocrinol Metab 72: 819–823, 1991
Sympathectomy-induced changes on the ventricular surface
Various investigators have shown that unilateral ganglionectomy or transection of the internal and external carotid nerves leads to a regenerative response in the ipsilateral superior cervical ganglion and to uninjured mature sympathetic neurons sprouting into bilaterally innervated shared target organs. In this study changes in the supraependymal neuronal network following unilateral and bilateral cervical sympathectomy on the infundibular floor of the third ventricle were studied by scanning electron microscopy in comparison with normal and sham-operated control animals. After unilateral cervical sympathectomy there was a great increase in the number of varicose nerve fibres on the infundibular floor as compared to the normal and sham-operated control animals. Not only was there an increase in the number of nerve fibres, but also their varicosities were substantially larger than those normally present on the ependymal surface. This study indicates the possible sympathetic projections from the superior cervical ganglia to the ependymal surface of the third cerebral ventricle.
http://www.ncbi.nlm.nih.gov/pubmed/17594665
http://www.ncbi.nlm.nih.gov/pubmed/17594665
Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis :
Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis : preliminary results
Journal of neurosurgery ISSN 0022-3085
1999, vol. 90, no3, pp. 463-467 (38 ref.)
Journal of neurosurgery ISSN 0022-3085
1999, vol. 90, no3, pp. 463-467 (38 ref.)
Postsympathectomy syndrome
Postsympathectomy limb pain, postsympathectomy parotid pain, and Raeder's paratrigeminal syndrome are pain states associated with the loss of sympathetic fibres and in particular with postganglionic sympathetic lesions. There is a characteristic interval of about 10 days between surgical sympathectomy and onset of pain. It is proposed that this pain in man is correlated with the delayed rise in sensory neuropeptides seen in rodents after sympathectomy. These chemical changes probably reflect the sprouting of sensory fibres and may result from the greater availability of nerve growth factor after sympathectomy. The balance between the sensory and sympathetic innervations of a peripheral organ may be determined by competition for a limited supply of nerve growth factor.
Lancet. 1985 Nov 23;2(8465):1158-60.
http://www.ncbi.nlm.nih.gov/pubmed/2414615
bilateral ETS causes the suppression of cardiovascular response to exercise
HR and BP at rest and cardiovascular response to exercise were similar in patients with palmar hyperhidrosis before ETS and in the normal control population. Therefore, we consider that patients with palmar hyperhidrosis have no overactivity of the sympathetic nerve. However, because bilateral ETS causes the suppression of cardiovascular response to exercise, patients that has been treated with ETS need to be observed during high-level exercise.
http://iars.org/abstracts/browsefile/browse.asp?command=N&absnum=45&dir=S190
Chest wall paresthesia affects a significant but previously overlooked proportion of patients
The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS. CONCLUSIONS: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS, but has minimal impact on post-operative satisfaction. Needlescopic VATS offers no apparent advantage over conventional VATS with regard to paresthesia.
http://www.ncbi.nlm.nih.gov/pubmed/15691688?dopt=Abstract
supersensitivity to sympathomimetic amines in the chronically denervated heart
http://www.ncbi.nlm.nih.gov/pubmed/2988820?dopt=Abstract
The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
NPY, NPY receptors and DPPIV in innate immunity and autoimmune disorders
| Book | The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer |
| Publisher | Birkhäuser Basel |
| DOI | 10.1007/3-7643-7427-6 |
| Copyright | 2005 |
| ISBN | 978-3-7643-7159-3 (Print) 978-3-7643-7427-3 (Online)
page 71: Lewis rats are much more likely to develop autoimmune disorders after sympathectomy (Dimitrova and Felten, 1995). This finding suggests that if sympathetic regulation were impaired in a genetically predisposed individual, an autoimmune disease might develop. Betrayal by the Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome and Related Neural Network Disorders by Jay A. Goldstein published by The Haworth Medical Press, 1996 |
Thursday, March 4, 2010
Melatonin levels markedly reduced after sympathectomy
J Clin Endocrinol Metab 72: 819–823, 1991
Sunday, February 28, 2010
Cerebral blood flow rose, while vascular resistance did not change after cervical sympathectomy
Cerebral blood flow rose, while vascular resistance did not change after cervical sympathectomy
After bilateral cervical sympathectomy (n = 9), carotid chemoreceptor reflex stimulation induced significantly different (P less than 0.01) effects on cerebral blood flow, which rose by 42 +/- 8%, and cerebral vascular resistance, which did not change.
To determine whether the difference in effect was due to the sympathectomy or merely to the repetition of the stimulus, another group of dogs (sham; n = 6) that had intact sympathetic nerves were studied a second time. In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy.
Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;
http://ajpheart.physiology.org/cgi/content/abstract/238/4/H594
Posted by Mia 0 comments
Melatonin levels markedly reduced after sympathectomy
In the patient with hyperhidrosis, a prominent melatonin rhythm was observed preoperatively in the CSF and plasma. After bilateral T1-T2 ganglionectomy, however, melatonin levels were markedly reduced, and the diurnal rhythm was abolished. These results provide direct evidence in humans for a diurnal melatonin rhythm in CSF and plasma as well as regulation of this rhythm by sympathetic innervation.
J Clin Endocrinol Metab 72: 819–823, 1991
Posted by Mia 0 comments
Sympathectomy-induced changes on the ventricular surface
Various investigators have shown that unilateral ganglionectomy or transection of the internal and external carotid nerves leads to a regenerative response in the ipsilateral superior cervical ganglion and to uninjured mature sympathetic neurons sprouting into bilaterally innervated shared target organs. In this study changes in the supraependymal neuronal network following unilateral and bilateral cervical sympathectomy on the infundibular floor of the third ventricle were studied by scanning electron microscopy in comparison with normal and sham-operated control animals. After unilateral cervical sympathectomy there was a great increase in the number of varicose nerve fibres on the infundibular floor as compared to the normal and sham-operated control animals. Not only was there an increase in the number of nerve fibres, but also their varicosities were substantially larger than those normally present on the ependymal surface. This study indicates the possible sympathetic projections from the superior cervical ganglia to the ependymal surface of the third cerebral ventricle.
http://www.ncbi.nlm.nih.gov/pubmed/17594665
Posted by Mia 0 comments
Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis :
Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis : preliminary results
Journal of neurosurgery ISSN 0022-3085
1999, vol. 90, no3, pp. 463-467 (38 ref.)
