after sympathectomy "He becomes more quiet, less impressionable, less agitated, tremor diminishes..."

Everyone seems to agree that when sympathectomy is successful the subjective symptoms of the patient show a considerable improvement. He becomes more quiet, less impressionable, less agitated, tremor diminishes, tachycardia, however, is little influenced or not at all, and the same is true for goiter.
   In conclusion it may be said that the results obtained from sympathectomy when present are very immediate. The ocular symptoms are the ones most happily influenced by the operation; the others such as nervousness, tachycardia, and goiter are problematical.
   Remote Results.- In going over the cases operated by Jaboulay as far back as twelve and fourteen years, A. Charlier was able to find that a number of his patients had been cured completely. He was able to retrace 18 out of the 31 cases operated by Jaboulay from four to fourteen years before. Three of them were completely cured, 9 of them were so ameliorated that the subjective cure was a complete one, the objective cure, however, being incomplete; the 6 remaining cases were doubtful. All these patients experienced considerable benefit to their nervous symptoms; improved and no trophic disturbances of any sort followed as the result of sympathectomy.

Title	Thyroid and Thymus
Author	André Crotti
Publisher	Lea & Febiger, 1918
Original from	Harvard University
Digitized	17 Dec 2007
Length	567 pages

An absence of afferent feedback concerning autonomically generated bodily states was associated with subtle impairments of emotional responses

nature neuroscience • volume 4 no 2 • february 2001 

Neuroanatomical basis for first- and second-order representations of bodily states
H. D. Critchley1,2, C. J. Mathias2,3 and R. J. Dolan1

The Effects of Thoracic Sympathotomy on Heart Rate Variability in Patients with Palmar Hyperhidrosis

Compared with preoperative variables, there was a significant increase in the number of adjacent normal R wave to R wave (R- R) intervals that differed by more than 50 ms, as percent of the total number of normal RR intervals (pNN50); root mean square difference, the square root of the mean of the sum of squared differences between adjacent normal RR intervals over the entire 24-hour recording; standard deviation of the average normal RR in- terval for all 5-minute segments of a 24-hour recording (SDANN) after thoracic sympathotomy. Low frequencies (LF, 0.04 to 0.15 Hz) decreased significantly.
Yonsei Med J 53(6):1081-1084, 2012

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481380/pdf/ymj-53-1081.pdf 

anatomical variations

"denervation of the T2-T3 thoracic sympathetic ganglia extends to the craniofacial region in 20.75% of cases, an area that is classically attributed to node T1."

Bronconeumol. 2003, 39: 19-22. - Vol 39 Núm.01

Patients with surgical sympathectomies have low plasma levels of DA and NE [49], whereas EPI:NE ratios are increased

Patients with surgical sympathectomies have low plasma levels of DA and NE [49], whereas EPI:NE ratios are increased (unpublished observations), suggesting decreased sympathetically mediated exocytosis and compensatory adrenomedullary activation.

Catecholamines 101, David S. Goldstein
Clin Auton Res (2010) 20:331–352

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block: "Korean J Pain. Jun 2010; 23(2): 142–146.
Published online May 31, 2010.



Background

Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy.



Methods

SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB.



Results

The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes.



Conclusions

We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased."

Local distribution of the effects of sympathetic stimulation on cerebral blood flow in the rat

Local distribution of the effects of sympathetic s... [Brain Res. 1990] - PubMed - NCBI: "Although the density of sympathetic fibres on the cerebral vessels varies regionally, the cerebral circulatory effects of electrical stimulation of these fibres on the cerebral circulation have not been mapped in detail. In the present study the effects of sympathetic stimulation on local cerebral blood flow were examined in urethane anaesthetized rats using autoradiographic techniques. Initial experiments determined that unilateral stimulation of the superior cervical ganglion altered cerebral circulatory dynamics to an extent sufficient to reduce cerebral venous pressure by 1.1 +/- 0.2 mm Hg. Local cerebral blood flow was measured with iodo[14C]antipyrine autoradiography in 4 groups: (1) sham; (2) sham + unilateral sympathetic nerve section; (3) unilateral stimulation of the superior cervical ganglion; and (4) unilateral sympathetic stimulation + contralateral sympathetic nerve section. In the sham animals, local cerebral blood flow was equivalent in the innervated and denervated hemispheres. During stimulation plus contralateral nerve section, a regionally heterogeneous response to sympathetic stimulation was observed. Local cerebral blood flow was reduced 11-19% on the stimulated side in over one half (15/28) of the regions examined (e.g. thalamic nuclei and caudate nucleus). In general, ipsilateral reductions in flow occurred in the territory supplied by the middle cerebral, posterior cerebral and posterior communicating arteries and their branches. Cerebral blood flow was symmetrical in regions supplied by the basilar and anterior cerebral arteries and in some midline structures."

