Relationship between autonomic nervous system function and acute mountain sickness

Objective: To elucidate the role of the autonomic nervous system (ANS) in acute mountain sickness (AMS) during the initial phase at acute high-altitude exposure. Methods: Ninety-nine healthy sea-level residents rapidly ascended to Tibet plateau (3 675 m altitude) by airplane from Chengdu plain (560 m altitude). ANS function was tested in plain and day 2–4 in Tibet by heart rate variability (HRV), cold pressor test (CPT). AMS was evaluated by clinic symptomatic scores. All subjects were divided into non-AMS group (57, scores≤4) and AMS group (42, scores>4). Results: Compared with non-AMS group, AMS group had higher standard deviation of normal to normal intervals (SDNN), root mean square of delta RR (rMSSD), low-frequency (LF) power, and normalized low-frequency (LFnu) power in plain (P<0.05). After arrival at 3 675 m altitude, AMS group had greater reduction in percentage of delta RR>50 ms(PNN50), rMSSD (P<0.01) and SDNN, LF, total power (TP) (P<0.05). Although no significant differences in the increase of SP and DP during CPT were found between 2 groups in plain, the SP increase during CPT of AMS group was less than non-AMS group (P<0.05) at 3 675 m altitude. AMS symptomatic scores was not only positively correlated with SDNN, rMSSD, LF/HF in plain (P<0.05), but also negatively correlated with HFnu in plain (P<0.05). Conclusion: During the initial high altitude exposure, ANS modulation is generally blunted, but the relatively predominant sympathetic control is enhanced, and this characteristic change of ANS function is positively correlated with the development of AMS.

Experimental Study of the Effect of Autonomic Nervous System on the Transmural Dispersion of Ventricular Repolarization under Acute Myocardial Ischemia in Vivo

The effect of the autonomic nerves on the transmural dispersion of ventricular repolarization(TDR)under acute myocardial ischemia in intact canine was investigated.Using the monophasic action potential(MAP)recording technique,MAPs of the epicardium(Epi),midmyocardium(Mid)and endocardium(Endo)were recorded simultaneously by specially designed plunge-needle electrodes at the left ventricular free wall under acute myocardial ischemia in 12 open-chest dogs.MAPD 90 and TDR among three myocardial layers as well as the incidence of the early afterdepolarization(EAD)before autonomic nervous stimulation and during autonomic nervous stimulation were compared.It was found that 10 min after acute myocardial ischemia,TDR was increased from 55±8 ms to 86±15 ms during sympathetic stimulation(P<0.01).The TDR(53±9 ms)during parasympathetic stimulation was not significantly different from that of the control(55±8 ms)(P>0.05).The EAD was elicited in the Mid of 2 dogs(16%)10 min after acute myocardial ischemia,but the EAD were elicited in the Mid of 7 dogs(58%)during sympathetic stimulation(P<0.01).It was concluded that:(1)Sympathetic stimulation can increase the transmural dispersion of repolari-zation and induce early afterdepolarizations in the Mid under acute myocardial ischemia,which provide the opportunity for the ventricular arrhythmia developing;(2)Parasympathetic stimulation has no significant effect on the transmural dispersion of repolarization under myocardial ischemia.

Effect of Autonomic Nervous System on the Transmural Dispersion of Ventricular Repolarization in Intact Canine