Posted by Mia 0 comments
Postsympathectomy syndrome
Postsympathectomy limb pain, postsympathectomy parotid pain, and Raeder's paratrigeminal syndrome are pain states associated with the loss of sympathetic fibres and in particular with postganglionic sympathetic lesions. There is a characteristic interval of about 10 days between surgical sympathectomy and onset of pain. It is proposed that this pain in man is correlated with the delayed rise in sensory neuropeptides seen in rodents after sympathectomy. These chemical changes probably reflect the sprouting of sensory fibres and may result from the greater availability of nerve growth factor after sympathectomy. The balance between the sensory and sympathetic innervations of a peripheral organ may be determined by competition for a limited supply of nerve growth factor.
Lancet. 1985 Nov 23;2(8465):1158-60.
http://www.ncbi.nlm.nih.gov/pubmed/2414615
Posted by Mia 0 comments
bilateral ETS causes the suppression of cardiovascular response to exercise
HR and BP at rest and cardiovascular response to exercise were similar in patients with palmar hyperhidrosis before ETS and in the normal control population. Therefore, we consider that patients with palmar hyperhidrosis have no overactivity of the sympathetic nerve. However, because bilateral ETS causes the suppression of cardiovascular response to exercise, patients that has been treated with ETS need to be observed during high-level exercise.
http://iars.org/abstracts/browsefile/browse.asp?command=N&absnum=45&dir=S190
Posted by Mia 0 comments
Chest wall paresthesia affects a significant but previously overlooked proportion of patients
The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS. CONCLUSIONS: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS, but has minimal impact on post-operative satisfaction. Needlescopic VATS offers no apparent advantage over conventional VATS with regard to paresthesia.
http://www.ncbi.nlm.nih.gov/pubmed/15691688?dopt=Abstract
Posted by Mia 0 comments
supersensitivity to sympathomimetic amines in the chronically denervated heart
http://www.ncbi.nlm.nih.gov/pubmed/2988820?dopt=Abstract
Posted by Mia 0 comments
The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
NPY, NPY receptors and DPPIV in innate immunity and autoimmune disorders
Book The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
Publisher Birkhäuser Basel
DOI 10.1007/3-7643-7427-6
Copyright 2005
ISBN 978-3-7643-7159-3 (Print) 978-3-7643-7427-3 (Online)
page 71:
Lewis rats are much more likely to develop autoimmune disorders after sympathectomy (Dimitrova and Felten, 1995). This finding suggests that if sympathetic regulation were impaired in a genetically predisposed individual, an autoimmune disease might develop.
Betrayal by the Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome and Related Neural Network Disorders
by Jay A. Goldstein
published by The Haworth Medical Press, 1996
Posted by Mia 0 comments
spontaneous vasospasm 10 days after sympathectomy
We have observed spontaneous vasospasm in the hands on emotional disturbances within ten days after sympathectomy, but no clinical evidence of this in the feet. I believe that sensitization of the denervated smooth muscle in the digital arterioles to adrenine is a better explanation of this phenomenon than local sensitivity to cold (Lewis, 1930), incomplete sympathectomy (Adson, and Leriche and Fontaine, 1933), or the common argument that Raynaud's disease is moresevere in the hands than in the feet.
PROCEEDINGS OF THE TWENTY-SEVENTH ANNUAL MEETING OF THE
AMERICAN SOCIETY FOR CLINICAL INVESTIGATION
HELD IN ATLANTIC CITY, N. J., MAY 6, 1935
Effect of Sympathectomy on Blood Flow
These experimental hemodynamic considerations, in general, explain the occasional untoward effects of sympathectomy, and provide support for some of the empirically derived indications and contra-in- dications for sympathectomy.
Sympathectomy should be tailored to denervate only the ischemic area, if this is possible. Sympathectomy should not be performed where collateral channels do not exist, because of the danger of flow shifts. Sympathectomy probably should not be employed for relief of intermittent claudication.
Annals of Surgery August 1963
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Reduced resistances of septal artery collateral channels after cardiac sympathectomy
Journal Basic Research in Cardiology
Publisher
Steinkopff
ISSN 0300-8428 (Print) 1435-1803 (Online)
Issue Volume 78, Number 4 / July, 1983
Posted by Mia 0 comments
No increase in muscle blood flow following sympathectomy
Recent evidence suggests that this increase in total blood flow represents, in the main, arteriovenous shunting with little, if any, effect on the nutritive blood flow at the tissue level. Studies aimed at investigating the effect of lumbar sympathectomy on regional tissue circulation have utilized the local clearance of radioactive isotopes. No significant change in the clearance of these substances in muscle have been noted following lumbar sympathectomy in man. However, the data on skin clearance remains conflicting.
Vascular and Endovascular Surgery, Vol. 6, No. 5, 227-238 (1972)
http://ves.sagepub.com/cgi/pdf_extract/6/5/227
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Imbalance of regional cerebral blood flow and oxygen consumption: effect of vascular alpha adrenoceptor blockade
Cerebral venous O2 saturations (a measure of cerebral O2 supply/consumption balance) were found to be significantly heterogeneous under control conditions. The coefficient of variation (CV = 100 x SD/mean) averaged 18%. The average cerebral venous O2 saturation was 59 +/- 11%. Administration of N-methyl chlorpromazine significantly reduced this heterogeneity through a reduction in the number of veins with low O2 saturations (CV = 11%). The average value increased slightly but significantly to 62 +/- 8%. Thus, N-methyl chlorpromazine eliminated many microregions of high O2 extraction. This indicated that vascular alpha adrenoceptors limit cerebral blood flow to some of the brain regions.
