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Ciri fiziko-kimia tanih di bahagian barat Pulau Indah, Klang, Selangor

Tukimat Lihan, Sahibin Abdul Rahim, Aeslina Abdul Kadir, Jauharatuddini Ariffin, Suzana Ismail

Sains Malaysiana, 2006;35:23-30.

Sebanyak dua puluh lima sampel tanih atas (0-15 cm) telah diambil dari enam stesen persampelan di kawasan Pulau Indah, Klang, Selangor. Sampel ini telah dianalisis untuk menentukan kandungan logam berat, ciri fiziko-kimia dan nutrien di dalam tanih. Tanih telah dikutip dari stesen berasingan berdasarkan jenis tanih dan aktiviti pembangunan gunatanah yang berlainan. Didapati bahawa tanih di kawasan kajian didominasi oleh tekstur pasir kecuali di Stesen 1 dan 6 yang didominasi oleh tekstur lempung. Kandungan nutrien tersedia dipengaruhi oleh jenis tanih, dengan purata kandungan K dan Mg tinggi dalam tanih lempung manakala purata kandungan PO tinggi dalam tanih pasir. Kandungan nutrien terlarut pula dipengaruhi oleh aktiviti gunatanah, dengan kandungan NO-N dan NH-N terlarut adalah tinggi di kawasan pertanian manakala kandungan SO terlarut pula tinggi di kawasan terminal minyak dan kawasan industri logam. Ciri kimia dipengaruhi oleh jenis tanih di mana pH, kapasiti pertukaran kation dan kandungan bahan organik lebih tinggi di dalam tanih lempung berbanding tanih pasir. Kandungan logam berat dipengaruhi oleh jenis guna tanah, dengan kandungan Pb dan Zn tinggi di kawasan pertanian. Kandungan As dan Co pula adalah tinggi di kawasan terminal minyak dan industri logam. Kawasan gudang menunjukkan bacaan yang tertinggi bagi Ni dan Cr manakala kawasan Pelabuhan Sarat menunjukkan bacaan Cu yang tertinggi. Secara keseluruhannya, kepekatan kandungan Pb, Cu, Ni dan Co masih berada di bawah paras yang berpotensi toksik dalam tanih manakala sebahagian dari nilai As, Cr dan Zn melebihi paras yang berpotensi toksik dalam tanih.

Matched MeSH terms: Autonomic Nervous System Diseases
Age-related neurone-loss and the occurrence of darkand light neurones inthe ganglia of cranial nervesand autonomic nervous system: a comparative evaluation of their developmental and growth changes

Pillay AC

JUMMEC, 1998;3:22-46.

Senescent-decliue in the nervous-system functions is very frequently atbibuted to age-related neurone-loss. Processes and mechanisms involved in neuro- degeneration form part of the structural frame-work for interpreting the functional consequences. The literature concerning this matter are confusing and contradicting. The behaviour of cranial nerve ganglia was studied using neuro-histological techniques. On the evidence available in the present study, the dark cells are considered as active ones; the light cells are considered as those which have failed to establish functional projections, inactive, dying, dead or degenerating ones. Probably it is during the me- dium-sized stage of cell growth, the peripheral and central processes (of axons) begin to grow from the cell body and attempt to get established in their projection fields. The light cells have appeared among the very-small cells just on the day of hatching. This probably signifies the possible attempt to elinlinate the growing cells since they are no longer needed to replace larger categories of cells which have already well- developed neuronat connections at this stage. It is assumed that the time of appear- ance of light cells might be indirectly related to the onset of establishment of active functional connections of neurones and to the functional importance of the organs which it supplies. KEYWORDS: Neurone-Loss and Ageing, Dark and Light Neurones, Sensory and Autonomic Ganglia

Matched MeSH terms: Autonomic Nervous System
Fulltext Rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD): a case with additional features and review of the literature

Chew HB, Ngu LH, Keng WT

BMJ Case Rep, 2011;2011.
PMID: 22715259 DOI: 10.1136/bcr.02.2010.2706

A rare syndrome of rapid-onset obesity with hypothalamic dysfunction, hypoventilation and autonomic dysregulation (ROHHAD) has been recently described. We report the first patient with this syndrome in Southeast Asia and review reported cases to date. Our patient was good health with normal development until the age of 2. He then developed hyperphagic obesity, hypersomnolence, seizures, alveolar hypoventilation, central hypothyroidism, sodium and water dysregulation, gastrointestinal dysmotility, strabismus, disordered temperature and irregular heart rate, altered sweating, delayed puberty, mental retardation and recurrent respiratory tract infections. The cardiomyopathy with heart failure and abnormal cerebral spinal fluid (CSF) neurotransmitter analysis present in our patient have not been reported previously. Tumours of the sympathetic nervous system are known to be associated with this syndrome but had not been found in our patient at the time of reporting. We highlight the difficulty of achieving the diagnosis of ROHHAD syndrome and its overlap with other well-established disease entities. The mortality and morbidity resulting from the high incidence of cardiorespiratory arrest may be prevented by early ventilatory support.

Matched MeSH terms: Autonomic Nervous System Diseases/diagnosis*
Fulltext Physiological roles for the subfornical organ: a dynamic transcriptome shaped by autonomic state

Hindmarch CC, Ferguson AV

J Physiol, 2016 Mar 15;594(6):1581-9.
PMID: 26227400 DOI: 10.1113/JP270726

The subfornical organ (SFO) is a circumventricular organ recognized for its ability to sense and integrate hydromineral and hormonal circulating fluid balance signals, information which is transmitted to central autonomic nuclei to which SFO neurons project. While the role of SFO was once synonymous with physiological responses to osmotic, volumetric and cardiovascular challenge, recent data suggest that SFO neurons also sense and integrate information from circulating signals of metabolic status. Using microarrays, we have confirmed the expression of receptors already described in the SFO, and identified many novel transcripts expressed in this circumventricular organ including receptors for many of the critical circulating energy balance signals such as adiponectin, apelin, endocannabinoids, leptin, insulin and peptide YY. This transcriptome analysis also identified SFO transcripts, the expressions of which are significantly changed by either 72 h dehydration, or 48 h starvation, compared to fed and euhydrated controls. Expression and potential roles for many of these targets are yet to be confirmed and elucidated. Subsequent validation of data for adiponectin and leptin receptors confirmed that receptors for both are expressed in the SFO, that discrete populations of neurons in this tissue are functionally responsive to these adipokines, and that such responsiveness is regulated by physiological state. Thus, transcriptomic analysis offers great promise for understanding the integrative complexity of these physiological systems, especially with development of technologies allowing description of the entire transcriptome of single, carefully phenotyped, SFO neurons. These data will ultimately elucidate mechanisms through which these uniquely positioned neurons respond to and integrate complex circulating signals.

Matched MeSH terms: Autonomic Nervous System/physiology*
Fulltext Pengetahuan pedagogi kandungan (ppk) guru bukan pengkhususan reka bentuk dan teknologi (rbt) di sekolah menengah

Cathrine Binti Masingan, Sabariah Bte Sharif

Malaysian Journal of Social Sciences and Humanities, 2019;4(6):64-71.
MyJurnal

Kajian ini bertujuan untuk meneroka kefahaman Pengetahuan Pedagogi Kandungan (PPK) guru bukan pengkhususan mata pelajaran Reka Bentuk dan Teknologi (RBT) di Sekolah Menengah. Kajian ini adalah kajian kualitatif single case yang melibatkan dua orang guru bukan pengkhususan mata pelajaran RBT dipilih sebagai peserta kajian. Pengumpulan data menggunakan kaedah temu bual, pemerhatian dan juga analisis dokumen. Proses analisis data melibatkan tiga peringkat koding dalam Grounded Theory iaitu open coding, axial coding dan selective coding. Hasil kajian mendapati kedua peserta belum memahami dan menguasai sepenuhnya hala tuju, matlamat dan fokus KSSM RBT. Selain itu, mereka juga masih menghadapi masalah dalam menguasai isi kandungan mata pelajaran tersebut dengan baik. Dari aspek pengetahuan pedagogi, walaupun peserta kajian sedar tentang pendekatan-pendekatan PdPc yang dicadangkan dalam DSKP KSSM mata pelajaran RBT, namun mereka kurang menggunakan pendekatan tersebut dan masih cenderung menggunakan pendekatan pengajaran tradisional yang lebih berpusatkan kepada guru dan menggunakan kaedah syarahan semasa proses PdPc.

Matched MeSH terms: Autonomic Nervous System Diseases
Tahap pengherotan kognitif, kesunyian, kemurungan, penghargaan kendiri, dan sokongan sosial dalam kalangan wanita hamil luar nikah

Nasir R, Zainah AZ, Khairudin R, Wan Shahrazad WS, Mohd Norahim MS, Aizan SA

Jurnal Psikologi Malaysia, 2015;olume 29:1-10.

Peningkatan jumlah kehamilan luar nikah dalam kalangan remaja perempuan sehingga awal dewasa membimbangkan ramai pihak. Kemahilan luar nikah bukan sahaja boleh mengundang kepada risiko jangkitan HIV/AIDS, malah ia juga boleh membawa kepada masalah lain seperti pembuangan bayi dan pengguguran. Kajian ini dilakukan adalah untuk melihat sejauhmana tahap ganguan kognitif, kemurungan, kesunyian, penghargaan kendiri dan sokongan sosial dalam kalangan wanita hamil tanpa nikah. Dapatan kajian menunjukkan bahawa subjek kajian mempunyai tahap sokongan sosial yang sederhana, gangguan kognitif yang rendah; kemurungan, kesunyian dan penghargaan kendiri yang sederhana. Hal ini menunjukkan bahawa wanita hamil tanpa nikah ini masih kurang mendapat sokongan sosial yang sewajarnya dan cenderung untuk mengalami kemurungan dan kesunyian yang berpanjangan. Cadangan intervensi turut dibincangkan di akhir perbincangan kajian.

Matched MeSH terms: Autonomic Nervous System Diseases
Fulltext The effects of stimulant and non-stimulant medications on the autonomic nervous system (ANS) functioning in people with ADHD: A systematic review and meta-analysis

Idrees I, Bellato A, Cortese S, Groom MJ

Neurosci Biobehav Rev, 2023 Jan;144:104968.
PMID: 36427764 DOI: 10.1016/j.neubiorev.2022.104968

We carried out a systematic review and meta-analysis to investigate the effects of stimulant and non-stimulant medications on autonomic functioning in people with ADHD (PROSPERO: CRD42020212439). We searched (9th August 2021) PsycInfo, MEDLINE, EMBASE, Web of Science and The Cochrane Library, for randomised and non-randomised studies reporting indices of autonomic activity, (electrodermal, pupillometry and cardiac), pre- and post-medication exposure in people meeting DSM/ICD criteria for ADHD. In the narrative syntheses, we included 5 electrodermal studies, 1 pupillometry study and 57 studies investigating heart rate and blood pressure. In the meta-analyses, 29 studies were included on blood pressure and 32 on heart rate. Administration of stimulants, and to a lesser degree, non-stimulants increased heart rate and blood pressure in people with ADHD. Similarly, an upregulation of arousal, reflected in increased electrodermal activity and pupil diameter was observed following stimulant use. Yet, the methodological diversity of studies presented in this review reinforces the need for more standardised and rigorous research to fully understand the relationship between arousal, medication, and behaviour in ADHD.

Matched MeSH terms: Autonomic Nervous System
Fulltext Comparative efficacy of biofeedback interventions in predicting improvements in bilateral soccer shooting performance

Srilekha Saha, Nurfarrah Ezzaty Mohd Zahir, Foujia Huda, Soumendra Saha

Movement Health & Exercise, 2015;4(1):27-38.
MyJurnal

The beneficial impact of the differential biofeedback intervention technique on modification in autonomic competence, as well as the ultimate impact on bilateral shooting ability, were studied on young and competitive male soccer players. A total of 45 young high-performing soccer players in the age range of 18 to 24 years were recruited. At first, the players were subjected to baseline evaluation of psychomotor (i.e., reaction time - RT), physiological (viz. resting heart-rate; VO2Max, electrical muscle potentiality, etc.), and psychobiological indices (such as skin conductance components - latency, amplitude and recovery time). Thereafter, they were equally categorized into: Control Group, Experimental Group I [who received skin conductance (Sc) biofeedback training], and Experimental Group II [who received electromyography (EMG) biofeedback intervention training]. Participants of the experimental groups were subjected to their respective interventions (Sc & EMG biofeedback intervention training), which were imparted for 24 sessions (15 mins/day; 2 days/week for 12 weeks). After six weeks of intervention, mid-term evaluation of all of the aforementioned parameters (assessed during baseline evaluation) was performed. Thereafter, intervention sessions continued following the identical protocol for six weeks. At the end of the 12th week, a post-intervention assessment on all of the psychological, psychomotor and psychobiological variables was carried out on all of the participants to verify the effect of training on dependent measures. Post-intervention analyses revealed improvements in physiological, psychobiological and performance parameters, which could be rationally attributed to the differential biofeedback therapeutic interventions introduced to the experimental groups. The outcome suggested that both interventions facilitated improvement in bilateral shooting ability, while indepth analyses clarified that a higher extent of autonomic recovery emerged as the most significant factor facilitating shooting ability in the experimental groups.

Matched MeSH terms: Autonomic Nervous System
Fulltext Knowledge, belief and barriers to adult influenza and pneumococcal vaccination among primary care doctors in Sarawak

Wong, L. K. S., Muthupalaniappen, L., Tie, S. T.

Medicine & Health, 2017;12(2):275-285.
MyJurnal

Adult influenza and pneumococcal vaccinations are grossly underutilized although there is clear benefit in reducing mortality and morbidity among those at risk. The aim of the study was to assess primary care physician’s knowledge on adult influenza and pneumococcal vaccinations, their beliefs and barriers to vaccination. A cross-sectional study using self-administered questionnaires was conducted at eight primary care centres in Kuching, Sarawak. A total of 108 primary care physicians participated in this study. Median age of participants was 29 years (IQR 4.0). The median knowledge score for influenza vaccine was 9 (IQR 3) and for pneumococcal vaccine was 8 (IQR 4). Female participants scored higher compared to their male counterparts for influenza and pneumococcal vaccines (P = 0.005 & 0.007). The highest percentage of correct responses for influenza vaccination was for side effects (75.3%) while the lowest was for contraindications (9.3%). The highest percentage of correct responses for pneumococcal vaccination was for side effects (69.1%) while the lowest was for advocated target groups (6.2%). Most participants believed that pneumococcal and influenza vaccines were safe (92.8 & 99%) and beneficial for patients (89.7 & 93.8%). Cost of influenza and pneumococcal vaccines (94.8% & 96.9%) and their availability (86.6% & 89.7%) were the main barriers to prescribing them. Primary care physicians in the public sector have moderate knowledge of both adult vaccinations. Areas of knowledge paucity and barriers need to be addressed to ensure a more comprehensive health care delivery to the aging Malaysian population.
Keywords: adult, belief, influenza vaccines, knowledge, pneumococcal vaccines

Matched MeSH terms: Autonomic Nervous System Diseases
Fulltext The comparison of QT dispersion and 24 hour ambulatory blood pressure monitoring amongst diabetic patients with and without microalbuminuria

Yeo CK, Hapizah MN, Khalid BAK, Wan Nazainimoon WM, Khalid Y

Med J Malaysia, 2004 Jun;59(2):185-9.
PMID: 15559168

Diabetes mellitus is an important coronary artery disease risk factor. The presence of microalbuminuria, which indicates renal involvement in diabetic patients, is associated with an increased cardiovascular risk. There are suggestions that diabetic patients with microalbuminuria have more adverse risk profile such as higher ambulatory blood pressure and total cholesterol levels to account for the increased cardiovascular morbidity and mortality. QT dispersion is increasingly being recognized as a prognostic factor for coronary artery disease and sudden death. Some studies have suggested that QT dispersion is an important predictor of mortality in Type II diabetic patients. Our cross sectional study was to compare the QT dispersion and 24 hour ambulatory blood pressure monitoring between diabetic patients with microalbuminuria and those without microalbuminuria. Diabetic patients with overt coronary artery disease were excluded from the study. A total of 108 patients were recruited of which 57 patients had microalbuminuria and 51 were without microalbuminuria. The mean value of QT dispersion was significantly higher in patients with microalbuminuria than in patients without microalbuminuria (58.9 +/- 27.9 ms vs. 47.1 +/- 25.0 ms, p < 0.05). The mean 24 hour systolic and diastolic blood pressures were significantly higher in patients with microalbuminuria than in patients without microalbuminuria (129.5 +/- 12.3 mm Hg vs 122.3 +/- 10.2 mm Hg, p < 0.05 and 78.4 +/- 6.9 mm Hg vs 75.3 +/- 6.8 mm Hg, p < 0.05, respectively). Our study suggests that QT dispersion prolongation, related perhaps to some autonomic dysfunction, is an early manifestation of cardiovascular aberration in diabetic patients with microalbuminuria. The higher blood pressure levels recorded during a 24-hour period min diabetics with microalbuminuria could also possibly account for the worse cardiovascular outcome in this group of patients.