Effects of stellate ganglion block on cerebral haemodynamics as assessed by transcranial Doppler ultrasonography

Background. Stellate ganglion block (SGB) causes vasodilatation in the skin of the head and neck

because of regional sympathetic block. Its effects on cerebral haemodynamics, in health or in

disease, are not clear. We evaluated the effects of SGB on ipsilateral middle cerebral artery flow

velocity (MCAFV), estimated cerebral perfusion pressure (eCPP), zero flow pressure (ZFP),

carbon dioxide reactivity (CO2R) and cerebral autoregulation using transcranial Doppler

ultrasonography (TCD).



Methods. Twenty male patients, with pre-existing brachial plexus injury, and undergoing SGB for

the treatment of complex regional pain syndrome of the upper limb, were studied. For SGB, 10 ml

of plain lidocaine 2% was used and the onset of block was confirmed by presence of ipsilateral

Horner’s syndrome. The MCAFV, eCPP, ZFP, CO2R, and cerebral autoregulation were assessed

before and after SGB using established TCD methods. The changes in these variables were

analysed using Wilcoxon’s signed rank test.



Results. The block caused a significant decrease in MCAFV from median (inter-quartile range)

value of 61 (53, 67) to 55 (46, 60) cm s 1, a significant increase in eCPP from 59 (51, 67) to

70 (60, 78) mm Hg, and a significant decrease in ZFP from 32 (26, 39) to 25 (16, 30) mm Hg. There

were no significant changes in CO2R or cerebral autoregulation.

http://bja.oxfordjournals.org/content/95/5/669.full.pdf

NE is critical for the acquisition of spatial working memory

The adrenergic system (utilizing norepinephrine, NE, as a neurotransmitter) is implicated in hippocampus-based learning and memory, in addition to its well known peripheral actions mediated by the sympathetic nervous system.

Using a more standard variation of the above protocol on the radial arm maze, we used this apparatus to test the role of NE in spatial working memory. We found significant, robust differences between Dbh-/- and Dbh+/- mice after a training period of approximately 14 days. To test whether this difference was due to a potential deficit in acquisition or performance, we restored NE in Dbh-/- mice by administering the synthetic precursor L-DOPS after four days of stable behavioral differences between genotypes. In a separate trial, we also restored NE signaling with dexmedetomidine, a selective alpha-2 receptor agonist. A gradual improvement by Dbh-/- mice to levels comparable to Dbh+/- mice indicated that NE is critical for the acquisition of spatial working memory, and suggested a role for the alpha-2 adrenergic receptor in the processing of spatial working memory.

Suggested Citation

Gertner, Michael J. and Thomas, Steven A., "The role of norepinephrine in spatial reference and spatial working memory" 08 June 2006. CUREJ: College Undergraduate Research Electronic Journal, University of Pennsylvania, http://repository.upenn.edu/curej/18.

Date Posted: 08 June 2006

This document has been peer reviewed.

Michael J. Gertner, University of Pennsylvania
Steven A. Thomas, University of Pennsylvania
http://repository.upenn.edu/curej/18/

Inflammation in dorsal root ganglia after peripheral nerve injury: Effects of the sympathetic innervation

Following a peripheral nerve injury, a sterile inflammation develops in sympathetic and dorsal root ganglia (DRGs) with axons that project in the damaged nerve trunk. Macrophages and T-lymphocytes invade these gan- glia where they are believed to release cytokines that lead to hyperexcitability and ectopic discharge, possibly contributing to neuropathic pain. Here, we examined the role of the sympathetic innervation in the inflammation of L5 DRGs of Wistar rats following transection of the sciatic nerve, comparing the effects of specific surgical in- terventions 10–14 days prior to the nerve lesion with those of chronic administration of adrenoceptor antago- nists. Immunohistochemistry was used to define the invading immune cell populations 7 days after sciatic transection. Removal of sympathetic activity in the hind limb by transecting the preganglionic input to the rele- vant lumbar sympathetic ganglia (ipsi- or bilateral decentralization) or by ipsilateral removal of these ganglia with degeneration of postganglionic axons (denervation), caused less DRG inflammation than occurred after a sham sympathectomy. By contrast, denervation of the lymph node draining the lesion site potentiated T-cell in- flux. Systemic treatment with antagonists of α1-adrenoceptors (prazosin) or β-adrenoceptors (propranolol) led to opposite but unexpected effects on infiltration of DRGs after sciatic transection. Prazosin potentiated the influx of macrophages and CD4+ T-lymphocytes whereas propranolol tended to reduce immune cell invasion. These data are hard to reconcile with many in vitro studies in which catecholamines acting mainly via β2-adrenoceptors have inhibited the activation and proliferation of immune cells following an inflamma- tory challenge. 

