Objectives : This study was performed to examine the hypothesis that the structural imbalance affect cardiac function and autonomic reflex system and to investigate the possibility of the chiropractic care for cardiovascular system. Methods : 78 of Dong-Guk University students with structural imbalance were recruited for the investigation from March to June 2007. Heart rate variability, Buss and Durkee Hostility inventory(BDHI) and physical examinations to evaluate psoas muscle contracture were performed. Results : Left psoas muscle contracture was associated with decrease of LF/HF ratio(p=0.048). Conclusion : Left side contracture of psoas muscle showed a tendency to decrease sympathetic activity.
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.
This study proposed a new algorithm to assess autonomic function activity using Time-Frequency Representation(TFR). TFR is a way of describing the time-valiant energy of a signal. A discrete Wigner representation that is capable of filtering out any cross terms occuring in the Wigner-Ville Distribution(WVD) is used for time-variant energy distribution of heart rate variability(HRV) signals. And the marginal condition are evaluated to estimate power spectrum of HRV signals. The proposed algorithm showed that estimated power spectrum of HRV signals well describe the autonomic nerve system function and also showed the dynamics of autonomic nervous system response.
Objectives : Essential hyperhidrosis is a socially and occupationally disabling disorder. There are many suggestions that hyperhidrosis is associated with the autonomic nervous system. This study was designed to investigate the autonomic nerve system the patients with hyperhidrosis. Methods : 348 palmar and plantar hyperhidrosis patients and 20 systemic hyperhidrosis patients in the ambulatory care were investigated. All patients were inspected at the first medical examination, using the PSA of HRV. HRV was measured for 5 minutes after 5 minutes' bed rest. We checked the frequency domain analysis of HRV (i.e. TP, VLF, LF, HF and LF/HF) which were transformed into natural logarithm of patients against the standard measures of the HRV components. Then, we compared the means of patients with means and highest values of in the normal range of Koreans 1) between the patients with palmar and plantar hyperhidrosis and the healthy controls and 2) between the patients with the systemic hyperhidrosis and healthy controls, by the frequency domain analysis of heart rate variability (HRV), respectively. We then compared the results between 1) and 2). Results : The values of natural logarithmic measures of LF/HF ratio in the patients with palmar and plantar hyperhidrosis we examined were significantly higher than the values of healthy controls, but those in the patients with systemic hyperhidrosis were not higher. Conclusion : This study suggests that the autonomic nervous function did not simply increase but that the balance between sympathetic and parasympathetic nervous function did matter in patients with palmar and plantar hyperhidrosis. This balance included that the sympathetic nervous function aggravated comparatively with parasympathetic nervous function. On the other hand, we couldn't find any significance of the patients with the systemic hyperhidrosis as for the autonomic nervous function.
Davin Bryant;Erin McCormack;Juan J. Cardona;Arada Chaiyamoon;Devendra Shekhawat;Francisco Reina;Ana Carrera;Joe Iwanaga;Aaron S. Dumont;R. Shane Tubbs
Anatomy and Cell Biology
/
제56권4호
/
pp.463-468
/
2023
The carotid sinus nerve (CSN) is well known as mediating baroreflexes. However, studies of its detailed histological analysis are scant in the literature. Therefore, the current anatomical study sought to better elucidate the microanatomy of the CSN. Ten fresh frozen adult cadavers underwent dissection of the CSN. Then, it was harvested and submitted for histological and immunohistochemical staining. Specimens were all shown to be nerve fibers on histology and immunohistochemistry. We identified tyrosine hydroxylase positive fibers in all CSN specimens. These fibers were always found to be within the CSN and not on its surface i.e., epineurium. Based on our findings, the majority of fibers contained in the CSN are tyrosine positive in nature. Further studies are necessary to understand the true function of this autonomic nerve fibers.
Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.