Matched MeSH terms: Autonomic Nervous System/physiopathology
Association of autonomic nervous system and EEG scalp potential during playing 2D Grand Turismo 5

Subhani AR, Likun X, Saeed Malik A

Annu Int Conf IEEE Eng Med Biol Soc, 2012;2012:3420-3.
PMID: 23366661 DOI: 10.1109/EMBC.2012.6346700

Cerebral activation and autonomic nervous system have importance in studies such as mental stress. The aim of this study is to analyze variations in EEG scalp potential which may influence autonomic activation of heart while playing video games. Ten healthy participants were recruited in this study. Electroencephalogram (EEG) and electrocardiogram (ECG) signals were measured simultaneously during playing video game and rest conditions. Sympathetic and parasympathetic innervations of heart were evaluated from heart rate variability (HRV), derived from the ECG. Scalp potential was measured by the EEG. The results showed a significant upsurge in the value theta Fz/alpha Pz (p<0.001) while playing game. The results also showed tachycardia while playing video game as compared to rest condition (p<0.005). Normalized low frequency power and ratio of low frequency/high frequency power were significantly increased while playing video game and normalized high frequency power sank during video games. Results showed synchronized activity of cerebellum and sympathetic and parasympathetic innervation of heart.

Matched MeSH terms: Autonomic Nervous System/physiology*
Atrial fibrillation classification and association between the natural frequency and the autonomic nervous system

Abdul-Kadir NA, Mat Safri N, Othman MA

Int J Cardiol, 2016 Nov 01;222:504-8.
PMID: 27505342 DOI: 10.1016/j.ijcard.2016.07.196

BACKGROUND: The feasibility study of the natural frequency (ω) obtained from a second-order dynamic system applied to an ECG signal was discovered recently. The heart rate for different ECG signals generates different ω values. The heart rate variability (HRV) and autonomic nervous system (ANS) have an association to represent cardiovascular variations for each individual. This study further analyzed the ω for different ECG signals with HRV for atrial fibrillation classification.
METHODS: This study used the MIT-BIH Normal Sinus Rhythm (nsrdb) and MIT-BIH Atrial Fibrillation (afdb) databases for healthy human (NSR) and atrial fibrillation patient (N and AF) ECG signals, respectively. The extraction of features was based on the dynamic system concept to determine the ω of the ECG signals. There were 35,031 samples used for classification.
RESULTS: There were significant differences between the N & NSR, N & AF, and NSR & AF groups as determined by the statistical t-test (p<0.0001). There was a linear separation at 0.4s(-1) for ω of both databases upon using the thresholding method. The feature ω for afdb and nsrdb falls within the high frequency (HF) and above the HF band, respectively. The feature classification between the nsrdb and afdb ECG signals was 96.53% accurate.
CONCLUSIONS: This study found that features of the ω of atrial fibrillation patients and healthy humans were associated with the frequency analysis of the ANS during parasympathetic activity. The feature ω is significant for different databases, and the classification between afdb and nsrdb was determined.

Matched MeSH terms: Autonomic Nervous System/physiology*
Fulltext Association of diabetic autonomic neuropathy with painless myocardial ischaemia induced by exercise

Quek DK, Khor PG, Ong SB

Singapore Med J, 1992 Apr;33(2):177-81.
PMID: 1621124

Silent myocardial ischaemia is now well-recognised in patients with symptomatic coronary artery disease. Its pathogenesis remains speculative, though diminished sensitivity to pain is thought to be one of the mechanisms involved. Because cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we postulate that it contributes towards painless myocardial ischaemia among them. Forty consecutive diabetic (type II) male patients and ten normal volunteers were studied. Using 5 previously-validated noninvasive tests for autonomic dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least 2 abnormal tests). All 50 subjects were then exercised on a motor-driven treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects were tested positive, with significant (greater than 1 mm) ST segment depression over at least 2 contiguous leads. Of these, 18 were associated with typical angina but the other 15 stopped because of fatigue or exhaustion (ie painless). Thirteen subjects who had definite autonomic neuropathy (AN+) had positive exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This contrasted with 15 patients who had painful ischaemia and 5 who had painless ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047, Fisher's exact test). There were no significant differences among the various groups for peak rate-pressure-product, all subjects attaining similar maximal oxygen consumption states during which ischaemic ST segment changes were noted (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/- 4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Matched MeSH terms: Autonomic Nervous System Diseases/complications*
Fulltext Torsade de pointes and sudden death associated with diabetic autonomic diarrhoea--a case report

