Sympathetic hyperactivity, hypertension, and tachycardia induced by stimulation of the ponto-medullary junction in humans
Sympathetic hyperactivity, hypertension, and tachycardia induced by stimulation of the ponto-medullary junction in humans
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DOI：
10.1016/j.clinph.2021.03.006
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发表时间：
2021-05-15
影响因子：
4.7
通讯作者：
Mukasa, Akitake
中科院分区：
文献类型：
--
作者：
Hamasaki, Tadashi;Yamakawa, Toshitaka;Mukasa, Akitake
目的：本研究的目的是调查手术操作或电刺激人类脑干所产生的自主活动和体循环的变化。方法：我们构建了一个系统，同时记录显微手术现场视频和代表自主活动的心率变异性（HRV）。在记录的 20 例脑干手术中，分析了 19 个高血压时期（定义为血压短暂升高的时期）的 HRV 特征和手术操作部位。我们分析了对脑桥髓质连接处进行电刺激的时间段，其目的是监测脑神经功能。结果：在高血压时期，HRV 分析显示交感神经活动优于副交感神经活动。与对照组相比，高血压时期与脑桥尾部或延髓头端区域的手术操作更相关。在电刺激期间，血压和心率显着升高，并伴有交感神经过度兴奋。结论：我们的研究结果提供了生理学证据，表明脑桥髓质连接处附近存在一个重要的自主神经中枢。意义：一项大型研究将揭示针对耐药性高血压等自主神经失衡疾病的神经调节候选靶点。(c) 2021 国际临床神经生理学联合会。 Elsevier B.V. 出版，版权所有
Objective: The purpose of this study is to investigate changes in autonomic activities and systemic circulation generated by surgical manipulation or electrical stimulation to the human brain stem.Methods: We constructed a system that simultaneously recorded microsurgical field videos and heart rate variability (HRV) that represent autonomic activities. In 20 brain stem surgeries recorded, HRV features and sites of surgical manipulation were analyzed in 19 hypertensive epochs, defined as the periods with transient increases in the blood pressure. We analyzed the period during electrical stimulation to the ponto-medullary junction, performed for the purpose of monitoring a cranial nerve function.Results: In the hypertensive epoch, HRV analysis showed that sympathetic activity predominated over the parasympathetic activity. The hypertensive epoch was more associated with surgical manipulation of the area in the caudal pons or the rostral medulla oblongata compared to controls. During the period of electrical stimulation, there were significant increases in blood pressures and heart rates, accompanied by sympathetic overdrive.Conclusions: Our results provide physiological evidence that there is an important autonomic center located adjacent to the ponto-medullary junction.Significance: A large study would reveal a candidate target of neuromodulation for disorders with autonomic imbalances such as drug-resistant hypertension.(c) 2021 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights