[On therapy of autonomic nervous system disorders in women].
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It has been postulated and there are indications that acupuncture affects the cardiovascular system via the autonomic nervous system. The blood vessels of the hand skin have sympathetic constrictor nerves only. Therefore, the possible effect of acupuncture on the ANS can be investigated by measurements of microvascular perfusion and thermoregulation of the hands. Knowing the physiological effects of acupuncture may help to improve acceptance of this unconventional medical approach.
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This study demonstrates that juvenile rheumatoid arthritis is associated with a dysregulation of the autonomic nervous system as well as with disturbances in the capacity of the immune system to respond to mediators of the autonomic nervous system. In patients with active disease heart rate at rest is higher than in healthy controls. In addition, 3-hydroxy-4-phenoxyphenylglycol levels in urine are higher in all patients than in the control group. Cardiovascular responses to an orthostatic stress test (tilt up) are reduced in patients with active and nonactive disease. Plasma norepinephrine responses to tilt up are reduced in subjects with active juvenile rheumatoid arthritis. In summary, our data show that patients with juvenile rheumatoid arthritis have an altered function of the autonomic nervous system associated with increased central noradrenergic outflow, presumably leading to increased vasoconstriction, resulting in a decreased response to an orthostatic stressor. The altered function of the autonomic nervous system is associated with changes in the response of leukocytes to mediators of the autonomic nervous system via beta2-adrenergic receptors. Leukocytes of patients with active juvenile rheumatoid arthritis have a lower cAMP response to a beta2-adrenergic agonist, presumably due to increased cAMP-phosphodiesterase activity in these cells.
The possible role of the autonomic nervous system in the development of myocardial sensitization to isoprenaline produced by DOCA-salt pretreatment was evaluated in bilaterally unanaesthetized rats subject to chronic ganglionic blockade with chlorisondamine or hexamethonium and to treatment with 6-hydroxydopamine. Isoprenaline produced ventricular fibrillation and death in rats pretreated for 6 days with DOCA (20 mg pellet, s.c.) and 0.9% saline. The incidence of mortality was dose dependent and was 76.6% with 150 microgram/kg of isoprenaline. Adrenalectomy did not alter the mortality rate. The combination of adrenalectomy with concurrent chronic ganglionic blockade significantly decreased the incidence of mortality and delayed the time of death. In contrast, 6-hydroxydopamine treatment and adrenalectomy did not alter the incidence of mortality nor time of death. No differences in myocardial noradrenaline turnover were detected in rats susceptible and nonsusceptible to death in ventricular fibrillation. We conclude that myocardial sensitization to isoprenaline induced by DOCA-salt requires a neurogenic component, which is not, however, manifested by changes in myocardial noradrenaline turnover.
Most studies show a decline in autonomic nervous system (ANS) function with advancing age. The occasional heterogenous responses of ANS to aging, however, suggest that psychosocial and physiologic factors alter aging of ANS function.
INTRODUCTION: Involvement of the autonomic nervous system during Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is rare. Localised hyperhydrosis and Claude Bernard Horner (CBH) syndrome have never been reported in patients with CIDP. CASE REPORT: We report the case of a 65-year-old right handed man who presented with hyperhydrosis localised to the right hemithorax and hemiface and a left CBH syndrome. After an extensive workup, the patient was found to have CIDP as the only cause of autonomic nervous system involvement. The symptoms resolved slowly after three courses of intravenous immunoglobulins. CONCLUSION: Signs of autonomic nervous system involvement can be observed in CIDP as in Guillain-Barré syndrome. This case report shows that immunomodulatory treatment can be effective against dysautonomia in CIDP.
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Digitalis produces many of its effects in intact animals and human beings by modifying the properties of the autonomic nervous system. The parasympathetic limb of the autonomic nervous system is most sensitive to these effects of digitalis, and its properties are significantly altered with therapeutic concentrations of the drug. These actions are particularly important in mediating the electrophysiologic effects of digitalis. With toxic concentrations of digitalis, stimulation of sympathetic nerve activity may also occur. This latter action may be involved in the arrhythmogenic effects of digitalis. These effects of digitalis on the autonomic nervous system play a major role in determining the pharmacodynamic actions of the drug in patients. The effects of digitalis on the autonomic nervous system also provide a setting for important interactions with other drugs that modify the properties of the sympathetic and parasympathetic nervous systems.