The effect of the autonomic nerves on the transmural dispersion of ventricular repolarization in intact canine was investigated. By using the monophasic action potential (MAP) recording technique, monophasic action potentials (MAPs) of the epicardium (Epi), midmyocardium (Mid) and endocardium (Endo) were recorded simultaneously by specially designed plunge needle electrodes at the left ventricular free wall in 12 open chest dogs. MAPD 90 and transmural dispersion of repolarization among three myocardial layers as well as the incidence of the EAD before autonomic nervous stimulation and during autonomic nervous stimulation were compared. The results showed that the MAPD 90 of Epi, Mid and Endo before autonomic nervous stimulation were 278±11 ms, 316±16 ms and 270±12 ms respectively, the MAPD 90 of Mid was significantly longer than that of Epi or Endo ( P <0.01). MAPD 90 of Epi, Mid and Endo were shortened by 19±4 ms, 45±6 ms, 18±3 ms respectively during sympathetic stimulation. Compared with that of the control, the transmural dispersion of repolarization during sympathetic stimulation was shortened from 44±4 ms to 15±3 ms ( P <0.01), but early afterdepolarizations were elicited in the Mid of 5 dogs (41 %) during sympathetic stimulation. Parasympathetic stimulation did not significantly affect the MAPD 90 in the three layers. It is concluded that there is the transmural dispersion of ventricular repolarization in intact canine. Sympathetic stimulation can reduce transmural dispersion of repolarization, but it can produce early afterdepolarizations in the Mid. Parasympathetic stimulation does not significantly affect the transmural dispersion of ventricular repolarization.

Assessment of the autonomic nervous system is an appropriate biological marker for the well-being in erectile dysfunction

Aim： To investigate whether the autonomic nervous system （ANS） components are suitable biological markers for representing well-being in patients with erectile dysfunction （ED）. Methods： The present study included 74 male patients who had applied for check-ups in the cardiology outpatient clinic at Kirikkale University （Kirikkale, Turkey） and who had been diagnosed as having hyperlipidemia. Of these patients, 26 had an additional diagnosis of ED and made up the patient group. The remaining 48 patients formed the control group. Well-being was assessed with shortform 36 （SF-36）. The International Index of Erectile Function （IIEF） was used as a measure of libido and erectile function. Quantitative assessment of the ANS was made based on the analysis of heart rate variability by means of 24-h holter monitorization. Results： Comparisons between the ED and control groups showed significant differences only in energy scale of SF-36. The ED group also had significantly higher values of sympathetic activity. Except for the general health score of SF-36, which was found to be correlated with parasympathetic activity only in ED group, there were similar correlation patterns within the groups. Although well-being and sympathetic activity were correlated negatively, parasympathetic activity and well-being were correlated positively. Conclusion： Quantitative assessment of the ANS by heart rate variability analysis might be a suitable marker for well-being of patients with ED.

Changes in Autonomic Nervous System Activity and Mood of Healthy People after Mindfulness Art Therapy Short Version

The aim of this study was to investigate changes in autonomic nervous system (ANS) activity and mood caused by Mindfulness Art Therapy Short version (MATS). The participants were 20 Japanese college students who were separated into high and low risk groups based on the median score of the General Health Questionnaire (GHQ). MATS consisted of mindfulness exercise and making of art in one session. ANS activity (TP: total energy, LF/HF: sympathetic nervous, HF: parasympathetic nervous system, LF: both sympathetic and parasympathetic) and mood (TA: tension arousal, EA: energy arousal) were measured psychologically before and after MATS. In the high risk group, TP significantly decreased and LF, HF, and LF/HF did not change significantly;while TA significantly decreased and EA significantly increased. In the low risk group, TP and LF significantly increased and HF and LF/HF did not change significantly;while TA significantly decreased and EA showed a non-significant increase. These results suggest that MATS affects the ANS differently for participants with different states of mental health, and particularly promotes activity in low-risk participants. Psychologically, MATS decreased tension or anxiety and increased energy. These findings justify further use of this therapy.

Changes of autonomic nervous system function in healthy young men during initial phase at acute high-altitude exposure

