Autonomic Neuroscience-Basic & Clinical最新文献

{"title":"The sympathetic nervous system in normotensive and hypertensive pregnancies","authors":"Sana Ayesha ,&nbsp;Margie H. Davenport ,&nbsp;Craig D. Steinback","doi":"10.1016/j.autneu.2025.103293","DOIUrl":"10.1016/j.autneu.2025.103293","url":null,"abstract":"<div><div>Pregnancy is associated with significant physiological adaptations that facilitate optimal foetal development and growth. Among the most notable changes in healthy pregnancies are increases in plasma volume, cardiac output, and sympathetic nervous system activity, alongside a reduction in total peripheral resistance. Normotensive pregnancies are among the few physiological states in which elevated sympathetic activity is considered normal and beneficial. However, the underlying mechanisms that reconcile this increase in SNA with the concomitant decrease in blood pressure remain incompletely understood. In contrast, excessive sympathetic activity, beyond the expected pregnancy-associated increase, has also been implicated in the pathophysiology of hypertensive disorders of pregnancy, such as gestational hypertension and preeclampsia, which are major contributors to maternal and foetal morbidity and mortality. This review aims to provide an overview of the current understanding of the physiological and pathophysiological mechanisms underlying both normotensive and hypertensive pregnancies.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103293"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-related differences in temperature regulation during heat stress from childhood to older age","authors":"Amélie Debray ,&nbsp;Soha Sardar ,&nbsp;Thomas A. Deshayes ,&nbsp;Adèle Mornas ,&nbsp;Katia Oubouchou ,&nbsp;Yousra Ouazaa ,&nbsp;Daniel Gagnon","doi":"10.1016/j.autneu.2025.103294","DOIUrl":"10.1016/j.autneu.2025.103294","url":null,"abstract":"<div><div>Epidemiological studies have observed that female sex is associated with a greater risk of adverse health outcomes during heat extremes. It remains unclear if sex-related differences in autonomic temperature regulation contribute to these observations. This narrative review article provides an overview of studies that compared autonomic temperature regulation during heat stress between males and females across the lifespan. Our literature search focused on studies that investigated components of heat loss thermoeffector loops and/or that accounted for confounding differences in body morphology and metabolic heat production between males and females. Guided by this framework, we present studies that compared autonomic temperature regulation between males and females during childhood to adolescence, adulthood, middle-age, and older age. The review highlights that few studies have specifically studied sex-related differences in autonomic temperature regulation during heat stress. Most studies have focused on thermoeffector output and core temperature. In contrast, little is known regarding thermoafferent signalling, central integration of thermoafferent feedback, thermoefferent signalling and thermoeffector organ structure and function. Additional research is needed to understand how biological sex modulates autonomic temperature regulation during heat stress and how any sex-related difference may contribute to the greater health risks observed in females during heat extremes.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103294"},"PeriodicalIF":3.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and orthostatic hypotension are associated with baroreflex sensitivity and cerebral oxygenation after postural change","authors":"Marjolein Klop ,&nbsp;Jurgen A.H.R. Claassen ,&nbsp;Arjen Mol ,&nbsp;Marijke C. Trappenburg ,&nbsp;Richard J.A. van Wezel ,&nbsp;Andrea B. Maier ,&nbsp;Carel G.M. Meskers","doi":"10.1016/j.autneu.2025.103291","DOIUrl":"10.1016/j.autneu.2025.103291","url":null,"abstract":"<div><div>Baroreflex sensitivity (BRS), maintaining blood pressure (BP), and cerebral autoregulation, maintaining cerebral blood flow (CBF), are regulatory mechanisms to counteract posture-related BP changes and their effect on CBF. These mechanisms may fail in geriatric conditions such as orthostatic hypotension (OH) and cause symptoms and falls. This study aimed to determine the association of age, sex, antihypertensive use, comorbidity, and OH with BRS and cerebral oxygenation after postural change.