Autore grazie al Dott. Lan Qin e Shane Stanek aiuto per la raccolta dei dati.

<ol>
	<li>Low, P. A., Denq, J. C., Opfer-Gehrking, T. L., Dyck, P. J., O'Brien, P. C., Slezak, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+age+and+gender+on+sudomotor+and+cardiovagal+function+and+blood+pressure+response+to+tilt+in+normal+subjects.">Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects.</a> Muscle Nerve. 20, 1561-1568 (1997).</li><li>Low, P. A., Denq, J. C., Opfer-Gehrking, T. L., Dyck, P. J., O'Brien, P. C., Slezak, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+age+and+gender+on+sudomotor+and+cardiovagal+function+and+blood+pressure+response+to+tilt+in+normal+subjects.">Effect of age and gender on sudomotor and cardiovagal function and blood pressure response to tilt in normal subjects.</a> Muscle Nerve. 20, 1561-1568 (1997).</li><li>Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Composite+autonomic+scoring+scale+for+laboratory+quantification+of+generalized+autonomic+failure.">Composite autonomic scoring scale for laboratory quantification of generalized autonomic failure.</a> Mayo Clin Proc. 68, 748-752 (1993).</li><li>Low, P. A., Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+evaluation+of+autonomic+function.">Laboratory evaluation of autonomic function.</a> Clinical Autonomic disorders. , 179-209 (1997).</li><li>Low, P. A., Low, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+evaluation+of+autonomic+failure.">Laboratory evaluation of autonomic failure.</a> Clinical Autonomic disorders. , 179-209 (2008).</li><li>Novak, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Assessment+of+sympathetic+index+from+Valsalva+maneuver.">Assessment of sympathetic index from Valsalva maneuver.</a> Neurology. , (2011).</li></ol>

Nessun conflitto di interessi dichiarati.

Le insidie Il completamento del test autonomici è nella maggior parte dei pazienti semplice e può essere fatto entro 1 ore. Insidie ​​particolari di ogni fase di test è discusso di seguito. Attrezzature, acquisizione dati e l&#39;elaborazione dei segnali autonomo. Ci sono certo numero di insidie ​​legate principalmente alla qualità dei dati. Inadeguata pulizia della pelle può portare ad eccessivo rumore nel segnale ECG che possono rendere il rilevamento delle onde R difficile. Distribuzione impropria del sensore di pressione del sangue mio dare falsi valori alti o bassi. Segnale Doppler transcranico di alta qualità può essere difficile da ottenere nei pazienti anziani a causa finestra ossea di piccole dimensioni. Software per l&#39;elaborazione dati potrebbero non essere sufficientemente robuste per distinguere gli artefatti con la pressione del sangue, per esempio nei pazienti con Parkinson tremore. La respirazione profonda <ol><li> Ansia e pattern respiratorio anormale possono influire sui risultati di respirazione profonda. Soggetto deve essere ben rilassato durante il test. Un buon indicatore di ansia è il profilo della frequenza cardiaca. Se il soggetto è ansioso, la frequenza cardiaca può essere elevato. Prima di iniziare il test di respirazione profonda, assicurarsi che la frequenza cardiaca non è in trend verso l&#39;alto o verso il basso, se questo è accaduto attendere che la frequenza cardiaca media rimane piatta. Il pattern respiratorio a riposo dovrebbe essere normale, ad esempio, non ci dovrebbero essere iperventilazione (come misurato dalla fine di marea di CO 2) o tachipnea (frequenza respiratoria è superiore a 11 al minuto). </li><li> Il test di respirazione profonda ha un&#39;utilità limitata in alcuni dysrythmia cardiaco ad esempio in fibrillazione atriale o quando la frequenza cardiaca è controllata da pacemaker, perché la modulazione del nervo vagale del cuore sarà da sostituire sia il cuore generata ritmo o da un pacemaker. Conoscenze di base di anomalie del ritmo cardiaco è raccomandato. </li><li> Rilevamento improprio di onde R artefatti dovuti ovviamente causare errori nei risultati. Questo può accadere se le onde R sono troppo piccole per essere rilevata con certezza, o se lo sfondo ECG è rumoroso per esempio il contatto pelle a causa poveri. </li></ol> Manovra di Valsalva Manovra di Valsalva richiede una notevole cooperazione da parte dei soggetti Molti pazienti anziani fragili o non in grado di eseguire correttamente la manovra di Valsalva. Motivo più comune è la debolezza dei muscoli della bocca che si traduce in perdita di aria durante lo sforzo respiratorio. In questo caso è efficace per gentile sigillare la perdita d&#39;aria attorno al tubo con le dita 6. Valutazione delle funzioni adrenergici non può essere fatto in un onda quadra variante di manovra di Valsalva (Figura 10). Questa risposta è rara ma può essere osservato in soggetti sani o in pazienti con insufficienza cardiaca congestizia. Tilt test Numero di farmaci possono influenzare il test interpretazione tilt il rendering del test difficile. Non è sempre pratico di interrompere il trattamento prima del test. Può essere difficile ottenere registrazioni di buona qualità in pazienti con disturbi del movimento, per esempio nei pazienti con Parkinson tremore. Sudomotor test (QSART) <ol><li> Rimozione incompleta della superficie oleosa o irritazione della pelle troppo può influenzare uscita sudore. </li><li> Perdite se la capsula non è a tenuta stagna o dolore dovuto capsula troppo stretto </li><li> Farmaco comunemente utilizzato ha effetto anticolinergico che interferisce con il test del sudore. In molti casi, è poco pratico di interrompere tali farmaci resa interpretazione dei risultati difficili. </li></ol> La classificazione di menomazione autonomo utilizzando il composito Severity Score autonomo (CASS). Generazione di punteggio CASS è piuttosto complicata perché si tratta di confronti multipli in entrambi i valori assoluti e per cento. Purtroppo, non esiste un software commerciale che consente di calcolare automaticamente il punteggio. A UMass, usiamo software proprietario che genera automaticamente il punteggio CASS. Esempio di punteggi CASS è sul tavolo 8.