Objective: To investigate the changes of autonomic nervous system (ANS) function during the initial phase at acute high-altitude exposure. Methods: Ninety-nine healthy sea-level male residents were studied in Chengdu plain and then Tibet plateau. Heart rate variability (HRV), cold pressor test (CPT), resting heart rate (HR) and blood pressure (BP) were measured at baseline (560 m altitude) and in 2 to 4 d after arriving at Tibet plateau (3 675 m altitude) to assess the ANS function. Results: Compared with baseline, on day 2 in Tibet the standard deviation of normal to normal intervals (SDNN), high-frequency (HF) power, total power (TP), root mean square of delta RR (rMSSD), percentage of delta RR>50 ms (PNN50), normalized high-frequency (HFnu) and fractal dimension (FD) decreased significantly (SDNN, HF, TP P<0.01, rMSSD, PNN50, HFnu, FD P<0.05), while the normalized low-frequency (LFnu) and LF/HF increased significantly (P<0.01). During day 3–4 in Tibet, SDNN, rMSSD, HF, TP and HFnu tended to rebound while LFnu and LF/HF decreased towards baseline day by day. In addition, in Tibet the increase in systolic pressure (SP) and diastolic pressure (DP) during CPT decreased significantly (P<0.01, 0.05), but resting HR increased compared with baseline (P<0.01). Conclusion: ANS modulation is generally blunted, and the relatively predominant sympathetic control is enhanced originally, then it reverts to the sea level states gradually during the initial days of acute high-altitude exposure.

The Effects of Green Kiwifruit Ingestion on Digestive Health, Blood Flow, Skin Health, and the Autonomic Nervous System

We aimed to assess the impact of consuming two Zespri Hayward green kiwifruit a day on 11 healthy women subjects over a period of 4 consecutive weeks. We analyzed the effects of kiwifruit consumption on intestinal, abdominal, and bowel movement related discomfort, bowel movement frequency, peripheral blood flow, skin health, and autonomic nervous system activity. This study was a randomized control trial, consisting of a four-week intervention period. Participants were divided to ensure equal age distributions and then randomly placed into two intervention groups: a kiwifruit consumption group (n = 11) and a control group (no kiwifruit consumption) (n = 5). The kiwifruit consumption group was instructed to consume two kiwifruit a day during the 4-week intervention period, while subjects in the control group were instructed not to consume kiwifruit for the duration of the study. Besides a restriction from eating yogurt and other fruits, subjects were requested to eat their meals as per usual. The results of this study showed a significant decrease in intestinal, abdominal, and bowel movement discomfort, and a significant increase in bowel movement frequency, at 4 weeks of kiwifruit consumption compared to before consumption. In addition, subjects in the kiwifruit consumption group experienced a significant increase in blood flow, particularly in the index and middle finger at 2 and 4 weeks of kiwifruit consumption. Furthermore, subjects in the kiwifruit consumption group experienced a significant increase in skin brightness at 4 weeks of kiwifruit consumption compared to before consumption. The results of this study suggest that kiwifruit appears to be a delicious and safe option for intestinal, abdominal, and bowel movement discomfort interventions for healthy women. In addition, kiwifruit may aid in increasing bowel movement frequency, peripheral blood flow, and brightness of skin among healthy women as well.

The Effect of Brief, Low-Intensity Stretching Gymnastics on Autonomic Nervous System Activity and Cognitive Function

Purpose: Stretching exercise and gymnastics both have beneficial effects, such as improvement of autonomic nervous system activity and mood. Additionally, studies on the effects of exercise on cognitive function have been conducted covering a wide range of age groups and have attracted much attention. However, conventional studies have set up programs with implementation times of 20 to 30 minutes. Therefore, shorter stretching programs are needed in order to fit them more easily into one’s free time. We examined the effects of a short 7-minute stretching gymnastics regime on the autonomic nervous system activity and cognitive function in 21 healthy participants. Methods: In this study, the participants performed a 10-minute cognitive task, followed by either Stretch Well Gymnastics, Stretch Band Gymnastics, or Radio Gymnastics sessions on different days. The participants then performed the cognitive task again. Heart rate was measured continuously throughout the experiment and we analyzed the heart rate variability. The cognitive tasks completed by all of the participants were evaluated for inhibitory control and cognitive flexibility. Results: A significant increase was shown in the sympathetic nerve activity during the Stretch Well Gymnastics, compared to the Radio Gymnastics and Stretch Band Gymnastics. Parasympathetic nerve levels were significantly increased after the gymnastics, compared to during the gymnastics, although there were no significant differences between any of the tasks. Additionally, in both the Stroop task and the number-Letter task, reaction times were faster in all of the sessions. In particular, the Stroop task showed the highest values for the Radio Gymnastics sessions, with marginally significantly lower scores for the Stretch Well Gymnastics sessions. Conclusion: The results showed that these heart rate variability responses supported the effects of autonomic activity associated with conventional low-intensity exercise. Additionally, stretching gymnastics for less than 10 minutes showed a positive effect on inhibitory function and cognitive flexibility.