Quek DK, H'ng PK

Singapore Med J, 1993 Jun;34(3):266-70.
PMID: 8266190

A 68-year-old diabetic and hypertensive woman presented with chronic autonomic diarrhoea, syncope and palpitations which were associated with QT prolongation and recurrent episodes of torsade de pointes. She was on glibenclamide, indapamide and probucol (for type V hyperlipidaemia). Despite intravenous infusions of potassium, lignocaine and amiodarone, the unstable rhythm persisted. However, intravenous magnesium sulphate with small doses of intravenous propranolol terminated the torsade de pointes. She was stabilised but following discharge she relapsed, and upon re-admission, succumbed to intractable ventricular fibrillation. Early recognition and aggressive treatment of this condition is emphasised. Multiple aggravating factors ie autonomic diarrhoea resulting in severe potassium and magnesium depletion, kaliuretic effect of indapamide, probable QT prolongation associated with diabetic autonomic neuropathy and probucol; probable underlying coronary artery disease and heightened emotional and sympathetic discharge could have contributed to this very unstable ventricular arrhythmia and sudden death.

Matched MeSH terms: Autonomic Nervous System Diseases/complications*
Fulltext Mechanisms underpinning sympathetic nervous activity and its modulation using transcutaneous vagus nerve stimulation

Deuchars SA, Lall VK, Clancy J, Mahadi M, Murray A, Peers L, et al.

Exp Physiol, 2018 Mar 01;103(3):326-331.
PMID: 29205954 DOI: 10.1113/EP086433

What is the topic of this review? This review briefly considers what modulates sympathetic nerve activity and how it may change as we age or in pathological conditions. It then focuses on transcutaneous vagus nerve stimulation, a method of neuromodulation in autonomic cardiovascular control. What advances does it highlight? The review considers the pathways involved in eliciting the changes in autonomic balance seen with transcutaneous vagus nerve stimulation in relationship to other neuromodulatory techniques. The autonomic nervous system, consisting of the sympathetic and parasympathetic branches, is a major contributor to the maintenance of cardiovascular variables within homeostatic limits. As we age or in certain pathological conditions, the balance between the two branches changes such that sympathetic activity is more dominant, and this change in dominance is negatively correlated with prognosis in conditions such as heart failure. We have shown that non-invasive stimulation of the tragus of the ear increases parasympathetic activity and reduces sympathetic activity and that the extent of this effect is correlated with the baseline cardiovascular parameters of different subjects. The effects could be attributable to activation of the afferent branch of the vagus and, potentially, other sensory nerves in that region. This indicates that tragus stimulation may be a viable treatment in disorders where autonomic activity to the heart is compromised.

Matched MeSH terms: Autonomic Nervous System Diseases/physiopathology*
Cardiorespiratory findings in epilepsy: A recent review on outcomes and pathophysiology

Akyüz E, Üner AK, Köklü B, Arulsamy A, Shaikh MF

J Neurosci Res, 2021 09;99(9):2059-2073.
PMID: 34109651 DOI: 10.1002/jnr.24861

Epilepsy is a debilitating disorder of uncontrollable recurrent seizures that occurs as a result of imbalances in the brain excitatory and inhibitory neuronal signals, that could stem from a range of functional and structural neuronal impairments. Globally, nearly 70 million people are negatively impacted by epilepsy and its comorbidities. One such comorbidity is the effect epilepsy has on the autonomic nervous system (ANS), which plays a role in the control of blood circulation, respiration and gastrointestinal function. These epilepsy-induced impairments in the circulatory and respiratory systems may contribute toward sudden unexpected death in epilepsy (SUDEP). Although, various hypotheses have been proposed regarding the role of epilepsy on ANS, the linking pathological mechanism still remains unclear. Channelopathies and seizure-induced damages in ANS-control brain structures were some of the causal/pathological candidates of cardiorespiratory comorbidities in epilepsy patients, especially in those who were drug resistant. However, emerging preclinical research suggest that neurotransmitter/receptor dysfunction and synaptic changes in the ANS may also contribute to the epilepsy-related autonomic disorders. Thus, pathological mechanisms of cardiorespiratory dysfunction should be elucidated by considering the modifications in anatomy and physiology of the autonomic system caused by seizures. In this regard, we present a comprehensive review of the current literature, both clinical and preclinical animal studies, on the cardiorespiratory findings in epilepsy and elucidate the possible pathological mechanisms of these findings, in hopes to prevent SUDEP especially in patients who are drug resistant.