Autonomic Neuroscience: Basic and Clinical 182 (2014) 108–117 

Neuroscience Research Australia, Randwick, NSW 2031, and the University of New South Wales, Sydney, NSW 2052, Australia 

electric stimulation of the sympathetic cord in the upper thoracic level on the 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

Treatment of social phobia by endoscopic thoracic sympathicotomy

Eur J Surg Suppl. 1998;(580):27-32.

Treatment of social phobia by endoscopic thoracic sympathicotomy.

Telaranta T.

THE PATHOGNOMONIC SYMPTOMS OF SOCIAL PHOBIA: HYPERHIDROSIS, PALPITATION, BLUSHING, TREMOR, AND ANXIETY, WERE ALL HIGHLY SIGNIFICANTLY (P < 0.001) ALLEVIATED BY ETS. 88% OF THE PATIENTS WERE SATISFIED WITH THE RESULT. THERE WERE NO COMPLICATIONS.

CONCLUSION:

ETS seems a promising alternative to conservative therapy for social phobia.

Can J Anaesth. 2002 Aug-Sep;49(7):758-9.

Unexpected beneficial effect of stellate ganglion block in a schizophrenic patient.

Takano M, Takano Y, Sato I.

http://www.ncbi.nlm.nih.gov/pubmed/12193502

Jpn J Ophthalmol. 2006 Nov-Dec;50(6):567-9.

Visual hallucinations following stellate ganglion block in a patient with central retinal artery occlusion.

Kurimoto T, Takata M, Nishimura M, Tagami Y, Okamoto N, Mimura O.

http://www.ncbi.nlm.nih.gov/pubmed/17180540

Masui. 1993 Nov;42(11):1696-8.

[Three case reports of the use of stellate ganglion block for the climacteric psychosis].

Ikeda K1, Isshiki A, Yoshimatsu N, Oumi A, Ito S, Ikeda T.

Author information

Abstract

There are many reports of the use of stellate ganglion block (SGB) for the climacteric psychosis, which is considered to be sympathicotonic response to stress. We experienced three cases of the SGB therapy for the climacteric psychosis. We performed SGB three times per week by 1% lidocaine 5 ml, and observed improvements of the symptoms after doing SGB for five times. The patients reported psychological relaxation after receiving SGB therapy. We examined the changes of the serum concentrations of ACTH, LH, FSH, and catecholamines (epinephrine, norepinephrine) before and after SGB in 8 patients who were suffering from climacteric psychosis, because we wanted to know the endocrinological response to SGB. We observed a significant decrease in norepinephrine concentration after SGB, which is reasonable considering the sympathetic blockage. There were no significant changes of ACTH, LH, FSH, and epinephrine. We conclude that SGB therapy must be effective for the climacteric psychosis because of sympathetic blockade. But we could not clarify the influence of endocrinological response to SGB.

"lowering of heart rate and blood pressure, decreased responsiveness of the cardiocirculatory system to emotional stimuli after sympathectomy

"lowering of heart rate and blood pressure, decreased responsiveness of the cardiocirculatory system to emotional stimuli: it is an effect that is especially noticeable in patients operated on for erythrophobia and less evident in those operated for hyperhidrosis. It is almost always a welcome phenomenon, which contributes considerably to the feeling of tranquility and serenity that generally supersedes anxiety. Excessive reduction in blood pressure or heart rate may lead to a state of weakness and fatigue that may require removal of the clips in approx. 2%. This rare state of asthenia contrasts with the increased energy and vigor that most patients experience when they feel freed from overwhelming anxiety."    

