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Autonomic nervous system
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[[File:Autonomic Nervous System.jpg|400px|thumb|right|Autonomic Nervous System]] The '''autonomic nervous system''' (ANS) is the branch of the [[peripheral nervous system]] that allows for communication between the internal organs and the [[brain]], and is responsible for regulating many involuntary processes in the body. The ANS's sympathetic nervous system is constantly active, responding to information from an individual’s environment and his or her body to regulate functions such as heart rate, [[breathing]], and [[digestion]].<ref name="McCorry2007">{{Cite journal | last = McCorry | first = Laurie Kelly | date = 2007-08-15 | title = Physiology of the Autonomic Nervous System | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1959222/ | journal = American Journal of Pharmaceutical Education | volume = 71 | issue = 4|issn=0002-9459|pmid=17786266}}</ref><ref name="merck">{{Cite web | url = https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/autonomic-nervous-system-disorders/overview-of-the-autonomic-nervous-system | title = Overview of the Autonomic Nervous System - Brain, Spinal Cord, and Nerve Disorders|work=Merck Manuals Consumer Version | access-date = 2018-08-31|language=en-US}}</ref><ref name="NBK539845">{{Cite book | title = Anatomy, Autonomic Nervous System | date = 2021 | url = http://www.ncbi.nlm.nih.gov/books/NBK539845/ | last = Waxenbaum | first = Joshua A. | last2 = Reddy | first2 = Vamsi | last3 = Varacallo | first3 = Matthew|location=Treasure Island (FL)| publisher = StatPearls Publishing|pmid=30969667}}</ref> == Function == The ANS is split into two main divisions: the [[sympathetic nervous system]] (SNS) and [[parasympathetic nervous system]] (PNS). The PNS and SNS serve the same organs, but one system will activate a bodily function while the other will inhibit it.<ref name="NBK539845" /> This opposition is operated by two main chemical messengers: [[norepinephrine]], which activates (excitatory) and [[acetylcholine]], which inhibits (inhibitory).<ref name="McCorry2007" /> The two divisions complement each other to regulate the body’s responses.<ref name="NBK539845" /> Functions regulated by the ANS include: * [[Blood pressure]] * [[Body temperature]] * [[Gastrointestinal system|Digestion]] and [[hunger]] * [[Emotional response]]s * [[Heart rate]] * [[Metabolism]] * Production of [[sweating episode|sweat]], [[dry mouth|saliva]] * [[Respiratory rate]] * [[Sexual response]] * [[Urination]]<ref name="McCorry2007" /><ref name="merck" /> === Sympathetic nervous system === The [[sympathetic nervous system]] (SNS) regulates what is referred to as the “fight-or-flight” response, which prepares the body against a perceived stress or threat. Stimulation of the SNS activates an internal alarm response. This causes an increase in: * Heart rate (more blood pumped throughout the body) * [[Muscle strength]] * Width of airways (maximizing the intake of [[oxygen]]/elimination of [[carbon dioxide]]) * The release of stored [[energy]] During perceived physiological or emotional stress, the SNS is activated while the PNS is less predominant. This redirects the body’s resources toward processes that are important in an emergency situation, resulting in a decrease in bodily functions controlled by the PNS, which are less important in an emergency situation.<ref name="McCorry2007" /> === Parasympathetic nervous system === The [[parasympathetic nervous system]] (PNS) is dominant in conditions referred to as “rest and digest”. It controls body processes during ordinary situations. This division of the ANS helps return the body to resting state after confronting a stressor, helping to conserve energy.