Purpose : The purpose of this study was to investigate the effect of electrical stimulation applied in dominant forearm on autonomic nervous system response of both hands. Methods : Fourteen healthy subjects (women) received low frequency-high intensity electrical stimulation to one forearm. The subjects assigned to two groups; a ipsilateral stimulation group (n=7) and a contralateral stimulation group (n=7). The electrode attachment was arranged on the forearm of the dominant arm and the electricity stimulus time was set as 15 minutes. Measuring items were the skin conduction velocity, the blood flow, and the pulse rate, which were measured total 3 times (pre, post, and post 10 min.). Results : The skin conduction velocity showed a significant difference according to the change of the time in both hands, but there was no significant difference according to time in the blood flow, and the change of the pulse frequency regardless of stimulus side. Conclusion : These results demonstrate that the low frequency-high intensity electrical stimulation applied dominant forearm can increase selectively only with the skin conduction velocity, which may be helpful for the activation of the sudomotor function of both hands by the activation of sympathetic nerve.
Although various criteria on the diagnosis of diabetic neuropathy are applied from trial to trial, being tailored in concert with its purpose, the utmost evidences of the diagnosis are subjective symptoms and objective signs of neurologic deficit. The application and interpretation of auxiliary electrophysiological test including nerve conduction study (NCS) should be made on the context of clinical pictures. The evaluation of the functions of small, thinly myelinated or unmyelinated nerve fibers has been increasingly stressed recently with the advent of newer techniques, e.g., measurement of intraepidermal fiber density, quantitative sensory testing, and autonomic function test. And the studies with those techniques have shed light to the nature of the evolution of diabetic neuropathy. The practical application of these techniques to the diagnosis of diabetic neuropathy in the individual patients, however, should be made cautiously due to several shortcomings: limited accessibility, wide overlapping zone between norm and abnormality with resultant unsatisfactory sensitivity and specificity, difficulty in performing subsequent tests, unproven quantitative correlation with clinical deficit, and invasiveness of some technique. NCS, as an extension of clinical examination, is still the most reliable electrophysiological test in evaluating neuropathy and gives the invaluable information about the nature of neuropathy, whereas the newer techniques need more refinement of the procedure and interpretation, and the accumulation of large scaled data of application to be considered as established diagnostic tools of peripheral neuropathy.
Twenty five patients, 14 males and 11 females with an average age of 75years with chronic Low Back Pain were tested before, during, and after 10minutes transcutaneous electrical nerve stimulation. It is important to consider the effect of TENS on the autonomic function because the pain pathway and the ANS pathway are somehow correlated to each other. There is still controversy among researchers who have reported the effect of TENS on autonomic function. So the purpose of this study is to measure the effect of TENS on the ANS and to see the relation of the pain control mechanism and the change in the ANS. The results were as follows : 1) Systolic blood pressure between before and during the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 2) Systolic blood pressure between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 3) Systolic blood pressure between before and after 10 minutes experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 4) Diastolic blood pressure between before and during experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 5) Diastolic blood pressure between during and after 10 minutes experiment was significantly decreased(P<.05). 6) Diastolic blood pressure between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 7) Heart rate between before and during the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05). 8) Heart rate between during and after 10 minutes the experiment was significantly decreased(P<.05). 9) Heart rate between before and after 10 minutes the experiment was significantly decreased(P<.05). 10) Skin temperature between before and during the experiment was significantly increased(P<.05). 11) Skin temperature between during and after 10 minutes the experiment was apt to be a little increased, but statistically there was no significant change(P>.05). 12) Skin temperature between before and after 10 minutes the experiment was significantly increased(P>.05). 13) Respiratory rate between before and during the experiment was apt to be a little increased, but statistically there was no significant change(Pgt;.05). 14) Respiratory rate between during and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(Pgt;.05). 15) Respiratory rate between before and after 10 minutes the experiment was apt to be a little decreased, but statistically there was no significant change(P>.05).
Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.
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