• Annals of Clinical Neurophysiology
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• 제20권2호
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• pp.55-56
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• 2018

• Annals of Clinical Neurophysiology
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• 제25권2호
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• pp.66-77
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• 2023

Orthostatic hypotension is a sustained and pathological drop in blood pressure upon standing. Orthostatic hypotension can be due to non-neurogenic conditions or autonomic disorders. Impaired baroreflex-mediated vasoconstriction and insufficient release of norepinephrine play key roles in the pathophysiology of neurogenic orthostatic hypotension. Its common symptoms mainly related to inadequate cerebral blood flow include dizziness, lightheadedness, and syncope. It is crucial to differentiate neurogenic orthostatic hypotension from non-neurogenic orthostatic hypotension. For the management of neurogenic orthostatic hypotension, physicians should implement non-pharmacological methods and, if possible, reverse combined non-neurological conditions. Depending on severity of symptoms, pharmacological intervention may be tried after or with non-pharmacological methods. Its management should be individualized based on intensity of symptoms, comorbid conditions, drug side effects, and etiology. In this review, we discuss the definition, pathophysiology, clinical approach, and management of neurogenic orthostatic hypotension.

• 대한한방내과학회지
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• 제27권3호
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• pp.698-705
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• 2006

Objectives : This study was designed to investigate the effect of PC6 and SP4 on autonomic nerve system in healthy adults. Methods : 22 healthy adults were recruited and randomized into the study group or control group. The study group (real acupuncture group) was acupuncturcd on PC6 and SP4. The control group (sham acupuncture group) was acupunctured superficially near PC6 and SP4 but not the exact points. The subjects rested for 10 minutes, and were then acupunctured. After 15 minutes, acupuncture needles were removed and the subjects rested for another 15 minutes. Heart rate variability(HRV) was continuously measured during the study period by FM-150 (digital Holter ECG recorder). Results : In the real acupuncture group. LF(low frequency) significantly decreased during the acupuncture period(p<0.05). LF/HF ratio also had a significant decrease during acupuncture period and the decrease was maintained during the post-treatment period as compared with the pre-treatment period. In the sham acupuncture group. LF significantly increased during the acupuncture period but LF/HF ratio had no significant changes. Conclusions : The results suggest that acupuncture on PC6 and SP4 can increase parasympathetic activity and balance autonomic nervous system.

• Safety and Health at Work
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• 제13권2호
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• pp.148-154
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• 2022

Background: Bus driving is a mentally demanding activity that requires prolonged attention to ensure safety. The aim of the study was to assess mental fatigue caused by driving a public bus and to find a profile of workers at higher risk. Methods: We evaluated changes of critical flicker fusion (CFF) (index of central arousal) and heart rate variability (HRV) (index of autonomic balance) in a 6-hour driving shift on a real route, in 31 professional bus drivers, and we tested the influence of personal factors such as sleep quality, BMI, and age. Paired t-test was used to test differences of CFF and HRV between both initial and final phase of driving, while multiple linear regression tested the influence of personal variables on the indexes of mental fatigue. Results: Results showed that CFF significantly decreased after 6 hours of bus driving (41.91 Hz, sd 3.31 vs. 41.15 Hz, sd 3.15; p = 0.041), and heart rate significantly decreased in the final phase of driving, with respect to the initial phase (85 vs. 78 bpm, p = 0.027). Increasing age (beta = -0.729, p = 0.022), risk of obstructive sleep apnea syndrome (beta = -0.530, p = 0.04), and diurnal sleepiness (beta = -0.406, p = 0.017) showed a significant effect on influencing mental fatigue. Conclusion: Elderly drivers at higher risk of sleep disorders are more prone to mental fatigue, when exposed to driving activity. Monitoring indexes of central arousal and autonomic balance, coupled with the use of structured questionnaires can represent a useful strategy to detect profile of workers at higher risk of mental fatigue in such duty.

• 대한물리치료과학회지
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• 제4권3호
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• pp.475-489
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• 1997

Connective tissue massage(CTM, Bindegewebs massage) are developed and named by Mrs. Elizabeth Dicke, a German physical therapist. The CTM is used primarily for internal disorder such as myocarditis, coronary insufficiency, high blood pressure, functional stomach and intestinal disorders, inflamma-tion of the gallbladder, and hepatitis, arterial circulatory problems, venous disorders, headache, particularly trauma to the head, and some gynecologic disorder, etc. Which is performed with special stroking technique of the subcutaneous tissue of the trunk, extremities, and face. The mechanism of effectiveness of CTM is based on a viscerocutaneous reflex. The stroking stimulates the nerve end-ings of the autonomic nervous system. The impulses activated by stroking travel to the sympathetic trunk and the spinal cord and brain, which causes a change in reaction susceptibility. The most important for apply CTM is necessary to know the reflex zone (Head's zone, Mackenzie's zone and Dicke's connective tissue zone). Dicke's connective tissue zones are only found by the special dia-gnostic stroking. Because the connective tissue zones no discomfort when unmanipulated, and thus the patient is unaware of them. It is characterized by diagnostic stroking that causes a sharp pain in the tissue. As a general rule, all treatment are preceded by the basic stroke from the level of the coccyx to the first lumbar vertebra and each stroke is done three times. The right side is done first, then the left side.