<ref name="McCorry2007" /> Functions of the PNS include: * Contraction of the [[bladder]] * Reducing blood pressure<ref name="McCorry2007" /><ref name="merck" /> * Slowing heart rate * Stimulating the digestive tract, including [[gland secretion]] == Autonomic disorder and dysfunction == Symptoms of autonomic dysfunction include: * Alterations in sweating, resulting in [[Body temperature|heat intolerance]] * [[Constipation]] or loss of [[bowel control]] * [[Exercise intolerance]]: inability to regulate heart rate during exercise * [[Gastroparesis]]: feeling prematurely full due to slow emptying of stomach * [[frequent urination|Hyperactive bladder]] or hypoactive bladder * [[Orthostatic intolerance]]: [[dizziness]] or light-headedness when a person stands up due to a significant decrease in blood pressure, which if severe can lead to [[syncope]] (fainting), attributed to cardiovascular deconditioning and/or postural idiopathic autonomic neuropathy * Sexual response problems (in men and women) * [[Visual dysfunction|Vision problems]]: inability of pupils to react to light quickly, [[blurred vision]]<ref name="merck" /><ref name="NBK539845" /> == Myalgic encephalomyelitis and the ANS == Altered ANS functioning has been seen in many [[myalgic encephalomyelitis]] (ME) patients, as they experience various altered autonomic responses. Symptoms of autonomic dysfunction in ME include: * Blood pressure ** Delayed [[gastric emptying]]<ref>{{Cite journal | last = Burnet | first = Richard B | last2 = Chatterton | first2 = Barry E | date = Dec 2004 | title = Gastric emptying is slow in chronic fatigue syndrome | url =https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-4-32 | journal = BMC Gastroenterology|language=en | volume = 4 | issue = 1|doi=10.1186/1471-230x-4-32|issn=1471-230X}}</ref> ** Elevated baseline heart rate in some studies<ref name="Cauwenbergh2014" /> * Body temperature ** [[thermostatic instability|Rhermostatic instability/impaired thermoregulation]], including significantly increased shivering and [[sweating episode]]s compared to controls<ref name="ICC2011primer">{{citation | last = Carruthers | first1 = BM | author-link1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | author-link2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | author-link3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | author-link4 = Nancy Klimas | last5 = Broderick | first5 = G | author-link5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | author-link8 = Donald Staines | last8 = Powles | first8 = ACP | author-link8 = A C Peter Powles | last9 = Speight | first9 = N | author-link9 = Nigel Speight | last10 = Vallings | first10 = R | author-link10 = Rosamund Vallings | last11 = Bateman | first11 = L | author-link11 = Lucinda Bateman | last12 = Bell | first12 = DS | author-link12 = David Bell | last13 = Carlo-Stella | first13 =N | author-link13 = Nicoletta Carlo-Stella | last14 = Chia | first14 = J | author-link14 = John Chia | last15 = Darragh | first15 = A | author-link15 = Austin Darragh | last16 = Gerken | first16 = A | author-link16 = Anne Gerken | last17 = Jo | first17 = D | author-link17 = Daehyun Jo | last18 = Lewis | first18 = DP | author-link18 = Donald Lewis | last19 = Light | first19 = AR | author-link19 = Alan Light | last20 = Light | first20 = KC | author-link20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 = S | author-link21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 = J | author-link22 = John McLaren-Howard | last23 = Mena | first23 = I | author-link23 = Ismael Mena | last24 = Miwa | first24 = K | author-link24 = Kunihisa Miwa | last25 = Murovska | first25 = M | author-link25= Modra Murovska | last26 = Stevens | first26 = SR | author-link26 = Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf}}</ref><ref