Matched MeSH terms: Autonomic Nervous System/physiology; Autonomic Nervous System/physiopathology*
Fulltext Electrocution induced symptomatic bradycardia necessitating pacemaker implantation

Yew KL

Heart Views, 2014 Apr;15(2):49-50.
PMID: 25104983 DOI: 10.4103/1995-705X.137497

Electrical or electrocution injury is a common accidental occurrence and mostly workplace related. Fatal arrhythmias, skin injury and sudden death may ensue. However, it is rare for electrocution to result in permanent low rate sinus bradycardia, incompatible with an active lifestyle. The probable mechanisms for this pathological sinus bradycardia are sinus node dysfunction and autonomic dysfunction with vagal predominance. We describe a young patient who suffered a non fatal electrocution with resultant low rate sinus bradycardia and its successful treatment with a dual chamber rate responsive pacemaker.

Matched MeSH terms: Autonomic Nervous System Diseases
Fulltext Severe tetanus--in spite of tetanus toxoid

Nivedita N

Med J Malaysia, 1994 Mar;49(1):105-7.
PMID: 8057983

A 66-year-old man sustained an injury to his right foot while gardening. Despite receiving tetanus toxoid one hour later and adequate wound toilet, he developed severe tetanus complicated with autonomic dysfunction six days later. He died 20 days after admission. This case shows that tetanus toxoid alone may not be sufficient to prevent tetanus in wounded patients. Careful consideration must be given to the immune status of the patient and to the nature of the wound sustained. Incompletely immunised patients or patients with unknown immune status who sustain a tetanus prone wound should be protected with both tetanus toxoid and tetanus immunoglobulin.

Matched MeSH terms: Autonomic Nervous System Diseases/etiology*
Fulltext Evoked K-complexes and altered interaction between the central and autonomic nervous systems during sleep in alcohol use disorder

Willoughby AR, de Zambotti M, Baker FC, Colrain IM

Alcohol, 2020 May;84:1-7.
PMID: 31539623 DOI: 10.1016/j.alcohol.2019.09.005

There is evidence for impairment in both central nervous system (CNS) and autonomic nervous system (ANS) function with prolonged alcohol use. While these impairments persist into abstinence, partial recovery of function has been demonstrated in both systems during sleep. To investigate potential ANS dysfunction associated with cortical CNS responses (impairment in CNS-ANS coupling), we assessed phasic heart rate (HR) fluctuation associated with tones that did and those that did not elicit a K-complex (KC) during stable N2 non-rapid eye movement (NREM) sleep in a group of 16 recently abstinent alcohol use disorder (AUD) patients (41.6 ± 8.5 years) and a group of 13 sex- and age-matched control participants (46.6 ± 9.3 years). Electroencephalogram (EEG) and electrocardiogram (ECG) data were recorded throughout the night. Alcohol consumption questionnaires were also administered to the AUD patients. AUD patients had elevated HR compared to controls at baseline prior to tone presentation. The HR fluctuation associated with KCs elicited by tone presentation was significantly smaller in amplitude, and tended to be delayed in time, in the AUD group compared with the control group, and the subsequent deceleration was also smaller in AUD patients. In both groups, the increase in HR was larger and occurred earlier when KCs were produced than when they were not, and there was no difference in the magnitude of the KC effect between groups. Phasic HR changes associated with KCs elicited by tones are impaired in AUD participants, reflecting ANS dysfunction possibly caused by an alteration of cardiac vagal trafficking. However, only the timing of the HR response was found to relate to estimated lifetime alcohol consumption in AUD. The clinical meaning and implications of these novel findings need to be determined.

Matched MeSH terms: Autonomic Nervous System/physiopathology*
Which somatic symptoms are associated with an unfavorable course in Chinese patients with major depressive disorder?

Novick D, Montgomery WS, Aguado J, Peng X, Brugnoli R, Haro JM

Asia Pac Psychiatry, 2015 Dec;7(4):427-35.
PMID: 26047023 DOI: 10.1111/appy.12189

This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD).

Matched MeSH terms: Autonomic Nervous System Diseases/epidemiology*

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