Tabella 9 Attrezzatura consigliata. <table border="1"><tbody><tr><td> Nome del materiale </td><td> Azienda </td><td> Commenti </td></tr><tr><td> Inclinazione tavolo motorizzato </td><td> WR medica elettronica </td><td> Qualsiasi tavolo con movimento fluido raggiungere 70 gradi entro 5-10 secondi </td></tr><tr><td> Monitor ECG </td><td></td><td> Qualsiasi dispositivo con uscita analogica </td></tr><tr><td> Non invasiva battito a battito Misuratore di pressione </td><td> Finapres Medical Systems </td><td> Sono disponibili diversi modelli, tutti sono simili </td></tr><tr><td> Q-Sweat </td><td> WR medica elettronica </td><td></td></tr><tr><td> Doppler transcranico </td><td></td><td> Qualsiasi dispositivo con uscita analogica </td></tr><tr><td> Sistema di registrazione </td><td> LabChart, ADInstruments </td><td> Semplicità di programmazione </td></tr><tr><td> Sistema di registrazione </td><td> Labview </td><td> Programmazione complessa </td></tr><tr><td> Sistema di registrazione </td><td> Matlab </td><td> Programmazione complessa </td></tr><tr><td> Sistema di registrazione </td><td> WR Medical </td><td> Flessibilità pronto da usare, ma limitato </td></tr><tr><td> CO2 monitorare </td><td></td><td> Molti modelli utilizzati per studi del sonno </td></tr><tr><td> Respiratorio monitorare </td><td></td><td> Termistore semplice collegata ad un sistema di registrazione </td></tr></tbody></table>