"The neurovegetative nervous system is, however, very dynamic and tends to adapt continuously during lifetime to all environmental or organic changes and conditions. Therefore, it reacts very individually when a reflex circuit has been blocked. The resulting side effects cannot be predicted in detail, and though they in most patients are relatively mild or even absent, there is a small group of patients developing heavy side effects. Therefore, surgery should only be considered in carefully selected cases in whom non-invasive treatment has failed and in whom the detrimental consequences of erythrophobia regarding the psychosocial situation and the quality of life is such to justify more adverse side effects. It should also always be kept in mind that therapy can be ineffective and that, in the long term, 10-15% of patients do not consider themselves satisfied with the result of surgery. In any case, the author prefers the use of a potentially reversible surgical technique (ESB), instead of destructive techniques (cutting, coagulation, removal of ganglia)."  

http://www.chir.it/en_erythrophobia.php

significant associations between heart rate and regional cerebral blood flow

Neurosci Biobehav Rev. 2012 Feb;36(2):747-56. doi: 10.1016/j.neubiorev.2011.11.009. Epub 2011 Dec 8.

A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health.

The intimate connection between the brain and the heart was enunciated by Claude Bernard over 150 years ago. In our neurovisceral integration model we have tried to build on this pioneering work. In the present paper we further elaborate our model and update it with recent results. Specifically, we performed a meta-analysis of recent neuroimaging studies on the relationship between heart rate variability and regional cerebral blood flow. We identified a number of regions, including the amygdala and ventromedial prefrontal cortex, in which significant associations across studies were found. We further propose that the default response to uncertainty is the threat response and may be related to the well known negativity bias. Heart rate variability may provide an index of how strongly 'top-down' appraisals, mediated by cortical-subcortical pathways, shape brainstem activity and autonomic responses in the body. If the default response to uncertainty is the threat response, as we propose here, contextual information represented in 'appraisal' systems may be necessary to overcome this bias during daily life. Thus, HRV may serve as a proxy for 'vertical integration' of the brain mechanisms that guide flexible control over behavior with peripheral physiology, and as such provides an important window into understanding stress and health.

http://www.ncbi.nlm.nih.gov/pubmed/22178086

important relationship among cognitive performance, HRV, and prefrontal neural function

"These findings in total suggest an important relationship among cognitive performance, HRV, and prefrontal neural function that has important implications for both physical and mental health. Future studies are needed to determine exactly which executive functions are associated with individual differences in HRV in a wider range of situations and populations."

http://www.ncbi.nlm.nih.gov/pubmed/19424767

The sympathoadrenal system is one of the major pathways mediating physiological responses in the organism

The sympathoadrenal system is one of the major pathways mediating physiological responsesin the organism. The sympathoadrenal system plays an important role in the regulation of blood pressure, glucose, sodium and other key physiological and metabolic processes. In many disease states, the sympathoadrenal system is affected and by corrective physiological responses the sympathoadrenal system preserves homeostasis. Many therapeutic agents are either adrenergic activators or inhibitors. Therefore, measurements of the components of the sympathoadrenal system and the activity of the sympathoadrenal system have been of major interest for decades.

Levels of plasma (p-) noradrenaline (NA), the sympathetic neurotransmitter, have been used to indicate activity of the neuronal sympathoadrenal component, while adrenaline (Adr) levels indicate activity of the hormonal adrenomedullary component of the sympathoadrenal system (Christensen 1991, Goldstein 1995, Christensen & Norsk 2000).

Based upon the absence of an arterio-venous increase in p-DOPA concentration in sympathectomized limbs and a decrease in p-DOPA after inhibition of tyrosine hydroxylase (TH) in dogs, it was concluded that DOPA can pass across sympathetic neuronal membranes to reach the general circulation and furthermore, that p-DOPA may be related to regional rate of tyrosine hydroxylation (Goldstein et al 1987a). P-DOPA only demonstrated minimal changes during stimuli that produced significant changes in p-NA. Due to partly parallel changes of p-NA and p-DOPA, however, it was believed that p-DOPA reflect the rate of catecholamine synthesis and that p-DOPA was a simple and direct index of TH activity in vivo (Eisenhofer et al 1988, Goldstein & Eisenhofer 1988, Garty et al 1989b). It was inferred that p-DOPA levels may be an index of sympathetic activity.

Department of Internal Medicine and Endocrinology, Herlev University Hospital, Herlev.

Correspondence: Ebbe Eldrup, Bolbrovænge 29, DK-2960 Rungsted Kyst.

Official opponents: Jens H. Henriksen, professor, MD, and Jan Abrahamsen, MD.

Dan Med Bull 2004;51:34-62.