Nutritional stimulation of the autonomic nervous system

Disturbance of the inflammatory response in the gut is important in several clinical diseases ranging from inflmmatory bowel disease to postoperative ileus. Several feedback mechanisms exist that control the inflammatory cascade and avoid collateral damage. In the gast rointestinal tract, it is of particular importance tocontrol the immune response to maintain the balance that allows dietary up take and utilization of nutrientson one hand, while preventing invasion of bacteria and toxins on the other hand. The process of digestion and absorption of nutrients requires a relative hyporesponsiveness of the immune cells in the gut to luminacontents which is not yet fully understood. Recentlythe autonomic nervous system has been identifi ed asan important pathway to control local and systemic inflammation and gut barrier integrity. Activation of thepathway is possible via electrical or via pharm acological interventions, but is also achieved in a physiologicamanner by ingestion of dietary lipids. Administration of dietary lipids has been shown to be very effectivein reducing the inflammatory cascade and maintaining intestinal barrier integrity in several experimental studies. This beneficial effect of nutrition on the inflammatory response and intestinal barrier integrity opens new therapeutic opportunities for treatment of certain gastrointestinal disorders. Furthermore, this neural feedback mechanism provides more insight in the relative hyporesponsiveness of the immune cells in the gut. Here, we will discuss the regulatory function of the autonomic nervous system on the inflammatory response and gut barrier function and the potential benefit in a clinical setting.

Stress prevention by modulation of autonomic nervous system (heart rate variability): A preliminary study using transcranial direct current stimulation

Introduction: Transcranial Direct Current Stimulation (tDCS) is a non-invasive, technique for brain stimulation. Anodal stimulation causes neuronal depolarisation and long-term potentiation, while cathodal stimulation causes hyperpolarisation and long-term depression. Stressors are associated with an increase in sympathetic cardiac control, a decrease in parasympathetic control, or both. Associated with these reactions is a frequently reported increase in Low Frequency (LF) Heart Rate Variability (HRV), a decrease in High Frequency (HF) power, and/or an increase in the LF/HF ratio. Objectives and aims: The present work aims to explore the tDCS potential in the modulation of the Autonomic Nervous System (ANS), through indirect stimulation of Anterior Cingulate Cortex (ACC). Methods: Two subjects, a 39 year old female and a 49 year old male, gave informed consent. Saline soaked synthetic sponges involving two, thick, metalic (stainless steel) rectangles, with an area of 25 cm2 each have been used as electrodes, connected to Iomed Phoresor II Auto device. It has been delivered a 2 mA current, for 20 minutes, over the left Dorsolateral Prefrontal Cortex (DLPFC) (Anode). Spectrum analysis (cStress software) of HRV has been performed before and after tDCS administration. Results: The female/male subject results of LF power, HF power and LF/HF ratio, before tDCS administration, were, respectively: 50.1 nu/60 nu, 46.1 nu/21.7 nu and 1.087/2.771;and, after tDCS administration, respectively: 33.5 nu/52.7 nu, 47.6 nu/ 22.8 nu and 0.704/2.312. Conclusions: tDCS over the left DLPFC (left ACC) increased parasympathetic activity and decreased sympathetic activity, suggesting the importance of tDCS in the management of stress-related disorders.