quantitative autonomic testing

Patologie associate a disfunzioni del sistema nervoso autonomo siano abbastanza comuni ma spesso non riconosciuto. Quantitativa test autonomici possono essere strumento prezioso per la valutazione di questi disturbi, sia nella clinica e nella ricerca. Ci sono certo numero di test autonomici, tuttavia, solo pochi sono stati validati clinicamente o sono di tipo quantitativo. Qui, il protocollo completamente quantitativa e clinicamente validato per i test delle funzioni autonomiche è presentato. Come minimo il laboratorio clinico autonomo dovrebbe avere una tabella di inclinazione, monitor ECG, continuo monitoraggio non invasivo della pressione sanguigna, il monitoraggio delle vie respiratorie e una media per la valutazione di dominio sudomotor. Il software per la registrazione e valutazione di test autonomici è fondamentale per la corretta valutazione dei dati. Il protocollo presentato valuta tre domini principali autonomo: cardiovagal, adrenergici e sudomotor. I test includono la respirazione profonda, la manovra di Valsalva, head-up tilt, e test quantitativo assone sudomotor (QSART). La gravità e la distribuzione di disautonomia è quantificato utilizzando Composite punteggi di gravità autonomo (CASS). Protocollo dettagliato è fornito evidenza aspetti essenziali della sperimentazione con particolare attenzione alla corretta acquisizione dei dati, ottenendo i relativi parametri e la valutazione imparziali di segnali autonomo. I dati normativi e CASS algoritmo per l&#39;interpretazione dei risultati sono forniti pure.

Watch this Scientific Journal Video about Quantitative Autonomic Testing at JoVE.com

Quantitative Autonomic Testing

Standardizzati, test completo e totalmente quantitativa delle funzioni autonome è descritto. I test autonomici consistere in una valutazione di questi tre settori principali autonomo compresi cardiovagal, adrenergici e sudomotor. La gravità e la distribuzione di disautonomia è quantificato utilizzando Composite punteggi di gravità autonomo.

Quantitativa test autonomici

Disorders associated with dysfunction of autonomic nervous system are quite common yet frequently unrecognized. Quantitative autonomic testing can be ...

Nanyang Technological University

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Unit 1

Drugs Acting on Autonomic Nervous System: Cholinergic Agonists and Antagonists Agents

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56.6K Views.  University of Massachusetts Medical School. Standardizzati, test completo e totalmente quantitativa delle funzioni autonome è descritto. I test autonomici consistere in una valutazione di questi tre settori principali autonomo compresi cardiovagal, adrenergici e sudomotor. La gravità e la distribuzione di disautonomia è quantificato utilizzando Composite punteggi di gravità autonomo.

Video: Quantitative Autonomic Testing

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Orthostatic tolerance (OT) refers to the ability to maintain cardiovascular stability when upright, against the hydrostatic effects of gravity, and hence to maintain cerebral perfusion and prevent syncope (fainting). Various techniques are available to assess OT and the effects of gravitational stress upon the circulation, typically by reproducing a presyncopal event (near-fainting episode) in a controlled laboratory environment. The time and/or degree of stress required to provoke this response provides the measure of OT. Any technique used to determine OT should: enable distinction between patients with orthostatic intolerance (of various causes) and asymptomatic control subjects; be highly reproducible, enabling evaluation of therapeutic interventions; avoid invasive procedures, which are known to impair OT1.
In the late 1980s head-upright tilt testing was first utilized for diagnosing syncope2. Since then it has been used to assess OT in patients with syncope of unknown cause, as well as in healthy subjects to study postural cardiovascular reflexes2-6. Tilting protocols comprise three categories: passive tilt; passive tilt accompanied by pharmacological provocation; and passive tilt with combined lower body negative pressure (LBNP). However, the effects of tilt testing (and other orthostatic stress testing modalities) are often poorly reproducible, with low sensitivity and specificity to diagnose orthostatic intolerance7.
Typically, a passive tilt includes 20-60 min of orthostatic stress continued until the onset of presyncope in patients2-6. However, the main drawback of this procedure is its inability to invoke presyncope in all individuals undergoing the test, and corresponding low sensitivity8,9. Thus, different methods were explored to increase the orthostatic stress and improve sensitivity.
Pharmacological provocation has been used to increase the orthostatic challenge, for example using isoprenaline4,7,10,11 or sublingual nitrate12,13. However, the main drawback of these approaches are increases in sensitivity at the cost of unacceptable decreases in specificity10,14, with a high positive response rate immediately after administration15. Furthermore, invasive procedures associated with some pharmacological provocations greatly increase the false positive rate1.
Another approach is to combine passive tilt testing with LBNP, providing a stronger orthostatic stress without invasive procedures or drug side-effects, using the technique pioneered by Professor Roger Hainsworth in the 1990s16-18. This approach provokes presyncope in almost all subjects (allowing for symptom recognition in patients with syncope), while discriminating between patients with syncope and healthy controls, with a specificity of 92%, sensitivity of 85%, and repeatability of 1.1&plusmn;0.6 min16,17. This allows not only diagnosis and pathophysiological assessment19-22, but also the evaluation of treatments for orthostatic intolerance due to its high repeatability23-30. For these reasons, we argue this should be the "gold standard" for orthostatic stress testing, and accordingly this will be the method described in this paper.