"Sympathectomy can enhance or suppress antibody production"

Neuropsychiatry - Google Books: Neuropsychiatry
 edited by Randolph B. Schiffer, Stephen M. Rao, Barry S. Fogel

Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder | Psychiatric Annals

Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder | Psychiatric Annals: "SGB has been shown to have utility for diagnostic, therapeutic, and prognostic purposes for a variety of conditions, including: chronic regional pain syndrome types I and II to the upper extremities (CRPS I and II); chronic and acute vascular insufficiency/occlusive vascular disorders of the upper extremities, such as Raynaud’s disease, intra-arterial embolization and vasospasm. SGB has also been found an effective treatment for poor lymphatic drainage and local edema of the upper extremity following breast surgery; postherpetic neuralgia; and phantom limb pain or amputation stump pain. Patients with quinine poisoning; sudden hearing loss and tinnitus; hyperhidrosis of the upper extremity; cardiac arrhythmias and ischemic cardiac pain; Bell’s palsy and a variety of orofacial pain syndromes, including neuropathic orofacial pain and trigeminal neuralgia; vascular headache such as cluster and migraine headaches; and neuropathic pain syndromes among cancer patients are all also candidates for SGB.2,3,12–16

SGB has also been recommended for improving blood flow to the cranium for angiography and following stroke/cerebrovascular accident and hyperhidrosis to the upper extremities.13,14 Additionally, SGB’s use has been reported in the treatment of Ménière’s syndrome3 and hot flashes.17–19"



https://archive.today/yOe5b

Sympathectomy causes wall thinning, elongation, convolution, and aneurysm formation

"Sympathectomy causes basilar artery enlargment, which is beneficial for maintaining cerebral blood flow; however, it also causes wall thinning, elongation, convolution, and aneurysm formation, which may be hazardous in stenoocclusive carotid artery disease. Sympathectomy can prevent new vessel formation and hyperthyrophic changes at the posterior circulation. Neovascularisation is not detected adequately in sympathectomised animals."



Acta Neurochirurgica156.5 (May 2014): 963-9.

epinephrine modulates brain limbic structures to encode and store new information

The excitatory actions of epinephrine were not observed

The excitatory actions of epinephrine were not observed in groups given an identical dose of the hormone after peripheral β-adrenergic receptor blockade with sotalol. These findings demonstrate that neural discharge in vagal afferent fibers is increased by elevations in peripheral concentrations of epinephrine and the significance of these findings in understanding how epinephrine modulates brain limbic structures to encode and store new information into memory is discussed.

Epinephrine administration increases neural impulses propagated along the vagus nerve: Role of peripheral β-adrenergic receptors

T. Miyashita and C.L. Williams

^aDepartment of Neurosciences, University of New Mexico, Albuquerque, NM 87131, USA
^bDepartment of Psychology, The University of Virginia, Charlottesville, VA 22904, USA

Received 9 June 2005; 

revised 17 August 2005; 

accepted 29 August 2005. 

Available online 17 October 2005.

Roles of catecholamine terminals in self-stimulation

Pharmacol Biochem Behav. 1986 Apr;24(4):1101-9.Links

Roles of catecholamine terminals and intrinsic neurons of the ventral tegmentum in self-stimulation investigated in neonatally dopamine-depleted rats.

Takeichi T, Kurumiya S, Umemoto M, Olds ME.

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.

The sympathetic system is responsible for the physiological responses to emotional states

The common epithet of “fight or flight” is being enlarged to be “fight, flight, or fright” or even “fight, flight, fright, or freeze.” Cannon’s original contribution was a catchy phrase to express some of what the nervous system does in response to a threat, but it is incomplete. The sympathetic system is responsible for the physiological responses to emotional states. The name “sympathetic” can be said to mean that (sym- = “together”; -pathos = “pain,” “suffering,” or “emotion”).
http://cnx.org/content/m46582/latest/?collection=col11496/latest

Increase in plasma NE = increase in brain NE

Norepinephrine Turnover Is Increased in Suprabulbar Subcortical Brain Regions and Is Related to Whole-Body Sympathetic Activity in Human Heart Failure

Anuradha Aggarwal, MBBS; Murray D. Esler, MBBS, PhD; Gavin W. Lambert, PhD;Jacqueline Hastings, PhD; Leonie Johnston, RN; David M. Kaye, MBBS, PhDFrom the Baker Medical Research Institute, Melbourne, Australia.
© 2002 American Heart Association, Inc.

