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Autonomic dysfunction: A unifying multiple sclerosis theory, linking chronic cerebrospinal venous insufficiency, vitamin D3, and Epstein-Barr virus
Zohara Sternberg,
Department of Neurology, Baird MS center, Jacobs Neurological Institute, 100 High St. Buffalo, NY 14203, USA

Abstract
Multiple sclerosis (MS) is a disease with multiple etiologies. The most recent theory of the vascular etiology of MS, Chronic Cerebrospinal Venous Insufficiency (CCSVI), suggests that cerebral venous obstruction could lead to cerebral venous reflux, promoting local inflammatory processes.

This review article offers strong evidence that the route of the observed narrowing of cerebral veins arises from autonomic nervous system dysfunction, particularly cardiovascular autonomic dysfunction.

The dysfunction of this system has two major effects: 1) the reduction of mean arterial blood pressure, which has the potential to reduce the cerebral perfusion pressure and the transmural pressure, and 2) the failure of cerebral autoregulation to maintain constant cerebral blood flow in the face of fluctuations in cerebral perfusion pressure. Alterations in cerebral autoregulation could in turn raise the critical closure pressure, indicated to be the cerebral perfusion pressure at which the transmural pressure will be sub-sufficient to overcome the active tension imparted by the smooth muscle layer of the vessel. These two effects of autonomic nervous system dysfunction (reduction in arterial blood pressure and alterations in cerebral autoregulation), when combined with inflammation-induced high levels of nitric oxide in the brain, will lower transmural pressure sufficiently to the point where the threshold for critical closure pressure is reached, leading to venous closure.

In addition, cerebral vessels fail to overcome the closure as a result of low central venous pressure, which is also regulated by autonomic nervous system function. Furthermore, through their neuroregulatory effects, infectious agents such as the Epstein-Barr virus and vitamin D3 are able to alter the functions of the autonomic nervous system, influencing the rate of CCSVI occurrence.

The absence of CCSVI specificity for MS, observed in recent clinical studies, may stem from a high prevalence of autonomic nervous system dysfunction in control groups which were recruited to these studies. Future studies should investigate CCSVI in relation to cardiovascular autonomic function.

Reduced Cardiac Vagal Modulation Impacts on Cognitive Performance in Chronic Fatigue Syndrome

Background
Cognitive difficulties and autonomic dysfunction have been reported separately in patients with chronic fatigue syndrome (CFS). A role for heart rate variability (HRV) in cognitive flexibility has been demonstrated in healthy individuals, but this relationship has not as yet been examined in CFS. The objective of this study was to examine the relationship between HRV and cognitive performance in patients with CFS.

Methods
Participants were 30 patients with CFS and 40 healthy controls; the groups were matched for age, sex, education, body mass index, and hours of moderate exercise/week. Questionnaires were used to obtain relevant medical and demographic information, and assess current symptoms and functional impairment. Electrocardiograms, perceived fatigue/effort and performance data were recorded during cognitive tasks. Between–group differences in autonomic reactivity and associations with cognitive performance were analysed.

Results
Patients with CFS showed no deficits in performance accuracy, but were significantly slower than healthy controls. CFS was further characterized by low and unresponsive HRV; greater heart rate (HR) reactivity and prolonged HR-recovery after cognitive challenge. Fatigue levels, perceived effort and distress did not affect cognitive performance. HRV was consistently associated with performance indices and significantly predicted variance in cognitive outcomes.

Conclusions
These findings reveal for the first time an association between reduced cardiac vagal tone and cognitive impairment in CFS and confirm previous reports of diminished vagal activity.

Heart rate variability response to alcohol, placebo, and emotional picture cue challenges: effects of 0.1-Hz stimulation.

Abstract

Vaschillo EG, Bates ME, Vaschillo B, Lehrer P, Udo T, Mun EY, Ray S
Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA. Evaschil@rci.rutgers.edu
Psychophysiology [2008, 45(5):847-858]

Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural
DOI: 10.1111/j.1469-8986.2008.00673.x


Heart rate variability (HRV) supports emotion regulation and is reduced by alcohol. Based on the resonance properties of the cardiovascular system, a new 0.1-Hz methodology was developed to present emotional stimuli and assess HRV reaction in participants (N=36) randomly assigned to an alcohol, placebo, or control condition. Blocked picture cues (negative, positive, neutral) were presented at a rate of 5 s on, 5 s off (i.e., 0.1-Hz frequency). SDNN, pNN50, and HF HRV were reduced by alcohol, compared to the placebo and control. The 0.1-Hz HRV index was diminished by alcohol and placebo, suggesting that autonomic regulation can be affected by cognitive expectancy. The 0.1-Hz HRV index and pNN50 detected changes in arousal during emotional compared to neutral cues, and the 0.1-Hz HRV index was most sensitive to negative valence. The 0.1-Hz HRV methodology may be useful for studying the intersection of cognition, emotion, and autonomic regulation.

A simple Internet search of " Magdeburg Spheres " may not open veins ... but I do hope it opens eyes ..... and minds ........
MrSuccess