Neuropharmacology. 1993 Mar;32(3):297-302.
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Long-term cardiopulmonary function after thoracic sympathectomy
Lung function tests revealed a significant decrease in forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of vital capacity (FEF25%–75%) in both groups (FEV1 of –6.3% and FEF25%–75% of –9.1% in the conventional thoracic sympathectomy group and FEV1 of –3.5% and FEF25%–75% of –12.3% in the simplified thoracic sympathectomy group). DLCO and heart rate at rest and maximal values after exercise were also significantly reduced in both groups (DLCO of –4.2%, DLCO corrected by alveolar volume of –6.1%, resting heart rate of –11.8 beats/min, and maximal heart rate of –9.5 beats/min in the conventional thoracic sympathectomy group and DLCO of –3.9%, DLCO corrected by alveolar volume of –5.2%, resting heart rate of –10.7 beats/min, and maximal heart rate of –17.6 beats/min in the simplified thoracic sympathectomy group). Airway resistance increased significantly in the group of patients undergoing conventional thoracic sympathectomy (+13%).
No significant differences were found between the conventional and simplified thoracic sympathectomy groups.
J Thorac Cardiovasc Surg 2010;139:405-410
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The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy
The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy.
HERTZMAN, A. B., AND DILLON, J. B.
Annual Review of Physiology
Vol. 4: 187-214 (Volume publication date March 1942)
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Importance of bilateral sympathetic innervation on cerebral blood flow autoregulation in the thalamus
Brain Res. 1987 Jun 16;413(2):297-301.
Effects of bilateral sympathetic innervation on the regulation of cerebral blood flow to the thalamus were examined in spontaneously hypertensive rats (SHR). The superior cervical ganglion was removed on one side or bilaterally, and blood flow in the thalamus was repeatedly measured with a hydrogen clearance technique during a stepwise increase in arterial pressure. Sympathectomy on one side neither had effects on the pressure-flow relationship nor on the blood pressure levels of upper limits of autoregulation in the ipsilateral thalamus. In contrast, bilateral sympathetic denervation impaired the autoregulatory function in the thalamus and the upper limits were significantly lower than those in intact rats: 206 +/- 8 vs 226 +/- 10 mm Hg, respectively (P less than 0.02).
PMID: 3607478 [PubMed - indexed for MEDLINE]
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effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow
Source: CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC
1992
Times Cited: 20 References: 41
Abstract: The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis.
Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR).
Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood
pressure and heart rate.
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Obviously, it is not simply a compensatory hyperhidrosis transposition from postoperative reduction
In contrast, it is of particular interest to find that patients with cerebroischemic syndrome who received thoracic sympathectomy rarely developed substantial postsympathectomy compensatory hyperhidrosis (PCH). The etiology of PCH is still unclear. Obviously, it is not simply a compensatory hyperhidrosis transposition from postoperative reduction of palmar sweating. Based on our observations, we postulated two possible mechanisms. The first of these mechanisms is denervation hypersensitivity of the surgically injured distal sympathetic stump. This could explain why CH may appear soon after sympathectomy, but is not found in patients who undergo local excision of axillary sweat glands or undergo local treatment. Another mechanism is regeneration of preganglionic fibers or collateral sprouting of sympathetic fibers from the proximal stump of the sympathetic trunk. This could explain the long-term existence of PCH.
Ann Thorac Surg 2001;72:667-668
Receptor hypersensitivity is a common problem after significant sympathetic injury, including clammy hands, erythema, and allodynia. When sympathetic nerves regenerate, they may establish aberrant connections to sensory receptors, muscles, or other sympathetics receptors; this may lead to an over-response or abnormal response.
http://wiki.cns.org/wiki/index.php/Injury,_Sympathetic_Nerve
Posted by Mia 0 comments
Cervical sympathectomy and cerebral microvascular and blood flow responses to hypocapnic hypoxia
The number of perfused arterioles and capillaries was significantly higher under hypoxic conditions than under normoxic conditions in sham and ganglionectomized animals. During hypoxia, the percent of arterioles per squared millimeter perfused increased to 63 +/- 5% in sham-lesioned rats and to a significantly greater extent, 80 +/- 6%, in ganglionectomized rats. The percentage of capillaries per squared millimeter perfused changed similarly. The peripheral sympathetic nervous system appeared to play an important role in the control of cerebral microvascular response to hypoxia.
Am J Physiol Heart Circ Physiol 256: H460-H467, 1989;
http://ajpheart.physiology.org/cgi/content/abstract/256/2/H460
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In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger.
In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger. Patients who become symptomatic within 5 minutes of standing are characterized by a pronounced orthostatic fall in blood pressure, cerebral blood velocity, and oxygenation manifest within the first 10 seconds of standing.
Stroke. 2000;31:1608-1614
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Increased cerebral vasoconstriction or reduced vasomotion also may attenuate CBFV variability
Altered cerebral hemodynamics in early Alzheimer disease: a pilot study using transcranial Doppler.
J Alzheimers Dis. 2009 Jul;17(3):621-9.
Posted by Mia 0 comments
Autonomic neural control of cerebral hemodynamics
it has been found that in humans CBFV in the middle cerebral artery decreased substantially during
lower body negative pressure (LBNP) and head-up tilt in the absence of systemic hypotension, which suggests the presence of cerebral vasoconstriction associated with augmented sympathetic nerve activity during orthostatic stress.
IEEE Eng Med Biol Mag. 2009 Nov-Dec;28(6):54-62.