We describe a "gold standard" for evaluating orthostatic tolerance (OT) using tilt testing with combined lower body negative pressure (LBNP). This can be combined with non-invasive evaluations of cardiovascular reflex control. Normal and abnormal responses are defined.

Tilt test combinato con la pressione del corpo inferiore negativo: un &quot;gold standard&quot; per la misurazione tolleranza ortostatica

Orthostatic tolerance (OT)  refers to the ability to maintain cardiovascular stability when upright,  against the hydrostatic effects of gravity, and ...

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Medicina

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Children

The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory rate, salivation, perspiration and renal function. The ANS has two main branches: the sympathetic nervous system, preparing the human body for action in times of danger and stress, and the parasympathetic nervous system, which regulates the resting state of the body.
ANS activity can be measured invasively, for instance by radiotracer techniques or microelectrode recording from superficial nerves, or it can be measured non-invasively by using changes in an organ's response as a proxy for changes in ANS activity, for instance of the sweat glands or the heart. Invasive measurements have the highest validity but are very poorly feasible in large scale samples where non-invasive measures are the preferred approach. Autonomic effects on the heart can be reliably quantified by the recording of the electrocardiogram (ECG) in combination with the impedance cardiogram (ICG), which reflects the changes in thorax impedance in response to respiration and the ejection of blood from the ventricle into the aorta. From the respiration and ECG signals, respiratory sinus arrhythmia can be extracted as a measure of cardiac parasympathetic control. From the ECG and the left ventricular ejection signals, the preejection period can be extracted as a measure of cardiac sympathetic control. ECG and ICG recording is mostly done in laboratory settings. However, having the subjects report to a laboratory greatly reduces ecological validity, is not always doable in large scale epidemiological studies, and can be intimidating for young children. An ambulatory device for ECG and ICG simultaneously resolves these three problems.
Here, we present a study design for a minimally invasive and rapid assessment of cardiac autonomic control in children, using a validated ambulatory device 1-5, the VU University Ambulatory Monitoring System (VU-AMS, Amsterdam, the Netherlands,<a href="http://www.vu-ams.nl" target="_blank"> www.vu-ams.nl</a>).

Measuring Cardiac Autonomic Nervous System ANS Activity in Children

Measurement of autonomic nervous system activity usually confines the researcher and participant to the laboratory, which may provide an intimidating environment to children. The VU University Ambulatory Monitoring System (VU-AMS) device can record cardiac autonomic control in any setting. The VU-AMS proved very amenable to testing in children.

Misurazione cardiaca Sistema Nervoso Autonomo (SNA) Attività nei bambini

The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory ...

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic conditions. As part of a diagnostic assessment, the early detection of postural deficits is important so that appropriate and targeted interventions can be prescribed. The Sensory Organization Test (SOT) on the EquiTest determines an individual&#39;s use of the sensory systems (somatosensory, visual, and vestibular) that are responsible for postural control. Somatosensory and visual input are altered by the calibrated sway-referenced support surface and visual surround, which move in the anterior-posterior direction in response to the individual&#39;s postural sway. This creates a conflicting sensory experience. The Motor Control Test (MCT) challenges postural control by creating unexpected postural disturbances in the form of backwards and forwards translations. The translations are graded in magnitude and the time to recover from the perturbation is computed.
Intermittent claudication, the most common symptom of peripheral arterial disease, is characterized by a cramping pain in the lower limbs and caused by muscle ischemia secondary to reduced blood flow to working muscles during physical exertion. Claudicants often display poor balance, making them susceptible to falls and activity avoidance. The Ankle Brachial Pressure Index (ABPI) is a noninvasive method for indicating the presence of peripheral arterial disease and intermittent claudication, a common symptom in the lower extremities. ABPI is measured as the highest systolic pressure from either the dorsalis pedis or posterior tibial artery divided by the highest brachial artery systolic pressure from either arm. This paper will focus on the use of computerized dynamic posturography in the assessment of balance in claudicants.