</div><div>Thirty-four younger adults (median age 25 years), 30 older adults (median age 77 years), and 41 geriatric outpatients (median age 76 years) performed 2–3 supine-stand transitions, while heart rate (electrocardiogram), BP (volume-clamp photoplethysmography), and cerebral oxygenation (near-infrared spectroscopy) were measured continuously. BRS, cerebral oxygenation and cerebral autoregulation were determined in the time and frequency domain. Associations were investigated using linear regression and group comparisons.</div><div>Higher age and presence of OH (OH in at least one supine-stand transition during a continuous BP measurement) were associated with lower BRS (1 % per year, 30 % when having OH). Higher age was associated with higher cerebral oxygenation recovery (0.1 μmol/L per year) after 30 s, while OH was associated with lower cerebral oxygenation recovery (1.3 μmol/L when having OH) at 1 min after postural change. No evidence of cerebral autoregulation impairment was found across all three groups.</div><div>Reduced BRS and cerebral oxygenation recovery specifically in participants with OH are in line with their assumed susceptibility to cerebral hypoxia. The role of cerebral autoregulation as a compensatory mechanism for failing BRS could not be confirmed.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103291"},"PeriodicalIF":3.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can ‘noisy data’ perform as well as ‘clean data’ in outcome modeling after aneurysmal subarachnoid haemorrhage?","authors":"Agnieszka Uryga ,&nbsp;Marek Czosnyka ,&nbsp;Magdalena Kasprowicz ,&nbsp;Małgorzata Burzyńska ,&nbsp;Barbara Dragan ,&nbsp;Karol Budohoski ,&nbsp;Nathalie Nasr","doi":"10.1016/j.autneu.2025.103292","DOIUrl":"10.1016/j.autneu.2025.103292","url":null,"abstract":"<div><h3>Background</h3><div>Baroreflex sensitivity (BRS) is associated with clinical outcome in patients with aneurysmal subarachnoid haemorrhage (aSAH); however few studies have investigated this in typical clinical settings. This two-centre study evaluated how outcome models differ when excluding patients who received beta-blockers and/or noradrenaline (‘clean data’ set) versus including all of them (‘noisy data’ set).</div></div><div><h3>Methods</h3><div>This retrospective study included consecutive aSAH patients from Addenbrooke's Hospital (UK) and Wroclaw Medical University (Poland). Early BRS was measured using the cross-correlation method. A favorable outcome was defined as a Glasgow Outcome Scale (GOS) score of 4–5 at discharge.</div></div><div><h3>Results</h3><div>A total of 108 patients were included, with 40 receiving beta-blockers and/or noradrenaline. The median age was 56 (IQR ± 17) years old, where 73 % were women. On admission, 57 % had a Glasgow Coma Scale (GCS) score of 13–15. Univariate logistic regression showed BRS was significantly associated with outcome in both the ‘clean data’ set (OR 1.16, 95%CI [1.02,1.30]) and ‘noisy data’ set (OR 1.10, 95%CI [1.03,1.18]). In multivariate analysis, the best ‘clean data’ model (χ² = 22.89, <em>p</em> &lt; 0.001, AUC = 0.88) included heart rate (HR) (OR 0.93, 95%CI [0.87,0.99]) and GCS (OR 1.38, 95%CI [1.12,1.69]). The best ‘noisy data’ model (χ² = 32.27; <em>p</em> &lt; 0.001, AUC = 0.84) included BRS (OR 1.10, 95%CI [1.01,1.20]) and GCS (OR 1.32, 95%CI [1.16,1.51]).</div></div><div><h3>Conclusions</h3><div>Early BRS was independently associated with short-term outcome after aSAH, regardless of beta-blockers or noradrenaline use. In the ‘clean data’ set, HR was significantly associated with outcome, whilst in the ‘noisy data’ set, BRS was significantly associated with outcome. A larger multicentre study is required to validate these findings.