This study, for the first time, demonstrates elevated suprabulbar subcortical noradrenergic activity in human CHF and identifies a positive correlation between this and the level of whole-body NE spillover. The findings suggest that the activation of noradrenergic neurons projecting rostrally from the brain stem mediates sympathetic nervous stimulation in CHF.

change in sympathetic nervous system activity after thoracic sympathectomy

The photoplethysmographic (PPG) signal, which measures cardiac-induced changes in tissue blood volume by light transmission measurements, shows spontaneous fluctuations. In this study, PPG was simultaneously measured in the right and left index fingers of 16 patients undergoing thoracic sympathectomy, and, from each PPG pulse, the amplitude of the pulse (AM) and its maximum (BL) were determined. The parameter AM/BL is proportional to the cardiac-induced blood volume increase, which depends on the arterial wall compliance. AM/BL increased after the thoracic sympathectomy treatment (for male patients, from 2.60±1.49% to 4.81±1.21%), as sympathetic denervation decreases arterial tonus in skin. The very low-frequency (VLF) fluctuations of BL or AM showed high correlation (0.90±0.11 and 0.92±0.07, respectively) between the right and left hands before the thoracic sympathectomy, and a significant decrease in the right-left correlation coefficient (to 0.54±0.22 and 0.76±0.20, respectively) after the operation. The standard deviation of the BL or AM VLF fluctuations also reduced after the treatment, indicating sympathetic mediation of the VLF PPG fluctuations. The study also shows that the analysis of the PPG signal and the VLF fluctuations of the PPG parameters enable the assessment of the change in sympathetic nervous system activity after thoracic sympathectomy.

Medical and Biological Engineering and Computing

2001, Volume 39, Issue 5, pp 579-583
http://link.springer.com/article/10.1007%2FBF02345149

Long-term sympathectomy induces sensory and parasympathetic fibres sprouting, and mast cell activation in the rat dura mater

Bergerot, A; Aubineau, P; (1998) Long-term sympathectomy induces sensory and parasympathetic fibres sprouting, and mast cell activation in the rat dura mater. EUR J NEUROSCI , 10 79 - 79. 

http://discovery.ucl.ac.uk/1330488/

Lewis rats are much more likely to develop autoimmune disorders after sympathectomy

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

significant change after sympathectomy: reduced sympathetic and increased vagal tone

The HRV analysis showed a significant change of indices reflecting sympatho-vagal balance indicating significantly reduced sympathetic (LF) and increased vagal (HF, rMSSD) tone. These changes still persisted after 2 years. Global HRV increased over time with significant elevation of SDANN after 2 years. QT dispersion was significantly reduced 1 month after surgery and the dispersion was further diminished 2 years later.

http://www.sciencedirect.com/science/article/pii/S0167527399001011

sympathectomized arteries become more susceptible to lipid accumulation

Combined effect of cholesterol feeding and sympathectomy on the lipid content in rabbit aortas

Atherosclerosis

Volume 37, Issue 4, December 1980, Pages 521–528

Decreased HRV is predictive of adverse cardiovascular outcomes in a variety of disease states

Water immersion-induced skin wrinkling (WISW) is dependent on intact peripheral sympathetic function. WISW was hypothesized to reflect autonomic function in subjects with- out peripheral neuropathy. We prospectively studied 70 healthy subjects (aged 31 88 years, 63% females) without cardiovascular risk factors or neurological disease. All sub- jects underwent short-term heart rate variability (HRV) stud- ies. Time and frequency domain variables were derived in- cluding the HRV index. WISW was graded using a previously validated scale of 1–4 of which 18.6% of subjects exhibited grade 1 (minimal) WISW and 35.7% had grade 2 WISW. On multivariate analysis using the HRV index, WISW was inde- pendently related to height and the HRV index. We conclude that WISW is related to central autonomic function.

Although the mechanism is not fully understood, WISW is felt to be caused by passive diffusion of water across the stratum corneum into the sweat ducts, which in turn alters electrolyte balance, decreases membrane stabilization, increases sympathetic neural firing and stimulates vasoconstriction [1–3, 8].WISW is decreased in diabetic patients and in patients after cervical sympathectomy [4, 9].

Heart rate variability (HRV) is the beat-to-beat variation in cardiac cycle length due to autonomic influence on the sinus node. Decreased HRV is predictive of adverse cardiovascular outcomes in a variety of disease states[5]. The influence of the central nervous system activity on autonomic function suggests that HRV may be a useful prognostic indicator in patients with cerebrovascular events [6].