COVID-19-induced gastrointestinal autonomic dysfunction:A systematic review

BACKGROUND It is common for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection to occur in the gastrointestinal tract,which can present itself as an initial symptom.The severity of coronavirus disease 2019(COVID-19)is often reflected in the prevalence of gastrointestinal symptoms.COVID-19 can damage the nerve supply to the digestive system,leading to gastrointestinal autonomic dysfunction.There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract.AIM To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction,including its manifestations,potential mechanisms,diagnosis,differential diagnosis,impact on quality of life,prognosis,and management and prevention strategies.METHODS We conducted a thorough systematic search across various databases and performed an extensive literature review.Our review encompassed 113 studies published in English from January 2000 to April 18,2023.RESULTS According to most of the literature,gastrointestinal autonomic dysfunction can seriously affect a patient's quality of life and ultimate prognosis.Numerous factors can influence gastrointestinal autonomic nervous functions.Studies have shown that SARS-CoV-2 has a well-documented affinity for both neural and gastrointestinal tissues,and the virus can produce various gastrointestinal symptoms by reaching neural tissues through different pathways.These symptoms include anorexia,dysgeusia,heartburn,belching,chest pain,regurgitation,vomiting,epigastric burn,diarrhea,abdominal pain,bloating,irregular bowel movements,and constipation.Diarrhea is the most prevalent symptom,followed by anorexia,nausea,vomiting,and abdominal pain.Although COVID-19 vaccination may rarely induce autonomic dysfunction and gastrointestinal symptoms,COVID-19-induced autonomic effects significantly impact the patient's condition,general health,prognosis,and quality of life.Early diagnosis and proper recognition are crucial for improving outcomes.It is important to consider the differential diagnosis,as these symptoms may be induced by diseases other than COVID-19-induced autonomic dysfunction.Treating this dysfunction can be a challenging task.CONCLUSION To ensure the best possible outcomes for COVID-19 patients,it is essential to take a multidisciplinary approach involving providing supportive care,treating the underlying infection,managing dysfunction,monitoring for complications,and offering nutritional support.Close monitoring of the patient's condition is crucial,and prompt intervention should be taken if necessary.Furthermore,conducting thorough research on the gastrointestinal autonomic dysfunction caused by COVID-19 is vital to manage it effectively.

Causal interactions between the cerebral cortex and the autonomic nervous system

Mental states such as stress and anxiety can cause heart disease.On the other hand,meditation can improve cardiac performance.In this study,the heart rate variability,directed transfer function and corrected conditional entropy were used to investigate the effects of mental tasks on cardiac performance,and the functional coupling between the cerebral cortex and the heart.When subjects tried to decrease their heart rate by volition,the sympathetic nervous system was inhibited and the heart rate decreased.When subjects tried to increase their heart rate by volition,the parasympathetic nervous system was inhibited and the sympathetic nervous system was stimulated,and the heart rate increased.When autonomic nervous system activity was regulated by mental tasks,the information flow from the post-central areas to the pre-central areas of the cerebral cortex increased,and there was greater coupling between the brain and the heart.Use of directed transfer function and corrected conditional entropy techniques enabled analysis of electroencephalographic recordings,and of the information flow causing functional coupling between the brain and the heart.

Sympathetic nervous system activation and heart failure:Current state of evidence and the pathophysiology in the light of novel biomarkers

Heart failure(HF)is a complex clinical syndrome characterized by the activation of at least several neurohumoral pathways that have a common role in maintaining cardiac output and adequate perfusion pressure of target organs and tissues.The sympathetic nervous system(SNS)is upregulated in HF as evident in dysfunctional baroreceptor and chemoreceptor reflexes,circulating and neuronal catecholamine spillover,attenuated parasympathetic response,and augmented sympathetic outflow to the heart,kidneys and skeletal muscles.When these sympathoexcitatory effects on the cardiovascular system are sustained chronically they initiate the vicious circle of HF progression and become associated with cardiomyocyte apoptosis,maladaptive ventricular and vascular remodeling,arrhythmogenesis,and poor prognosis in patients with HF.These detrimental effects of SNS activity on outcomes in HF warrant adequate diagnostic and treatment modalities.Therefore,this review summarizes basic physiological concepts about the interaction of SNS with the cardiovascular system and highlights key pathophysiological mechanisms of SNS derangement in HF.Finally,special emphasis in this review is placed on the integrative and up-to-date overview of diagnostic modalities such as SNS imaging methods and novel laboratory biomarkers that could aid in the assessment of the degree of SNS activation and provide reliable prognostic information among patients with HF.