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103292"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Transient immediate orthostatic hypotension’ is preferable to ‘initial’ orthostatic hypotension","authors":"David G. Benditt ,&nbsp;Artur Fedorowski ,&nbsp;Richard Sutton ,&nbsp;J. Gert van Dijk ,&nbsp;G. Baron-Esquivas ,&nbsp;I. Biaggioni ,&nbsp;M. Brignole ,&nbsp;J.S.Y. De Jong ,&nbsp;F.J. De Lange ,&nbsp;R. Freeman ,&nbsp;R. Furlan ,&nbsp;B. Grubb ,&nbsp;M.H. Hamdan ,&nbsp;R.A. Kenny ,&nbsp;P.B. Lim ,&nbsp;Moya Mitjans Angel ,&nbsp;B. Olshansky ,&nbsp;M. Rafanelli ,&nbsp;S.R. Raj ,&nbsp;J. Reyes ,&nbsp;I.A. Van Rossum","doi":"10.1016/j.autneu.2025.103288","DOIUrl":"10.1016/j.autneu.2025.103288","url":null,"abstract":"<div><div>A drop of systemic blood pressure (BP) occurring shortly after individuals move from supine or seated position to upright posture with subsequent prompt spontaneous resolution is a common physiological occurrence in humans. If the induced hypotension is severe, lightheadedness or postural instability leading to falls and injury may occur. By consensus, a transient systolic BP drop &gt;40 mmHg within 15 s of standing is deemed abnormal and has become termed ‘initial orthostatic hypotension’ (initial OH, iOH). However, the term ‘initial OH’ implies that another hypotensive event will follow shortly. In essence, if an OH event is deemed to be ‘initial’, then one might reasonably assume that a subsequent OH event is imminent. However, in the setting of abrupt movement to upright posture, the BP drop is usually solitary and brief (resolution within 15–30 s); thereafter the individual is usually OH symptom-free until they undertake another similar postural change. Currently, there is no single descriptor for a posture change driven, short-lived, spontaneously resolving OH event, without the implication that further hypotension is imminent as is implied by the term ‘initial OH’. In order to foster more accurate nomenclature, we recommend that ‘initial OH’ be retired, and ‘immediate OH’ or transient ‘immediate OH’ be substituted. While ‘immediate’ OH may be imperfect, it conveys an early onset event without implying additional imminent OH. Thus immediate OH or transient immediate are more accurate descriptors of this common transient hypotensive event. The abbreviation, ‘iOH’, remains unchanged.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103288"},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanism of heat treatment on exercise pressor reflex in hindlimb ischemia-reperfusion: Does the temperature gradient matter?","authors":"Lu Qin,&nbsp;Xuexin Zhang,&nbsp;Jianhua Li","doi":"10.1016/j.autneu.2025.103290","DOIUrl":"10.1016/j.autneu.2025.103290","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the effect of heat treatment (HT) with two temperature gradients in skeletal muscle: 1.5 and 3 °C, on the exercise pressor reflex (EPR) responses following limb ischemia-reperfusion (IR). Specifically, the involvement role of the P2Xs (receptors of ATP) pathway in the muscle afferent neurons was accessed.</div></div><div><h3>Methods</h3><div>An experimental IR model was induced by 6 h of ischemia followed by 18 h of reperfusion in rats (IR rats). For HT groups, three HT sessions (muscle temperature increased by 1.5 or 3 °C) lasted for 30 mins each were applied. EPR responses were evoked by static muscle contraction (30s). Protein expression of P2X3 receptor in dorsal root ganglions (DRGs) was evaluated by western blot. In addition, a calcium imaging study was applied to detect calcium influx induced by activation of P2X3 in the isolated muscle DRG neurons of studied animal groups. Data are presented as mean ± standard deviation (M ± SD).