Cardiology 2010;116:247–250 DOI: 10.1159/000316043

Received: May 10, 2010

Accepted after revision: May 28, 2010 Published online: August 18, 2010

electric stimulation of the sympathetic cord in the upper thoracic level on the 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

Cerebral sympathetic nerve activity has a major regulatory role in the cerebral circulation in REM sleep

Cassaglia PA, Griffiths RI, Walker AM.

Source

Ritchie Centre for Baby Health Research, Monash Institute of Medical Research, Monash University, Melbourne, Australia.

Abstract

Sympathetic nerve activity (SNA) in neurons projecting to skeletal muscle blood vessels increases during rapid-eye-movement (REM) sleep, substantially exceeding SNA of non-REM (NREM) sleep and quiet wakefulness (QW). Similar SNA increases to cerebral blood vessels may regulate the cerebral circulation in REM sleep, but this is unknown. We hypothesized that cerebral SNA increases during phasic REM sleep, constricting cerebral vessels as a protective mechanism against cerebral hyperperfusion during the large arterial pressure surges that characterize this sleep state. We tested this hypothesis using a newly developed model to continuously record SNA in the superior cervical ganglion (SCG) before, during, and after arterial pressure surges occurring during REM in spontaneously sleeping lambs. Arterial pressure (AP), intracranial pressure (ICP), cerebral blood flow (CBF), cerebral vascular resistance [CVR = (AP - ICP)/CBF], and SNA from the SCG were recorded in lambs (n = 5) undergoing spontaneous sleep-wake cycles. In REM sleep, CBF was greatest (REM > QW = NREM, P < 0.05) and CVR was least (REM < QW = NREM, P < 0.05). SNA in the SCG did not change from QW to NREM sleep but increased during tonic REM sleep, with a further increase during phasic REM sleep (phasic REM > tonic REM > QW = NREM, P < 0.05). Coherent averaging revealed that SNA increases preceded AP surges in phasic REM sleep by 12 s (P < 0.05). We report the first recordings of cerebral SNA during natural sleep-wake cycles. SNA increases markedly during tonic REM sleep, and further in phasic REM sleep. As SNA increases precede AP surges, they may serve to protect the brain against potentially damaging intravascular pressure changes or hyperperfusion in REM sleep.

Comment in

• Have a safe night: intimate protection against cerebral hyperperfusion during REM sleep. [J Appl Physiol. 2009]

PMID:

 

19150858

 

[PubMed - indexed for MEDLINE] 

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cilio-spinal center can extend to T5

The ciliospinal reflex (pupillary-skin reflex) consists of dilation of the ipsilateral pupil in response to pain applied to the neck, face, and upper trunk. If the right side of the neck is subjected to a painful stimulus, the right pupil dilates (increases in size 1-2mm from baseline). This reflex is absent in Horner's syndrome and lesions involving the cervical sympathetic fibers. The enhanced ciliospinal reflex in asymptomatic patients with cluster headache is due to preganglionic sympathetic mechanisms.
http://en.wikipedia.org/wiki/Ciliospinal_reflex

The cilio-spinal center is not sharply confined to TI spinal level, but may extend downwards as low as T5

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1396202/pdf/annsurg00366-0044.pdf

High plasma norepinephrine and depression

Copyright © 1999 Society of Biological Psychiatry. Published by Elsevier Science Inc.

Plasma norepinephrine and prediction of outcome in major depressive disorder

Timothy G. Johnston^a, Christopher B. Kelly^, a, Michael R. Stevenson^b and Stephen J. Cooper^a 

^a Department of Mental Health, Whitla Medical Building, The Queen’s University of Belfast, Belfast, UK (TGJ, CBK, SJC)

^b Department of Medical Statistics, Mulhouse Building, The Queen’s Unversity of Belfast, Belfast, UK (MRS)

Received 1 February 1999; revised 17 May 1999; accepted 21 May 1999. Available online 30November 1999.

Background: Several epidemiologic and clinical factors have been shown to predict long term outcome in major depressive disorder (MDD). The value of biological predictors has not been extensively studied. This study examined whether plasma norepinephrine may be useful in predicting outcome in MDD.

Methods: Forty patients were followed up 8 years after an index major depressive episode. Three outcome variables were assessed: time to first recurrence (the primary outcome measure), the Lee and Murray criteria and the Depression Outcome Scale (DOS). The results were examined against plasma norepinephrine value, at the index episode, using survival analysis and linear regression.

