Potential interactions between the autonomic nervous system and higher level functions in neurological and neuropsychiatric conditions

Frontiers in Neurology, 2015 · DOI: 10.3389/fneur.2015.00182 · Published: September 4, 2015

Simple Explanation

The autonomic nervous system (ANS) regulates internal body functions and interacts with brain structures. ANS failure is seen in neurological and neuropsychiatric disorders and can affect higher-level functions, impacting patient outcomes. This review explores the connection between ANS and higher-level dysfunctions, especially how blood pressure drops (orthostatic hypotension) or autonomic-reflex issues affect cognitive performance. While the direct cause of the relationship between ANS and higher-level dysfunctions is debated, it could influence neuro-rehabilitation strategies to improve patient outcomes.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Cardiovascular autonomic failure may negatively affect neurological disorders. There is evidence that ANS efficiency, cognitive performance, and brain activity are correlated, and baroreceptor stimulation reduces pain perception.
2
Orthostatic hypotension (OH), is a common sign of ANS dysregulation. Various techniques exist to detect ANS dysfunction, including subclinical cases.
3
ANS dysregulation may contribute to cognitive symptoms in neurological conditions. Cognitive fluctuations, a key symptom in DLB, could be partially explained by AF.

Research Summary

The autonomic nervous system (ANS) maintains internal homeostasis by interacting with brain structures, and its failure is commonly observed in neurological and neuropsychiatric disorders. This review discusses potential relationships between ANS and higher-level dysfunctions in neurological and neuropsychiatric disorders, particularly focusing on the effect of orthostatic hypotension and autonomic-reflex impairment on cognitive performances. Despite the controversial causal relationship between ANS involvement and higher-level dysfunctions, there are implications for neuro-rehabilitation strategies aimed at improving patient clinical outcome.

Practical Implications

Neuro-rehabilitation strategies

Understanding the relationship between ANS dysfunction and cognitive impairment can help improve neuro-rehabilitation programs, potentially leading to better patient prognosis.

Pharmacological and non-pharmacological interventions

Considering the contribution of ANS dysfunctions may open new perspective for pharmacological and non-pharmacological interventions in several neurological and neuropsychiatric disorders.

Longitudinal Studies

Longitudinal studies using standardized procedures for clinical and subclinical assessment of ANS dysregulation are needed to fully clarify the relationship between CAD and CI.

Study Limitations

1
The exact relationship between cognitive impairment (CI) and autonomic failure (AF) still remains to be fully clarified.
2
Limited studies investigate the relationship between brain lesion, AF, and CI due to patient heterogeneity.
3
A strict association between cardiac autonomic dysregulation (CAD) and cognition needs to be demonstrated in familial leukoencephalopathies and prion diseases.

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