</div></div><div><h3>Results</h3><div>The mean arterial pressure (MAP) response to the static muscle contraction was significantly exaggerated in rats of IR 18 h (vs. sham, <em>p</em> &lt; 0.01). The exaggerated BP response was attenuated with increasing Tm by 1.5 and 3 °C (vs. IR, <em>p</em> &lt; 0.05). The expression of the P2X3 receptor was significantly enhanced in the DRGs of IR 18 h rats (vs. sham, <em>p</em> &lt; 0.01). The upregulated P2X3 was suppressed in the DRGs of IR 18 h rats +HT of 1.5 °C and 3 °C (vs. IR, <em>p</em> &lt; 0.05). In the isolated muscle afferent neurons, the Ca²⁺ entry induced by extracellular application of α,β-Me-ATP (30 μM) were significantly increased in IR rats (vs. sham, <em>p</em> &lt; 0.001). Both HT protocols suppressed the enhanced IR-induced Ca²⁺ entry (vs. IR, p &lt; 0.001). There was no difference between the BP responses in HT1.5 °C and 3 °C groups, nor P2X3 expression in muscle afferent DRG, P2X-mediated Ca²⁺ entry in isolated muscle afferent neurons (all <em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>IR injury leads to upregulation of EPR responses, and HT attenuates this effect. The P2X3 signaling pathway was involved in the beneficial regulatory effect of HT on EPR in IR. The temperature gradient did not play a role in the extent of BP and muscle afferent P2X pathway activity attenuation in the present study.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"259 ","pages":"Article 103290"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term effects of parity on maternal autonomic function","authors":"Virginia R. Nuckols ,&nbsp;Kristen G. Davis ,&nbsp;Mark K. Santillan ,&nbsp;Donna A. Santillan ,&nbsp;Gary L. Pierce","doi":"10.1016/j.autneu.2025.103285","DOIUrl":"10.1016/j.autneu.2025.103285","url":null,"abstract":"<div><div>The mechanisms by which parity and gravidity, number of pregnancies reaching twenty weeks gestational age and total number of pregnancies, respectively, contribute to cardiovascular disease risk remains unknown. Autonomic function was assessed in 65 parous women 1–5 years after normotensive pregnancy, quantified by spontaneous cardiovagal baroreflex sensitivity (BRS) and beat-to-beat blood pressure variability (BPV). Gravidity was negatively associated with BRS independent of age and body mass index (β = −2.01, <em>P</em> = 0.003). A similar trend was observed with greater parity (β = −1.74, <em>P</em> = 0.06). Gravidity and parity were not associated with BPV. These findings suggest a persistent and cumulative adverse effect of pregnancy on cardiac autonomic function in women.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103285"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute hyperoxia elicits decreases in muscle sympathetic nerve activity and action potential activation in a sex-dependent manner","authors":"Jinan Saboune ,&nbsp;Brittany K. Schwende ,&nbsp;Amélie Debray ,&nbsp;Charlotte W. Usselman ,&nbsp;Margie H. Davenport ,&nbsp;Craig D. Steinback","doi":"10.1016/j.autneu.2025.103287","DOIUrl":"10.1016/j.autneu.2025.103287","url":null,"abstract":"<div><div>Acute hyperoxia (100 % oxygen) has been shown to reduce muscle sympathetic nerve activity (MSNA), suggesting that hyperoxia could be a potential strategy for lowering blood pressure. However, the efficacy of hyperoxia to reduce blood pressure (e.g., mean arterial pressure; MAP) remains unclear. Therefore, we compared MSNA and MAP responses to acute hyperoxia (1-min pokilocapnic + 3-min, PetO₂ O₂ + 300 Torr) between 18 females and 13 males. Baseline integrated total MSNA was not different between females and males (24 ± 7 vs 23 ± 8 bursts/min, respectively; <em>P</em> = 0.68) while MAP was lower in females than males (85 ± 7 vs 93 ± 7 mmHg; <em>P</em> &lt; 0.01). Overall, hyperoxia evoked reductions in MSNA burst frequency (BF; <em>P</em> = 0.02) but not burst amplitude (BA; <em>P</em> = 0.82) or total MSNA (=BF ∗ BA; <em>P</em> = 0.26), To further probe these responses, 1-min nadir total MSNA response to hyperoxia were extracted within each participant. Total MSNA was reduced from baseline during nadir hyperoxia only in males (sex ∗ cond: <em>P</em> = 