副交感神经和交感神经系统监测和焦虑样症状:改善分化和改善预后

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摘要

焦虑障碍(DSM-5)和具有焦虑症状的障碍(例如,创伤后应激障碍和注意力障碍)通常包括几种涉及副交感神经系统和交感神经系统(P&S)的生理症状。我们的研究已经确定了与这些症状相关的四种P&S障碍:1)副交感神经过度(SE)继发于副交感神经过度(PE),是一种异常的应激反应;2)与直立功能障碍相关的俯卧姿势(站立)时的交感神经退出(SW); 3)与晕厥相关的站立时的交感神经退出(SE); 4)自主介导的心律失常,包括窦性心律失常。所有这四种疾病都涉及大脑充盈不足,这是已知的导致焦虑样症状的原因。它们还会导致(亚临床)抑郁症,这是另一种常见的合并症。使用ANSAR医疗技术公司对静息和挑战P&S反应进行无创评估。(Philadelphia, PA)软件(ANX 3.0自主功能监视器)。在城市和农村地区服务的大型心脏病学实践中,诊断为焦虑或焦虑样症状的患者在4年内接受了一次以上的评估(平均每位患者3.3次评估;50.5%的女性;平均年龄57岁)。被诊断为焦虑或焦虑样症状,患有四种P&S障碍之一的患者也接受了P&S障碍的治疗。在这个队列中,缓解p&s功能障碍可以减少45%以上的焦虑或焦虑样症状。对焦虑或类似焦虑症状的患者进行P&S指导治疗,可以减轻焦虑的负担,改善患者的预后和生活质量,降低自杀的风险,帮助精神科医生关注焦虑的病因,并降低医疗保健费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Parasympathetic and Sympathetic Nervous System Monitoring and Anxiety-Like Symptoms: Improved Differentiation and Improved Outcomes
Anxiety disorders (DSM-5) and disorders having anxiety laden symptoms (e.g., PTSD and attention disorders) often include several physiologic symptoms which involve the Parasympathetic and Sympathetic nervous systems (P&S). Our research has identified four P&S disorders that are associated with these symptoms: 1) Sympathetic Excess (SE) secondary to Parasympathetic Excess (PE) as an abnormal stress response, 2) Sympathetic Withdrawal (SW) upon assuming headup posture (standing) associated with Orthostatic Dysfunction, 3) SE upon standing associated with Syncope, and 4) Autonomically mediated cardiac arrhythmia, including Sinus Arrhythmia. All four disorders involve poor brain profusion which is known to contribute to Anxiety-like symptoms. They also contribute to (sub-clinical) depression, another frequent co-morbidity. Resting and challenge P&S responses were assessed noninvasively using the ANSAR Medical Technologies, Inc. (Philadelphia, PA) software (ANX 3.0 autonomic function monitor). Patients diagnosed with Anxiety or Anxiety-like symptoms from a large cardiology practice serving both urban and rural areas were followed with more than one assessment over four years (an average of 3.3 assessments per patient; 50.5% Female; average age of 57 years). Patients diagnosed with Anxiety or Anxiety-like symptoms, with one of the four P&S disorders were also treated for their P&S disorder. Relieving P&S dysfunction within this cohort reduced Anxiety or Anxiety-like symptoms by over 45%. P&S guided therapy for patients with Anxiety or Anxiety-like symptoms, may reduce the burden of Anxiety, improve patient outcomes and quality of life, reduce the risk of suicide, aid the psychiatrist in focusing on the etiology of Anxiety, and reduce healthcare costs.
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