Individuals with intermittent claudication exhibit poor balance compared to healthy controls. Computerized dynamic posturography is an objective method for measuring an individual's postural responses to balance disturbances. This provides an objective reflection of the person&#x2019;s ability to respond to situations under which sensory stimuli are altered and unexpected perturbations occur.

Computerized dynamic posturography with the EquiTest is an objective technique for measuring postural strategies under challenging static and dynamic ...

Development of an Algorithm to Perform a Comprehensive Study of Autonomic Dysreflexia in Animals with High Spinal Cord Injury Using a Telemetry Device

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the mid-thoracic level can lead to a potentially life-threatening hypertensive condition called autonomic dysreflexia (AD) that is often triggered by noxious or non-noxious somatic or visceral stimuli below the level of injury. One of the most common triggers of AD is the distension of pelvic viscera, such as during bladder and bowel distension or evacuation. This protocol presents a novel pattern recognition algorithm developed for a JAVA platform software to study the fluctuations of cardiovascular parameters as well as the number, severity and duration of spontaneously occurring AD events. The software is able to apply a pattern recognition algorithm on hemodynamic data such as systolic blood pressure (SBP) and heart rate (HR) extracted from telemetry recordings of conscious and unrestrained animals before and after thoracic (T3) complete transection. With this software, hemodynamic parameters and episodes of AD are able to be detected and analyzed with minimal experimenter bias.

The catheter of a telemetry device is implanted into the abdominal aorta in order to continuously collect beat-by-beat hemodynamic data from animals pre and post-high thoracic spinal cord transection. A novel JAVA software was employed to analyze hemodynamic parameters as well as frequency and intensity of spontaneous episodes of autonomic dysreflexia.

Sviluppo di un algoritmo di effettuare uno studio globale di autonomica disreflessia in animali con alta ferita del midollo spinale Uso di un dispositivo di telemetria

Spinal cord injury (SCI) is a debilitating neurological condition characterized by somatic and autonomic dysfunctions. In particular, SCI above the ...

Measuring Cardiac Autonomic Nervous System (ANS) Activity in Toddlers - Resting and Developmental Challenges

The autonomic nervous system (ANS) consists of two branches, the parasympathetic and sympathetic nervous systems, and controls the function of internal organs (e.g., heart rate, respiration, digestion) and responds to everyday and adverse experiences 1. ANS measures in children have been found to be related to behavior problems, emotion regulation, and health 2-7. Therefore, understanding the factors that affect ANS development during early childhood is important. Both branches of the ANS affect young children&#8217;s cardiovascular responses to stimuli and have been measured noninvasively, via external monitoring equipment, using valid and reliable measures of physiological change 8-11. However, there are few studies of very young children with simultaneous measures of the parasympathetic and sympathetic nervous systems, which limits understanding of the integrated functioning of the two systems. In addition, the majority of existing studies of young children report on infants&#8217; resting ANS measures or their reactivity to commonly used mother-child interaction paradigms, and less is known about ANS reactivity to other challenging conditions. We present a study design and standardized protocol for a non-invasive and rapid assessment of cardiac autonomic control in 18 month old children. We describe methods for continuous monitoring of the parasympathetic and sympathetic branches of the ANS under resting and challenge conditions during a home or laboratory visit and provide descriptive findings from our sample of 140 ethnically diverse toddlers using validated equipment and scoring software. Results revealed that this protocol can produce a range of&#160;physiological responses to both resting and developmentally challenging conditions, as indicated by changes in heart rate and indices of parasympathetic and sympathetic activity. Individuals demonstrated&#160;variability in resting levels, responses to challenges, and challenge reactivity, which provides additional evidence that this protocol is useful for the examination of ANS individual differences for toddlers.

Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges

We describe the methods for continuous monitoring of the autonomic nervous system under resting and challenge conditions with 18 month old children. Results revealed that this protocol can produce meaningful physiological responses in both branches of the autonomic nervous system and elicit significant individual variability in patterns of responses.