Results: High plasma norepinephrine at the index episode was positively and significantly associated with time to first recurrence for patients with nonpsychotic MDD (n = 31, χ² = 8.38, on 1 df, p < .01). Similarly, plasma norepinephrine was significantly associated with good global outcome, both using Lee and Murray criteria (n = 34, adjusted R² = .24, p < .01) and DOS criteria (n = 31, adjusted R² = .17, p < .01) for this group of patients. In contrast, plasma norepinephrine was not significantly related to outcome for MDD with psychotic features.

Conclusions: Plasma norepinephrine at index episode seems to be a predictor of outcome in MDD.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T4S-3Y0RJKC-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a88b42c007e4dcb51054a00cf6662e2d

A neurotransmitter involved in emotional arousal enhances learning

A neurotransmitter involved in emotional arousal enhances learning by phosphorylating glutamate receptors.

Do you remember the song that was playing during your first kiss? Both positive and negative emotions influence learning and memory but researchers have not determined the mechanism. Now Hu et al. report that the neurotransmitter norepinephrine regulates glutamate receptor trafficking in a recent article in Cell.

Axon terminals containing norepinephrine synapse in the hippocampus and amygdala, which are important in emotional memory. In the hippocampus, norepinephrine reduces the threshold for long-term potentiation (LTP), which is thought to be a substrate of memory. Norepinephrine acts at -adrenergic receptors, where it activates cAMP-dependent protein kinase (PKA) and calcium/calmodulin-dependent protein kinase II (CaMKII). These kinases phosphorylate serines 845 and 831, respectively, in the AMPA glutamate receptor type 1 (GluR1). The authors proposed that norepinephrine regulates learning by phosphorylating AMPA receptors.

Hu, H. et al. Emotion enhances learning via norepinephrine regulation of AMPA-receptor trafficking. Cell 131, 160–173 (2007). | Article | PubMed |

Emotional intelligence

Neuroscience Gateway (October 2007) | doi:10.1038/aba1787

RSD due to nerve injury

According to the National Institute of Neurological Disorders and Stroke (NINDS), RSD is "a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems." According to MedicineNet, RSD involves "irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin."

Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the capacity to activate pain pathways after tissue or nerve injury, resulting in RSD. Another theory suggests that RSD, which follows an injury, is caused by triggering an immune response and symptoms associated with inflammation (redness, warmth, swelling). RSD is not thought to have a single cause, but rather multiple causes producing similar symptoms.

http://arthritis.about.com/od/rsd/a/rsd.htm

sympathectomy led to significant decrements in escape and avoidance responding

PsycNET - Option to Buy: "Chemical sympathectomy and avoidance learning in the rat.
By Di Giusto, E. L.; King, M. G.
Journal of Comparative and Physiological Psychology, Vol 81(3), Dec 1972, 491-500.
Abstract
Reports results of 5 experiments with male Wistar rats (N = 108). Depletion of peripheral sympathetic noradrenaline induced by administration of 6-hydroxydopamine, ip, led to significant decrements in escape and avoidance responding when the required response was difficult, but not when it was relatively easy to acquire. Results are similar to previous findings obtained with adrenal-demedullated Ss. Findings clarify the role of the sympathetic nervous system in the motivation of behavior elicited by aversive stimulation. Implications for 2-process theory and the "Kamin effect," or "learned helplessness," are discussed. (40 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)"

Patients report that they feel less anxious in stressful situations. Stage fright is reduced. The results are usually permanent.

http://neuro.templehealth.org/content/ETShyperhidrosis.htm

peripheral autonomic denervation affects fear and arousal

States of peripheral autonomic arousal are represented within brain regions that overlap those implicated in emotion Critchley et al. 2000a, Critchley et al. 2000b, Critchley et al. 2001a, Critchley et al. 2001b and Critchley et al. 2001c. Moreover, activity within areas involved in central autonomic control is modulated by feedback of peripheral autonomic responses (Critchley et al., 2001a). These autonomic arousal states bias emotional behavior and influence processes such as memory (e.g., Damasio et al. 1990,Cahill et al. 1994 and Cahill and McGaugh 1998). For example, amygdala is associated with memory enhancement for emotional material, a process thought to be mediated through the influence of states of arousal on amygdalo-hippocampal functional connectivity Cahill et al. 1994, Cahill and McGaugh 1998 and Cahill et al. 1999. Peripheral autonomic arousal may also influence conditioning, as suggested by pharmacological and motivational manipulations in animals Young et al. 1995 and Maren et al. 1994.
http://www.sciencedirect.com/science/article/pii/S0896627302005883