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SYMPATHETIC-NERVE STIMULATION IN HUMANS INCREASES MIDDLE CEREBRAL-ARTERY BLOOD-FLOW VELOCITY
The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis. Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR). Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood pressure and heart rate.
CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC 1992
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ETS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy
On the 123I-MIBG imaging studies, the early H/M ratio before EUTS was 2.35 ± 0.26 and postoperatively it was 2.29 ± 0.23. The delayed H/M ratio before EUTS was 2.59 ± 0.3 and after the procedure it was 2.66 ± 0.27. There was no significant difference between the H/M ratio before and after EUTS. The washout rate after EUTS (14.27 ± 4.71%) was significantly lower than that measured before EUTS (18.36 ± 5.13%; p < 0.01).
Endoscopic upper thoracic sympathectomy is a minimally invasive procedure; no local denervation was found after EUTS. Findings on 123I-MIBG imaging studies indicate that EUTS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.
Journal of Neurosurgery March 2004 Volume 100, Number 3
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a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate
In pulmonary function tests, we found a statistically significant decrease forced expiratory flow in small airways and an increase of residual volume, a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate, and a significant increase of oxygen pulse (O2 pulse) and oxygen peak uptake ( peak) after ETS (p < 0.05).
Eur J Cardiothorac Surg 2009;36:491-496. doi:10.1016/j.ejcts.2009.03.059
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Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed
The maximal midexpiratory flow was the only variable that showed significant changes, from 101% (SD, 26%) to 92% (SD, 27%) [p < 0.05]. Ten patients had positive bronchial challenge test results that remained positive 3 months after surgery, and 2 patients whose challenge test results were negative before surgery became positive after sympathectomy. Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed during the maximal exercise test.
Chest. 2005 Oct;128(4):2702-5.
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Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis
Patients who underwent T-2 sympathectomy demonstrated a significant increase in blood flow volume and flow velocities of the CAs and MCA, especially on the left side. Asymmetry of sympathetic influence on the hemodynamics of the CAs and MCA was noted. The usefulness of sympathectomy for the treatment of ischemic cardiovascular and cerebrovascular disease deserves further investigation.
Journal on Neurosurgery March 1999 Volume 90, Number 3
http://thejns.org/doi/abs/10.3171/jns.1999.90.3.0463
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Clinical significance of chemosensitivity in chronic heart failure
Increased chemosensitivity has been observed in HF (heart failure) and, in order to clarify its pathophysiological and clinical relevance, the aim of the present study was to investigate its impact on neurohormonal balance, breathing pattern, response to exercise and arrhythmic profile.
Those with enhanced chemosensitivity to both hypoxia and hypercapnia (i.e. HVR and HCVR), compared with those with normal chemosensitivity, had significantly (all P<0.01) higher noradrenaline (norepinephrine) and BNP (B-type natriuretic peptide) levels, higher prevalence of daytime and night-time CSR, worse NYHA (New York Heart Association) class and ventilatory efficiency [higher VE (minute ventilation)/VCO(2) (carbon dioxide output) slope], and a higher incidence of chronic atrial fibrillation and paroxysmal non-sustained ventricular tachycardia, but no difference in left ventricular volumes or LVEF. A direct correlation was found between HVR or HCVR and noradrenaline.
Clin Sci (Lond). 2008 Apr;114(7):489-97.
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Impaired autonomic function results in impaired cerebral regulation
The absence of an increase in the power of 0.1 Hz blood pressure and cerebral blood flow velocity oscillations confirmed autonomic neuropathy in the diabetic patients. Gain analysis did not show altered cerebral regulation. The decrease in phase shift in the patients indicates a more passive transmission of neck suction-induced blood pressure fluctuations onto the cerebrovascular circulation, i.e. altered cerebral regulation, in the patients, and is therefore suited to identifying subtle impairment of cerebral regulation in these patients.
http://www.springerlink.com/content/14m7g478j7ux11hv/
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Superior cervical ganglionectomy caused a marked decrease in noradrenaline concentrations in major cerebral arteries
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.
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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.
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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.
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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.
After bilateral cervical sympathectomy (n = 9), carotid chemoreceptor reflex stimulation induced significantly different (P less than 0.01) effects on cerebral blood flow, which rose by 42 +/- 8%, and cerebral vascular resistance, which did not change.
To determine whether the difference in effect was due to the sympathectomy or merely to the repetition of the stimulus, another group of dogs (sham; n = 6) that had intact sympathetic nerves were studied a second time. In "sham" dogs, the repeat response to carotid chemoreceptor stimulation also induced significantly different effects from those in dogs with sympathectomy.
Am J Physiol Heart Circ Physiol 238: H594-H598, 1980;
http://ajpheart.physiology.org/cgi/content/abstract/238/4/H594
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Melatonin levels markedly reduced after sympathectomy
In the patient with hyperhidrosis, a prominent melatonin rhythm was observed preoperatively in the CSF and plasma. After bilateral T1-T2 ganglionectomy, however, melatonin levels were markedly reduced, and the diurnal rhythm was abolished. These results provide direct evidence in humans for a diurnal melatonin rhythm in CSF and plasma as well as regulation of this rhythm by sympathetic innervation.
J Clin Endocrinol Metab 72: 819–823, 1991
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Sympathectomy-induced changes on the ventricular surface
Various investigators have shown that unilateral ganglionectomy or transection of the internal and external carotid nerves leads to a regenerative response in the ipsilateral superior cervical ganglion and to uninjured mature sympathetic neurons sprouting into bilaterally innervated shared target organs. In this study changes in the supraependymal neuronal network following unilateral and bilateral cervical sympathectomy on the infundibular floor of the third ventricle were studied by scanning electron microscopy in comparison with normal and sham-operated control animals. After unilateral cervical sympathectomy there was a great increase in the number of varicose nerve fibres on the infundibular floor as compared to the normal and sham-operated control animals. Not only was there an increase in the number of nerve fibres, but also their varicosities were substantially larger than those normally present on the ependymal surface. This study indicates the possible sympathetic projections from the superior cervical ganglia to the ependymal surface of the third cerebral ventricle.
http://www.ncbi.nlm.nih.gov/pubmed/17594665
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Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis :
Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis : preliminary results
Journal of neurosurgery ISSN 0022-3085
1999, vol. 90, no3, pp. 463-467 (38 ref.)