Misurazione cardiaca Sistema Nervoso Autonomo (ANS) Attività in Toddlers - Riposo e di sviluppo sfide

The autonomic nervous system (ANS) consists of two branches, the parasympathetic and sympathetic nervous systems, and controls the function of internal ...

Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing

Central facilitation and modulation of incoming nociceptive signals play an important role in the perception of pain. Disruption in central pain processing is present in many chronic pain conditions and can influence responses to specific therapies. Thus, the ability to precisely describe the state of central pain processing has profound clinical significance in both prognosis and prediction. Because it is not practical to record neuronal firings directly in the human spinal cord, surrogate behavior tests become an important tool to assess the state of central pain processing. Dynamic QST is one such test, and can probe both the ascending facilitation and descending modulation of incoming nociceptive signals via TS and CPM, respectively. Due to the large between-individual variability in the sensitivity to noxious signals, standardized TS and CPM tests may not yield any meaningful data in up to 50% of the population due to floor or ceiling effects. We present methodologies to individualize TS and CPM so we can capture these measures in a broader range of individuals than previously possible. We have used these methods successfully in several studies at the lab, and data from one ongoing study will be presented to demonstrate feasibility and potential applications of the methods.

By assessing pain in response to repetitive or different types of standardized stimuli, dynamic quantitative sensory testing (QST) can reveal changes in the central processing of pain. We present methods to optimize and individualize two dynamic QST measures: temporal summation (TS) and conditioned pain modulation (CPM).

Dinamico Quantitative Sensory Test per caratterizzare Central Processing Pain

Central facilitation and modulation of incoming nociceptive signals play an important role in the perception of pain. Disruption in central pain ...

Neuroscienze

Novel Approach for Simultaneous Recording of Renal Sympathetic Nerve Activity and Blood Pressure with Intravenous Infusion in Conscious, Unrestrained Mice.

Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice. However, mice usually exhibit very low systemic blood pressure and hemodynamic instability for several hours during anesthesia and surgery. Meaningful interpretation of RSNA is confounded by this non-physiological state, given the intimate relationship between sympathetic nervous tone and cardiovascular status. To address this limitation of traditional approaches, we developed a new method for measuring RSNA in conscious, freely-moving mice. Mice were chronically instrumented with radio-telemeters for continuous monitoring of blood pressure as well as a jugular venous infusion catheter and custom-designed bipolar electrode for direct recording of RSNA. Following a 48-72 hour recovery period, survival rate was 100% and all mice behaved normally. At this time-point, RSNA was successfully recorded in 80% of mice, with viable signals acquired up to 4 and 5 days post-surgery in 70% and 50% of mice, respectively. Physiological blood pressures were recorded in all mice (116&plusmn;2 mmHg; n=10). Recorded RSNA increased with eating and grooming, as well-established in the literature. Furthermore, RSNA was validated by ganglionic blockade and modulation of blood pressure with pharmacological agents. Herein, an effective and manageable method for clear recording of RSNA in conscious, freely-moving mice is described.

Anesthetized mice exhibit non-physiological systemic blood pressure, which precludes meaningful assessment of autonomic tone given the intimate relationship between blood pressure and the autonomic nervous system. Thus, a novel method to simultaneously record renal sympathetic nerve activity and blood pressure with intravenous infusion in conscious mice is outlined.

Nuovo approccio per la registrazione simultanea di attività simpatica renale del nervo e pressione del sangue con l'infusione endovenosa in consapevole, topi sfrenati.

Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity ...

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Investigating potential pharmacodynamic effects in an early phase of central nervous system (CNS) drug research can provide valuable information for further development of new compounds. A computerized and thoroughly validated battery of neuropsychological and neurophysiological tests has been shown to be sensitive to detect drug-induced effects of multiple new and existing compounds. The test battery covers the main CNS domains, which have been shown to respond to drug effects and can be repeatedly administered following drug administration to characterize the concentration-effect profile of a drug.
The standard tests in the battery are saccadic eye movement, smooth pursuit eye movement, the Bowdle visual analog scale (VAS), the Bond and Lader VAS, body sway, adaptive tracking, visual verbal learning, and quantitative electroencephalography (qEEG). However, the test battery is adaptive in nature, meaning that it can be composed and adjusted with tests fit to investigate specific drug classes, or even specific receptors.
Showing effects of new cholinergic drugs designed to have a pro-cognitive outcome has been difficult. The pharmacological challenge model is a tool for early proof-of-pharmacology. Here, a marketed drug is used to induce temporary and reversible disease-like symptoms in healthy subjects, via a pharmacological mechanism related to the disease that is targeted as indication for the new compound. The test battery was implemented to investigate the potential of the nicotinic receptor antagonist mecamylamine to be used as a challenge model for cholinergic dysfunction, as seen in neurodegenerative disorders.
A worsening of scores in a dose dependent manner on the visual verbal learning test (VVLT; a test for learning and memory abilities) and the adaptive tracking test (a measure of visuomotor control and arousal), in particular, showed that the test battery is sensitive to showing acute pharmacodynamic effect after administration of anti-cholinergic drugs.