0.04). Females exhibited a bimodal distribution of sympatho-inhibitors (F_I) and non-inhibitors (F_NI). F_NI demonstrated limited reductions in BF (<em>P</em> = 0.11 vs inhibitors) coupled with increases in BA (<em>P</em> &lt; 0.01 vs inhibitors), resulting in no net change in total MSNA (P &lt; 0.01 vs inhibitors). Mechanistically, action potential (AP) detection analyses revealed that F_NI increased AP firing during hyperoxia (baseline: 313 ± 172 vs hyperoxia: 404 ± 192 spikes/min; <em>P</em> = 0.02), whereas hyperoxia blunted AP firing in F_I (baseline: 387 ± 263 vs hyperoxia: 267 ± 199 spikes/min; <em>P</em> = 0.02). In sum, approximately 50 % of healthy females responded to acute hyperoxia with unexpected increases in AP firing. These data may suggest that benefit of hyperoxia as a sympatho-inhibitor may be limited in young and healthy females.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103287"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is cardiovascular disease risk in transgender, gender-diverse, and non-binary adults associated with autonomic imbalance?","authors":"Keila Turino Miranda ,&nbsp;Brittany K. Schwende ,&nbsp;Alicia Duval ,&nbsp;Carl G. Streed Jr ,&nbsp;Shannon I. Delage ,&nbsp;Kit Chokly ,&nbsp;Vegas Hodgins ,&nbsp;Charlotte W. Usselman","doi":"10.1016/j.autneu.2025.103283","DOIUrl":"10.1016/j.autneu.2025.103283","url":null,"abstract":"<div><div>Blood pressure is a key indicator of cardiovascular health with chronically high levels increasing the risk of cardiovascular diseases (CVD) such as heart attack and stroke. Emerging evidence shows that transgender, gender-diverse, and non-binary (TGD) adults tend to have higher blood pressure than age-matched cisgender adults, corresponding to an increased CVD risk in this population. Yet, the mechanisms underlying elevated blood pressure in TGD adults remain unclear, posing challenges to TGD-affirming healthcare. Given the autonomic nervous system's role in CVD – wherein reduced parasympathetic and heightened sympathetic activity are key risk factors for CVD – this review explores the question: “Is cardiovascular disease risk in TGD adults associated with autonomic imbalance?” Limited research exists on autonomic balance within TGD populations. Accordingly, this review considers how TGD-specific factors, such as minority stress, lifestyle behaviors, sex and gender, and hormones (i.e., testosterone, estrogen, progesterone), may impact autonomic balance. Finally, this review aims to underscore the critical need for interdisciplinary research to elucidate these mechanisms and advance TGD-inclusive healthcare in the domains of autonomic control of blood pressure and overall cardiovascular health.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103283"},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation for control of refractory hypertension","authors":"Zoe H. Adams ,&nbsp;Emma C. Hart ,&nbsp;Nikunj K. Patel","doi":"10.1016/j.autneu.2025.103286","DOIUrl":"10.1016/j.autneu.2025.103286","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) is an emerging treatment for patients with severe drug-resistant hypertension, particularly for those in whom other non-pharmacological treatments (e.g., renal denervation, baroreflex activation therapy) have failed. Growing numbers of case studies demonstrate long-term reductions in blood pressure with DBS of the ventrolateral periaqueductal gray. This is likely achieved via modulation of autonomic blood pressure control centres, reducing sympathetic outflow to the vasculature. We discuss recent advances, including whether the ventrolateral periaqueductal gray alone is a robust enough target, and whether DBS has the potential to reinstate beneficial physiological characteristics of blood pressure, such as diurnal variation.</div></div>","PeriodicalId":55410,"journal":{"name":"Autonomic Neuroscience-Basic & Clinical","volume":"260 ","pages":"Article 103286"},"PeriodicalIF":3.2,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}