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Postsympathectomy syndrome
Postsympathectomy limb pain, postsympathectomy parotid pain, and Raeder's paratrigeminal syndrome are pain states associated with the loss of sympathetic fibres and in particular with postganglionic sympathetic lesions. There is a characteristic interval of about 10 days between surgical sympathectomy and onset of pain. It is proposed that this pain in man is correlated with the delayed rise in sensory neuropeptides seen in rodents after sympathectomy. These chemical changes probably reflect the sprouting of sensory fibres and may result from the greater availability of nerve growth factor after sympathectomy. The balance between the sensory and sympathetic innervations of a peripheral organ may be determined by competition for a limited supply of nerve growth factor.
Lancet. 1985 Nov 23;2(8465):1158-60.
http://www.ncbi.nlm.nih.gov/pubmed/2414615
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bilateral ETS causes the suppression of cardiovascular response to exercise
HR and BP at rest and cardiovascular response to exercise were similar in patients with palmar hyperhidrosis before ETS and in the normal control population. Therefore, we consider that patients with palmar hyperhidrosis have no overactivity of the sympathetic nerve. However, because bilateral ETS causes the suppression of cardiovascular response to exercise, patients that has been treated with ETS need to be observed during high-level exercise.
http://iars.org/abstracts/browsefile/browse.asp?command=N&absnum=45&dir=S190
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Chest wall paresthesia affects a significant but previously overlooked proportion of patients
The rates and characteristics of the paresthesia following needlescopic VATS are similar to those observed after conventional VATS. CONCLUSIONS: Chest wall paresthesia affects a significant but previously overlooked proportion of patients following needlescopic VATS, but has minimal impact on post-operative satisfaction. Needlescopic VATS offers no apparent advantage over conventional VATS with regard to paresthesia.
http://www.ncbi.nlm.nih.gov/pubmed/15691688?dopt=Abstract
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supersensitivity to sympathomimetic amines in the chronically denervated heart
http://www.ncbi.nlm.nih.gov/pubmed/2988820?dopt=Abstract
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The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
NPY, NPY receptors and DPPIV in innate immunity and autoimmune disorders
Book The NPY Family of Peptides in Immune Disorders, Inflammation, Angiogenesis and Cancer
Publisher Birkhäuser Basel
DOI 10.1007/3-7643-7427-6
Copyright 2005
ISBN 978-3-7643-7159-3 (Print) 978-3-7643-7427-3 (Online)
page 71:
Lewis rats are much more likely to develop autoimmune disorders after sympathectomy (Dimitrova and Felten, 1995). This finding suggests that if sympathetic regulation were impaired in a genetically predisposed individual, an autoimmune disease might develop.
Betrayal by the Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome and Related Neural Network Disorders
by Jay A. Goldstein
published by The Haworth Medical Press, 1996
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spontaneous vasospasm 10 days after sympathectomy
We have observed spontaneous vasospasm in the hands on emotional disturbances within ten days after sympathectomy, but no clinical evidence of this in the feet. I believe that sensitization of the denervated smooth muscle in the digital arterioles to adrenine is a better explanation of this phenomenon than local sensitivity to cold (Lewis, 1930), incomplete sympathectomy (Adson, and Leriche and Fontaine, 1933), or the common argument that Raynaud's disease is moresevere in the hands than in the feet.
PROCEEDINGS OF THE TWENTY-SEVENTH ANNUAL MEETING OF THE
AMERICAN SOCIETY FOR CLINICAL INVESTIGATION
HELD IN ATLANTIC CITY, N. J., MAY 6, 1935
Effect of Sympathectomy on Blood Flow
These experimental hemodynamic considerations, in general, explain the occasional untoward effects of sympathectomy, and provide support for some of the empirically derived indications and contra-in- dications for sympathectomy.
Sympathectomy should be tailored to denervate only the ischemic area, if this is possible. Sympathectomy should not be performed where collateral channels do not exist, because of the danger of flow shifts. Sympathectomy probably should not be employed for relief of intermittent claudication.
Annals of Surgery August 1963
Posted by Mia 0 comments
Reduced resistances of septal artery collateral channels after cardiac sympathectomy
Journal Basic Research in Cardiology
Publisher
Steinkopff
ISSN 0300-8428 (Print) 1435-1803 (Online)
Issue Volume 78, Number 4 / July, 1983
Posted by Mia 0 comments
No increase in muscle blood flow following sympathectomy
Recent evidence suggests that this increase in total blood flow represents, in the main, arteriovenous shunting with little, if any, effect on the nutritive blood flow at the tissue level. Studies aimed at investigating the effect of lumbar sympathectomy on regional tissue circulation have utilized the local clearance of radioactive isotopes. No significant change in the clearance of these substances in muscle have been noted following lumbar sympathectomy in man. However, the data on skin clearance remains conflicting.
Vascular and Endovascular Surgery, Vol. 6, No. 5, 227-238 (1972)
http://ves.sagepub.com/cgi/pdf_extract/6/5/227
Posted by Mia 0 comments
Imbalance of regional cerebral blood flow and oxygen consumption: effect of vascular alpha adrenoceptor blockade
Cerebral venous O2 saturations (a measure of cerebral O2 supply/consumption balance) were found to be significantly heterogeneous under control conditions. The coefficient of variation (CV = 100 x SD/mean) averaged 18%. The average cerebral venous O2 saturation was 59 +/- 11%. Administration of N-methyl chlorpromazine significantly reduced this heterogeneity through a reduction in the number of veins with low O2 saturations (CV = 11%). The average value increased slightly but significantly to 62 +/- 8%. Thus, N-methyl chlorpromazine eliminated many microregions of high O2 extraction. This indicated that vascular alpha adrenoceptors limit cerebral blood flow to some of the brain regions.