A validated computerized battery of neuropsychological and neurophysiological tests is used to study pharmacodynamic effects on the central nervous system of newly developed drugs in early phase development. To demonstrate the test battery, the acute effects of mecamylamine and the reversal of these effects by two agonist drugs are described.

Una batteria di Test computerizzato per studiare effetti farmacodinamici sul sistema nervoso centrale di farmaci colinergici in fase precoce di sviluppo di farmaci

Investigating potential pharmacodynamic effects in an early phase of central nervous system (CNS) drug research can provide valuable information for ...

Quantifying Acute Changes in Renal Sympathetic Nerve Activity in Response to Central Nervous System Manipulations in Anesthetized Rats

Renal sympathetic nerve activity (RSNA) and mean arterial pressure are important parameters in cardiovascular and autonomic research; however, there are limited resources directing scientists in the techniques for measuring and analyzing these variables. This protocol describes the methods for measuring RSNA and mean arterial pressure in anesthetized rats. The protocol also includes the approaches for accessing the brain during RSNA recordings for central nervous system (CNS) manipulations. The RSNA recording technique is compatible with pharmacologic, optogenetic, or electrical stimulation of the CNS. The approach is useful when an investigator will measure short-term (min to h) autonomic responses in non-survival experiments to correlate anatomically with CNS nuclei. The approach is not intended to be used to obtain chronic (survival) recordings of RSNA in rats. Discharges in RSNA, averaged rectified RSNA, and mean arterial pressure can be quantified and analyzed further using parametric statistical tests. Methods for obtaining venous access, recording mean arterial pressure telemetrically, and brain fixation for future histological analysis are also described in the article.

Methods for measuring sympathetic and cardiovascular responses to central nervous system (CNS) manipulations are important for advancing neuroscience. This protocol was developed to assist scientists with measuring and quantifying acute changes in renal sympathetic nerve activity (RSNA) in anesthetized rats (non-survival).

Quantificare i cambiamenti acuti nell'attività comprensiva renale del nervo in risposta a manipolazioni del sistema nervoso centrale in ratti anestetizzati

Renal sympathetic nerve activity (RSNA) and mean arterial pressure are important parameters in cardiovascular and autonomic research; however, there are ...

A Quantitative Sensory Testing Paradigm to Obtain Measures of Pain Processing in Patients Undergoing Breast Cancer Surgery

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and lower quality of life. Persistent postsurgical pain is relatively refractory to treatment hence generating a high need for preventive strategies and treatments. Therefore, the identification of patients at risk of developing persistent pain is an area of active ongoing research. Recently it was demonstrated that peri-operative disruptions in central pain processing may be able to predict persistent postsurgical pain at long term follow-up in breast cancer patients. The aim of the current report is to present a short protocol to obtain pain thresholds to different stimuli at multiple sites and a measure of endogenous analgesia in breast cancer patients. We have used this method successfully in a clinical context and detail some representative results from a clinical study.

Persistent postsurgical pain may be related to changes in pain processing. By assessing pain in response to standardized stimuli, changes in pain processing can be elucidated. We present methods to obtain pain thresholds to different stimuli and a measure of endogenous analgesia in patients undergoing breast cancer surgery.

Un paradigma di test sensoriale quantitativo per ottenere misure di elaborazione nei pazienti sottoposti a chirurgia del cancro al seno dolore

Chronic pain following surgery, persistent postsurgical pain, is an important highly prevalent condition contributing to significant symptom burden and ...