Analogs of microgravity: the function of Schlemm's canal, intraocular pressure and autonomic nervous during the head-down tilt test in healthy subjects

AIM:To evaluate the ocular outcomes and to elucidate possible mechanisms underlying intraocular pressure(IOP)change following the head-down tilt(HDT)test.METHODS:The study included 21 participants at the Department of Ophthalmology of Tongji Hospital.Subjects received the test of I-care tonometry,enhanced depth imaging optical coherence tomography and heart rate variability(HRV)analysis before and after 15 min HDT test.The lumen area of Schlemm’s canal(SCAR),IOP,HRV were calculated.RESULTS:IOP increased significantly after 20°head down position from 14.0±3.0 to 17.0±3.3 mm Hg(P<0.001).SCAR decreased from 13449.0±5454.9μm^(2) at sitting condition to 9576.6±4130.9μm^(2) post 15 min HDT test.High frequency(HF)indices increased significantly from 1462±865 Hz at baseline to 2128±824 Hz.Heart rate(HR)decreased significantly from 76±11.48 to 70±11.52 bpm after the HDT.The linear regression analysis showed that the difference of HF and SCAR significantly correlated with each other during the HDT(R^(2)=20%,P=0.04).CONCLUSION:These outcomes perform the first evidence of the activation of autonomic nervous system of HDT may cause the collapse of Schlemm’s canal lumen,which in turn leading to the increased IOP.

Measurement and Evaluation of the Autonomic Nervous Function in Daily Life

We developed a smart-phone based system to measure the activities of autonomic nervous system during everyday life. Using commonly marketed smart phones, by touching your fingertips on the phone’s camera over a short time of about 30 seconds, it will detect changes in the brightness of the blood flow and in turn analyze your heart rate variability. By using this system, about 100,000 cases were measured and from this large amount of data regarding heart rate variability, we evaluated the autonomic nervous function in their daily life. As a result, for the correlation between autonomic nervous system and age, we found that as the increase of age, the total power becomes decreased and the sympathetic nervous system tends to increase between thirties and fifties. For the correlation between autonomic nervous system and BMI (Body Mass Index), it is found that in general, the higher the BMI, the lower the total power and the stronger the sympathetic nervous system. In other words, people who are fat are lower about the total power and stronger about the sympathetic nervous system. In addition, for the correlation between autonomic nervous system and one day life, it is found that total power and sympathetic function tend to increase, while as evening approaches, sympathetic function tends to become suppressed.

Research progress of acupuncture analgesia based on autonomic nerve regulation pathway

The autonomic nervous system(ANS)includes the sympathetic,parasympathetic,and enteric nervous systems,and its senior regulatory center includes the brainstem,cingulate gyrus,and hypothalamus.Acupuncture can affect visceral,vascular,and glandular functions via the autonomic nervous regulatory pathway.In this paper,the relationship between pain and autonomic nervous function,the application of acupuncture guided by the autonomic nervous system,and the basis and clinical research on acupuncture analgesia are reviewed.

On Human Autonomic Nervous Activity Related to Behavior, Daily and Regional Changes Based on Big Data Measurement via Smartphone

This research uses a large amount of autonomic nervous system data (approximately 100,000 entries) to investigate the relationship between human autonomic nervous activity and behaviors, daily and regional changes. Data were measured via a heart rate variability analysis system that utilizes the camera of smartphones. This system was developed by the authors during previous research. The relations between autonomic nervous system and behaviors, total power and sympathetic nervous activity were found to rise after waking, while during leisure time, the total power rises and sympathetic nervous activity is inhibited. Concerning the relationship between autonomic nervous system and day of the week, it was found that total power decreases from the middle through the latter part of the week (namely, Wednesday, Thursday, and Friday), while it rises on Saturday, while the sympathetic nervous activity is suppressed on Saturday. Regarding the relationship between autonomic nervous system and region, it was found that total power is lower in the Kanto region of Japan than in others. This study also shows statistical proof (using a large amount of measurement data) to ideas held by the public for years. Thus, the data can be considered meaningful to the society, and the authors hope that it helps to improve work-life balance.

On Human Autonomic Nervous Activity Related to Weather Conditions Based on Big Data Measurement via Smartphone

This research uses our previously-developed smartphone camera-based heart rate change analysis system to survey the correlation between weather patterns and the autonomic nervous activity across a big data set of approximately 200,000 entries. The results showed a trend in which a significant decrease was seen in sympathetic nervous activity in both males and females—the higher the temperature. In addition, a significant increase was seen in the sympathetic nervous system in both males and females—the higher the atmospheric pressure. Lastly, a significant decrease was seen in the sympathetic nervous system in both males and females—the more precipitation there was. These results accord with prior research and with human biological phenomena, and we were able to use a data set of approximately 200,000 entries to statistically demonstrate our hypothesis. We believe this represents a valuable set of reference data for use in the health care.

Association between Depression, Pressure Pain Sensitivity, Stress and Autonomous Nervous System Function in Stable Ischemic Heart Disease: Impact of Beta-Adrenergic Receptor Blockade

Background: Depression and ischemic heart disease (IHD) are associated with persistent stress and autonomic nervous system (ANS) dysfunction. The former can be measured by pressure pain sensitivity (PPS) of the sternum, and the latter by the PPS and systolic blood pressure (SBP) response to a tilt table test (TTT). Beta-blocker treatment reduces the efferent beta-adrenergic ANS function, and thus, the physiological stress response. Objective: To test the effect of beta-blockers on changes in depression score in patients with IHD, as well as the influence on persistent stress and ANS dysfunction. Methods: Three months of non-pharmacological intervention aiming at reducing PPS and depression score in patients with stable IHD. Beta-blocker users (N = 102) were compared with non-users (N = 75), with respect to signs of depression measured by the Major Depressive Inventory questionnaire (MDI), resting PPS, and PPS and SBP response to TTT. Results: MDI score decreased 30% in non-users (p = 0.005) compared to 4% (p > 0.1) among users (between-group p = 0.003;effect size = 0.4). Resting PPS decreased in both the groups. Among most vulnerable patients with MDI ≥ 15, reductions in MDI score and resting PPS score correlated in non-users, only (r = 0.69, p = 0.007). Reduction in resting PPS correlated with an increase in PPS and SBP response to TTT. Conclusions: Stress intervention in patients with IHD was anti-depressive in non-users, only. Similarly, the association between the reduction in depression, reduction in persistent stress, and restoration of ANS dysfunction was only seen in non-users, suggesting a central role of beta-adrenergic receptors in the association between these factors.

Clinical Study on Evaluation of Autonomic Nervous Dysfunction Based on Imaging Urodynamic Examination with Slow Filling and Synchronous Blood Pressure Monitoring in the Patients with Cervicothoracic Spinal Cord Injury

Objective: Explore the rule of autonomic nervous dysfunction in the patients with urination disorder after high level spinal cord injury, and seek a safe, objective and accurate method to evaluate autonomic nervous function. Patients and Method: 48 patients with dysuria after cervicothoracic SCI were selected. Before, during and after imaging urodynamic examination with slow filling in supine position, blood pressure and ECG were monitored simultaneously. The symptoms of sweating, shivering, headache, flushing and chills were observed and recorded. The study of the relationship among the changes of blood pressure, heart rate and urodynamic indexes and the above symptoms was analyzed. Results: They were divided into three groups: group A (no obvious abnormality), group B (hyperactivity) and group C (hypoactivity) according to their BP, HR and existing the symptoms or not. Conclusion: The incidence of autonomic dysfunction in the high level SCI patients with dysuria was very high (79.17%), most of them were hyperactivity, and a few were low function. The changes of SBP and DBP in the hypoactivity group all appeared an increasing and then declining trend, while the change of HR in the low function one was lower than normal and decreased continuously. The main inducements of AD are neurogenic detrusor overactivity, detrusor sphincter dyssynergia, elevated abdominal pressure and abnormal bladder sensitivity. The asymptomatic patients had a higher occurrence rate (43.75%). Only by imaging urodynamic examination with slow filling and synchronous blood pressure monitoring, can autonomic nervous function of the patients be evaluated safely, objectively, early and accurately.