Neuropharmacology. 1993 Mar;32(3):297-302.
Posted by Mia 0 comments
Long-term cardiopulmonary function after thoracic sympathectomy
Lung function tests revealed a significant decrease in forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of vital capacity (FEF25%–75%) in both groups (FEV1 of –6.3% and FEF25%–75% of –9.1% in the conventional thoracic sympathectomy group and FEV1 of –3.5% and FEF25%–75% of –12.3% in the simplified thoracic sympathectomy group). DLCO and heart rate at rest and maximal values after exercise were also significantly reduced in both groups (DLCO of –4.2%, DLCO corrected by alveolar volume of –6.1%, resting heart rate of –11.8 beats/min, and maximal heart rate of –9.5 beats/min in the conventional thoracic sympathectomy group and DLCO of –3.9%, DLCO corrected by alveolar volume of –5.2%, resting heart rate of –10.7 beats/min, and maximal heart rate of –17.6 beats/min in the simplified thoracic sympathectomy group). Airway resistance increased significantly in the group of patients undergoing conventional thoracic sympathectomy (+13%).
No significant differences were found between the conventional and simplified thoracic sympathectomy groups.
J Thorac Cardiovasc Surg 2010;139:405-410
Posted by Mia 0 comments
The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy
The cerebral vessels became hypersensitive to epinephrine after cervical sympathectomy.
HERTZMAN, A. B., AND DILLON, J. B.
Annual Review of Physiology
Vol. 4: 187-214 (Volume publication date March 1942)
Posted by Mia 0 comments
Importance of bilateral sympathetic innervation on cerebral blood flow autoregulation in the thalamus
Brain Res. 1987 Jun 16;413(2):297-301.
Effects of bilateral sympathetic innervation on the regulation of cerebral blood flow to the thalamus were examined in spontaneously hypertensive rats (SHR). The superior cervical ganglion was removed on one side or bilaterally, and blood flow in the thalamus was repeatedly measured with a hydrogen clearance technique during a stepwise increase in arterial pressure. Sympathectomy on one side neither had effects on the pressure-flow relationship nor on the blood pressure levels of upper limits of autoregulation in the ipsilateral thalamus. In contrast, bilateral sympathetic denervation impaired the autoregulatory function in the thalamus and the upper limits were significantly lower than those in intact rats: 206 +/- 8 vs 226 +/- 10 mm Hg, respectively (P less than 0.02).
PMID: 3607478 [PubMed - indexed for MEDLINE]
Posted by Mia 0 comments
effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow
Source: CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC
1992
Times Cited: 20 References: 41
Abstract: The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis.
Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR).
Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood
pressure and heart rate.
Posted by Mia 0 comments
Obviously, it is not simply a compensatory hyperhidrosis transposition from postoperative reduction
In contrast, it is of particular interest to find that patients with cerebroischemic syndrome who received thoracic sympathectomy rarely developed substantial postsympathectomy compensatory hyperhidrosis (PCH). The etiology of PCH is still unclear. Obviously, it is not simply a compensatory hyperhidrosis transposition from postoperative reduction of palmar sweating. Based on our observations, we postulated two possible mechanisms. The first of these mechanisms is denervation hypersensitivity of the surgically injured distal sympathetic stump. This could explain why CH may appear soon after sympathectomy, but is not found in patients who undergo local excision of axillary sweat glands or undergo local treatment. Another mechanism is regeneration of preganglionic fibers or collateral sprouting of sympathetic fibers from the proximal stump of the sympathetic trunk. This could explain the long-term existence of PCH.
Ann Thorac Surg 2001;72:667-668
Receptor hypersensitivity is a common problem after significant sympathetic injury, including clammy hands, erythema, and allodynia. When sympathetic nerves regenerate, they may establish aberrant connections to sensory receptors, muscles, or other sympathetics receptors; this may lead to an over-response or abnormal response.
http://wiki.cns.org/wiki/index.php/Injury,_Sympathetic_Nerve
Posted by Mia 0 comments
Cervical sympathectomy and cerebral microvascular and blood flow responses to hypocapnic hypoxia
The number of perfused arterioles and capillaries was significantly higher under hypoxic conditions than under normoxic conditions in sham and ganglionectomized animals. During hypoxia, the percent of arterioles per squared millimeter perfused increased to 63 +/- 5% in sham-lesioned rats and to a significantly greater extent, 80 +/- 6%, in ganglionectomized rats. The percentage of capillaries per squared millimeter perfused changed similarly. The peripheral sympathetic nervous system appeared to play an important role in the control of cerebral microvascular response to hypoxia.
Am J Physiol Heart Circ Physiol 256: H460-H467, 1989;
http://ajpheart.physiology.org/cgi/content/abstract/256/2/H460
Posted by Mia 0 comments
In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger.
In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger. Patients who become symptomatic within 5 minutes of standing are characterized by a pronounced orthostatic fall in blood pressure, cerebral blood velocity, and oxygenation manifest within the first 10 seconds of standing.
Stroke. 2000;31:1608-1614
Posted by Mia 0 comments
Increased cerebral vasoconstriction or reduced vasomotion also may attenuate CBFV variability
Altered cerebral hemodynamics in early Alzheimer disease: a pilot study using transcranial Doppler.
J Alzheimers Dis. 2009 Jul;17(3):621-9.
Posted by Mia 0 comments
Autonomic neural control of cerebral hemodynamics
it has been found that in humans CBFV in the middle cerebral artery decreased substantially during
lower body negative pressure (LBNP) and head-up tilt in the absence of systemic hypotension, which suggests the presence of cerebral vasoconstriction associated with augmented sympathetic nerve activity during orthostatic stress.