• 대한불안의학회지
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• 제2권2호
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• pp.101-107
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• 2006

Object : Since autonomic nerve system dysfunction was known as the mechanism of panic disorder, many researchers used heart rate variability (HRV) as means of measuring autonomic nerve function of patients with panic disorder. We aimed to examine the effect of paroxetine medication for 3 months on symptom improvement and change of heart rate variability of the patients with panic disorder. Methods : The subjects were patients with panic disorder who visited the psychiatric outpatient clinic of Samsung Medical Center in Seoul. We included panic disorder patients who were aged from 20 to 50 and in normal BMI range (from 18 to 30) to minimize the effect of age and weight on HRV data. We excluded the patients with EKG abnormalities, hypertension or other major psychiatric disorders. They took 20-40 mg paroxetine medication a day for 3 months. Alprazolam was used only during the first month to control the acute panic symptoms and was tapered off after that. We measured the acute panic inventory (API), Hamilton rating scale for anxiety and depression (HAM-A & HAM-D), Spielberger state-trait anxiety inventory (STAIS, STAIT), and Beck depression inventory (BDI) in order to assess clinical improvement of the patients. And we measured time and frequency domain HRV in the resting, standing and cognitive stress states to assess the change of HRV. All measurements were done before and after paroxetine treatment. Result : After paroxetine medication, patients showed significant improvement in all psychiatric scales. In time domain of HRV, standard deviations of all R-R intervals (SDNN) were significantly increased in all states. In frequency domain of HRV, the ratio of high frequency to total power (HF/TP) in the standing state was significantly increased. Conclusion : After 3 months paroxetine medication, panic disorder patients showed significant clinical improvement and change in HRV data such as SDNN in all states and HF/TP ratio in the standing state. This result suggests that paroxetine medication is effective for the improvement of autonomic nerve system dysfunction in panic disorder patients.

• 구강회복응용과학지
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• 제32권2호
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• pp.102-108
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• 2016

두통은 전체 인구중 상당수가 일생에 한번 이상 겪게되는 질환으로, 계속하여 논의되고 개정되어 현재까지 국제적인 분류법이 마련되어 왔다. 원발두통은, 다른 원인질환에 의하지 않은 통증을 의미하며, 다음과 같이 분류할 수 있다: 1) 편두통 2) 긴장형두통 3) 군발두통과 기타 삼차자율신경두통 4) 기타 원발두통. 한편 턱관절장애에 기인한 두통 및 약물 과용 두통은 두통의 원인이 기질적인 경우로 이차성 두통에 분류된다. 본 종설에서는 국제두통질환분류 제3판의 베타판(ICHD-3 beta)에 근거한 두통의 진단에 대하여 고찰해보고자 한다.

• Korean Journal of Acupuncture
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• 제33권3호
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• pp.95-101
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• 2016

Objectives : This study aims to overview the therapeutic mechanism of back-shu points in terms of sympathetic visceral motor nervous system. Methods : Studies about autonomic nervous system, and studies and ancient texts about back-shu points were reviewed. We interpreted possible mechanism of back-shu points considering similarities of anatomical and physiological characteristics of back-shu points and visceral motor nervous system. Results : Afferent signals for organ lesions that can develop the symptoms of autonomic neurological symptoms, pain, hyperalgesia through the skin segment. Through a physical examination of the myotome and dermatome, it is possible to diagnose segmental disorders. Treatment stimulation of the thick fibers of the disorder segment skin can reduce abnormal autonomic influence over the sympathetic reflex mechanism. In addition, if spinal muscles are relaxed, the pressure on the nerve roots could be reduced and consequently the hyperactivity of the sympathetic visceral motor signal would be suppressed. Conclusions : The back-shu points treatments work through the mechanism of the sympathetic nervous reflex. Moreover, segmental acupuncture can reduce tension of the spinal muscles, thereby improving pathological conditions of the sympathetic nervous system.

• Journal of Genetic Medicine
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• 제11권1호
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• pp.11-15
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• 2014

Congenital central hypoventilation syndrome (CCHS) is a disorder of the autonomic nervous system characterized by a decreased response to hypercarbia. CCHS is frequently associated with congenital megacolon; the combination is called Haddad syndrome. CCHS is associated with dysfunction in respiratory features of the autonomic nervous system and with other disorders, including facial deformities, cardiovascular symptoms, and tumors. Patients with CCHS frequently have a mutation in the homeobox protein 2b (PHOX2B) gene. Most mutations involve heterozygous expansion of alanine repeats (GCN). Interestingly, a higher polyalanine repeat number is associated with a more severe clinical phenotype. To clarify the role of PHOX2B in disease pathogenesis, we introduce and review the clinical and molecular features of CCHS and Haddad syndrome.

• 감성과학
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• 제22권4호
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• pp.57-64
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• 2019

분노는 알코올 사용 장애자들이 재발하기 전에 가장 흔하게 경험하는 정서 중 하나이다. 본 연구는 알코올 사용장애자의 분노 경험에 따른 자율신경계 반응 특성을 규명하고자 하였다. 본 연구에는 알코올 사용 장애로 진단받고 치료 중인 남성 환자 12명과 이들과 연령 및 학력수준이 유사한 일반인 남성 14명이 참여하였다. 분노를 유발하기 위하여 시청각 동영상을 제시하고, 이때 나타난 심리 및 자율신경계 반응(피부전기 활동)을 측정하였다. 연구 결과, 참여자들이 경험한 정서의 강도에서는 알코올 집단과 일반인 집단에서 차이가 나타나지 않았다. 반면, 알코올 집단은 안정 상태에 비해 분노 상태에서 비중독자에 비해 피부전도 수준, 피부전도 반응 그리고 피부전도반응 수가 유의하게 낮았다. 이 결과는 알코올 중독자들이 분노를 처리하는 동안에 생리 반응에서 이상이 나타남을 시사하였다. 알코올 사용 장애자들의 분노 경험 동안에 나타난 생리 반응 이상을 완화할 수 있는 개입방법을 개발한다면 알코올 사용 장애자들의 정서 처리 문제를 해결할 수 있어 그들의 재발 방지에 도움을 줄 수 있을 것이다.