IEEE Eng Med Biol Mag. 2009 Nov-Dec;28(6):54-62.
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SYMPATHETIC-NERVE STIMULATION IN HUMANS INCREASES MIDDLE CEREBRAL-ARTERY BLOOD-FLOW VELOCITY
The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis. Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR). Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood pressure and heart rate.
CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC 1992
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ETS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy
On the 123I-MIBG imaging studies, the early H/M ratio before EUTS was 2.35 ± 0.26 and postoperatively it was 2.29 ± 0.23. The delayed H/M ratio before EUTS was 2.59 ± 0.3 and after the procedure it was 2.66 ± 0.27. There was no significant difference between the H/M ratio before and after EUTS. The washout rate after EUTS (14.27 ± 4.71%) was significantly lower than that measured before EUTS (18.36 ± 5.13%; p < 0.01).
Endoscopic upper thoracic sympathectomy is a minimally invasive procedure; no local denervation was found after EUTS. Findings on 123I-MIBG imaging studies indicate that EUTS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.
Journal of Neurosurgery March 2004 Volume 100, Number 3
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a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate
In pulmonary function tests, we found a statistically significant decrease forced expiratory flow in small airways and an increase of residual volume, a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate, and a significant increase of oxygen pulse (O2 pulse) and oxygen peak uptake ( peak) after ETS (p < 0.05).
Eur J Cardiothorac Surg 2009;36:491-496. doi:10.1016/j.ejcts.2009.03.059
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Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed
The maximal midexpiratory flow was the only variable that showed significant changes, from 101% (SD, 26%) to 92% (SD, 27%) [p < 0.05]. Ten patients had positive bronchial challenge test results that remained positive 3 months after surgery, and 2 patients whose challenge test results were negative before surgery became positive after sympathectomy. Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed during the maximal exercise test.
Chest. 2005 Oct;128(4):2702-5.
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Changes in hemodynamics of the carotid and middle cerebral arteries before and after endoscopic sympathectomy in patients with palmar hyperhidrosis
Patients who underwent T-2 sympathectomy demonstrated a significant increase in blood flow volume and flow velocities of the CAs and MCA, especially on the left side. Asymmetry of sympathetic influence on the hemodynamics of the CAs and MCA was noted. The usefulness of sympathectomy for the treatment of ischemic cardiovascular and cerebrovascular disease deserves further investigation.
Journal on Neurosurgery March 1999 Volume 90, Number 3
http://thejns.org/doi/abs/10.3171/jns.1999.90.3.0463
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Clinical significance of chemosensitivity in chronic heart failure
Increased chemosensitivity has been observed in HF (heart failure) and, in order to clarify its pathophysiological and clinical relevance, the aim of the present study was to investigate its impact on neurohormonal balance, breathing pattern, response to exercise and arrhythmic profile.
Those with enhanced chemosensitivity to both hypoxia and hypercapnia (i.e. HVR and HCVR), compared with those with normal chemosensitivity, had significantly (all P<0.01) higher noradrenaline (norepinephrine) and BNP (B-type natriuretic peptide) levels, higher prevalence of daytime and night-time CSR, worse NYHA (New York Heart Association) class and ventilatory efficiency [higher VE (minute ventilation)/VCO(2) (carbon dioxide output) slope], and a higher incidence of chronic atrial fibrillation and paroxysmal non-sustained ventricular tachycardia, but no difference in left ventricular volumes or LVEF. A direct correlation was found between HVR or HCVR and noradrenaline.
Clin Sci (Lond). 2008 Apr;114(7):489-97.
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Impaired autonomic function results in impaired cerebral regulation
The absence of an increase in the power of 0.1 Hz blood pressure and cerebral blood flow velocity oscillations confirmed autonomic neuropathy in the diabetic patients. Gain analysis did not show altered cerebral regulation. The decrease in phase shift in the patients indicates a more passive transmission of neck suction-induced blood pressure fluctuations onto the cerebrovascular circulation, i.e. altered cerebral regulation, in the patients, and is therefore suited to identifying subtle impairment of cerebral regulation in these patients.
http://www.springerlink.com/content/14m7g478j7ux11hv/
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Superior cervical ganglionectomy caused a marked decrease in noradrenaline concentrations in major cerebral arteries
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.
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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.
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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.
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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.
Monday, January 11, 2010
Importance of bilateral sympathetic innervation on cerebral blood flow autoregulation in the thalamus
Brain Res. 1987 Jun 16;413(2):297-301.
Effects of bilateral sympathetic innervation on the regulation of cerebral blood flow to the thalamus were examined in spontaneously hypertensive rats (SHR). The superior cervical ganglion was removed on one side or bilaterally, and blood flow in the thalamus was repeatedly measured with a hydrogen clearance technique during a stepwise increase in arterial pressure. Sympathectomy on one side neither had effects on the pressure-flow relationship nor on the blood pressure levels of upper limits of autoregulation in the ipsilateral thalamus. In contrast, bilateral sympathetic denervation impaired the autoregulatory function in the thalamus and the upper limits were significantly lower than those in intact rats: 206 +/- 8 vs 226 +/- 10 mm Hg, respectively (P less than 0.02).
PMID: 3607478 [PubMed - indexed for MEDLINE]
Effects of bilateral sympathetic innervation on the regulation of cerebral blood flow to the thalamus were examined in spontaneously hypertensive rats (SHR). The superior cervical ganglion was removed on one side or bilaterally, and blood flow in the thalamus was repeatedly measured with a hydrogen clearance technique during a stepwise increase in arterial pressure. Sympathectomy on one side neither had effects on the pressure-flow relationship nor on the blood pressure levels of upper limits of autoregulation in the ipsilateral thalamus. In contrast, bilateral sympathetic denervation impaired the autoregulatory function in the thalamus and the upper limits were significantly lower than those in intact rats: 206 +/- 8 vs 226 +/- 10 mm Hg, respectively (P less than 0.02).
PMID: 3607478 [PubMed - indexed for MEDLINE]
Sunday, January 10, 2010
effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow
Source: CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC
1992Times Cited: 20 References: 41
Abstract: The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis.
Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR).
Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood
pressure and heart rate.
Cervical sympathectomy and cerebral microvascular and blood flow responses to hypocapnic hypoxia
The number of perfused arterioles and capillaries was significantly higher under hypoxic conditions than under normoxic conditions in sham and ganglionectomized animals. During hypoxia, the percent of arterioles per squared millimeter perfused increased to 63 +/- 5% in sham-lesioned rats and to a significantly greater extent, 80 +/- 6%, in ganglionectomized rats. The percentage of capillaries per squared millimeter perfused changed similarly. The peripheral sympathetic nervous system appeared to play an important role in the control of cerebral microvascular response to hypoxia.
Am J Physiol Heart Circ Physiol 256: H460-H467, 1989;http://ajpheart.physiology.org/cgi/content/abstract/256/2/H460
Friday, January 8, 2010
Autonomic neural control of cerebral hemodynamics
In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger.
In patients with sympathetic failure, the orthostatic reduction in cerebral blood velocity and oxygenation is larger. Patients who become symptomatic within 5 minutes of standing are characterized by a pronounced orthostatic fall in blood pressure, cerebral blood velocity, and oxygenation manifest within the first 10 seconds of standing.
Stroke. 2000;31:1608-1614
Stroke. 2000;31:1608-1614
Increased cerebral vasoconstriction or reduced vasomotion also may attenuate CBFV variability
Altered cerebral hemodynamics in early Alzheimer disease: a pilot study using transcranial Doppler.
J Alzheimers Dis. 2009 Jul;17(3):621-9.Autonomic neural control of cerebral hemodynamics
it has been found that in humans CBFV in the middle cerebral artery decreased substantially during
lower body negative pressure (LBNP) and head-up tilt in the absence of systemic hypotension, which suggests the presence of cerebral vasoconstriction associated with augmented sympathetic nerve activity during orthostatic stress.
IEEE Eng Med Biol Mag. 2009 Nov-Dec;28(6):54-62.
lower body negative pressure (LBNP) and head-up tilt in the absence of systemic hypotension, which suggests the presence of cerebral vasoconstriction associated with augmented sympathetic nerve activity during orthostatic stress.
IEEE Eng Med Biol Mag. 2009 Nov-Dec;28(6):54-62.
SYMPATHETIC-NERVE STIMULATION IN HUMANS INCREASES MIDDLE CEREBRAL-ARTERY BLOOD-FLOW VELOCITY
The effect of electric stimulation of the sympathetic cord in the upper thoracic level on the middle cerebral artery blood flow veloCitY (V(MCA)) in humans was examined using transcranial Doppler sonography monitoring during surgery for palmar hyperhidrosis. Sympathetic stimulation resulted in marked and rapid increases Of V(MCA). The responses were preceded by prompt increases of mean arterial blood pressure (MABP) and heart rate (HR). Division of the sympathetic cord cranially or caudally to the stimulation site partially reduced the V(MCA), MABP and HR responses. Both these operations reduced sympathetic pathways to the heart as reflected by a decrease in HR and MABP. The integrity of the sympathetic pathway from the stimulation site through the superior cervical ganglion and the carotid plexus was not a prerequisite for a V(MCA) response. Our data suggest that the V(MCA) increase mainly results from stimulation of the heart and the cardiovascular system, resulting in marked increases of blood pressure and heart rate.
CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC 1992
CEREBROVASCULAR DISEASES Volume: 2 Issue: 6 Pages: 359-364 Published: NOV-DEC 1992
ETS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy
On the 123I-MIBG imaging studies, the early H/M ratio before EUTS was 2.35 ± 0.26 and postoperatively it was 2.29 ± 0.23. The delayed H/M ratio before EUTS was 2.59 ± 0.3 and after the procedure it was 2.66 ± 0.27. There was no significant difference between the H/M ratio before and after EUTS. The washout rate after EUTS (14.27 ± 4.71%) was significantly lower than that measured before EUTS (18.36 ± 5.13%; p < 0.01).
Endoscopic upper thoracic sympathectomy is a minimally invasive procedure; no local denervation was found after EUTS. Findings on 123I-MIBG imaging studies indicate that EUTS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.
Journal of Neurosurgery March 2004 Volume 100, Number 3
Endoscopic upper thoracic sympathectomy is a minimally invasive procedure; no local denervation was found after EUTS. Findings on 123I-MIBG imaging studies indicate that EUTS suppresses the activation of the sympathetic nervous system slightly, similar to beta-blocker therapy.
Journal of Neurosurgery March 2004 Volume 100, Number 3
a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate
In pulmonary function tests, we found a statistically significant decrease forced expiratory flow in small airways and an increase of residual volume, a significant decrease in heart rate and ejection fraction, a significant decrease of ‘rest’ and ‘peak’ heart rate, and a significant increase of oxygen pulse (O2 pulse) and oxygen peak uptake ( peak) after ETS (p < 0.05).
Eur J Cardiothorac Surg 2009;36:491-496. doi:10.1016/j.ejcts.2009.03.059
Eur J Cardiothorac Surg 2009;36:491-496. doi:10.1016/j.ejcts.2009.03.059
Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed
The maximal midexpiratory flow was the only variable that showed significant changes, from 101% (SD, 26%) to 92% (SD, 27%) [p < 0.05]. Ten patients had positive bronchial challenge test results that remained positive 3 months after surgery, and 2 patients whose challenge test results were negative before surgery became positive after sympathectomy. Significant reductions in maximal heart rate (HR) and oxygen and carbon dioxide uptakes were observed during the maximal exercise test.Chest. 2005 Oct;128(4):2702-5.
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