name="Wyller2077">{{Cite journal | title = Abnormal Thermoregulatory Responses in Adolescents With Chronic Fatigue Syndrome: Relation to Clinical Symptoms | date = 2007-07-01 | url = https://doi.org/10.1542/peds.2006-2759 | journal = Pediatrics | volume = 120 | issue = 1| pages = e129–e137 | last = Wyller | first = Vegard Bruun | author-link = Vegard Bruun Wyller | last2 = Godang | first2 = Kristin | author-link2 = Kristin Godang | last3 = Mørkrid | first3 = Lars | author-link3 = | last4 = Saul | first4 = Jerome Philip | author-link4 = | last5 = Thaulow | first5 = Erik | author-link5 = | last6 = Walløe | first6 = Lars | author-link6 = | first9 = | first11 = |doi=10.1542/peds.2006-2759|pmc=|pmid=|access-date=|issn=0031-4005|quote=|via=}}</ref> ** Reduced capacity to recover from exercise-induced [[muscle acidosis]] (can be attributed to dysfunction of vascular runoff, in part controlled by the ANS)<ref name="Jones2011" /><ref name="ICC2011primer" /> * Digestion ** Increased [[gut-intestinal permeability]] (dysfunction of the PNS via abnormal glandular secretion in digestion)<ref>{{Cite journal | last = Maes | first = Michael | last2 = Mihaylova | first2 = Ivana | last3 = Leunis | first3 = Jean-Claude | date = Apr 2007 | title = Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability | url = https://www.ncbi.nlm.nih.gov/pubmed/17007934 | journal = Journal of Affective Disorders | volume = 99 | issue = 1-3 | pages = 237–240|doi=10.1016/j.jad.2006.08.021|issn=0165-0327|pmid=17007934}}</ref> * [[Exercise intolerance]] * Heart rate ** Higher prevalence and severity of [[Postural orthostatic tachycardia syndrome|POTS]]<ref name="Cauwenbergh2014" /> ** Impaired [[blood pressure variability]]<ref>{{Cite journal | last = Frith | first = J. | last2 = Zalewski | first2 = P. | last3 = Klawe | first3 = J.J. | last4 = Pairman | first4 = J. | last5 = Bitner | first5 = A. | last6 = Tafil-Klawe | first6 = M. | last7 = Newton | first7 = J.L. | date = Sep 2012 | title = Impaired blood pressure variability in chronic fatigue syndrome--a potential biomarker |url =https://www.ncbi.nlm.nih.gov/pubmed/22670061 | journal = QJM: monthly journal of the Association of Physicians | volume = 105 | issue = 9 | pages = 831–838|doi=10.1093/qjmed/hcs085|issn=1460-2393|pmid=22670061}}</ref> ** [[Orthostatic intolerance]]<ref name="Cauwenbergh2014">{{Cite journal | last = Van Cauwenbergh | first = Deborah | last2 = Nijs | first2 = Jo | last3 = Kos | first3 = Daphne | last4 = Van Weijnen | first4 = Laura | last5 = Struyf | first5 = Filip | last6 = Meeus | first6 = Mira | date = 2014-04-17 | title = Malfunctioning of the autonomic nervous system in patients with chronic fatigue syndrome: a systematic literature review | url =https://onlinelibrary.wiley.com/doi/epdf/10.1111/eci.12256 | journal = European Journal of Clinical Investigation|language=en | volume = 44 | issue = 5 | pages = 516–526|doi=10.1111/eci.12256|issn=0014-2972}}</ref><ref>{{Cite journal | last = Rowe | first = Peter C. | last2 = Lucas | first2 = Katherine E. | date = Mar 2007 | title = Orthostatic Intolerance in Chronic Fatigue Syndrome | url =https://www.amjmed.com/article/S0002-9343(06)00316-0/fulltext | journal = The American Journal of Medicine|language=English | volume = 120 | issue = 3| pages = e13|doi=10.1016/j.amjmed.2006.02.033|issn=0002-9343}}</ref> ** Reduced [[heart rate variability]] at night<ref>{{Cite journal | date = 2013-10-01 | title = Heart rate variability in patients with fibromyalgia and patients with chronic fatigue syndrome: A systematic review | url =https://www.sciencedirect.com/science/article/pii/S0049017213000516 | journal = Seminars in Arthritis and Rheumatism|language=en | volume = 43 | issue = 2 | pages = 279–287|doi=10.1016/j.semarthrit.2013.03.004|issn=0049-0172}}</ref> ** Reduced [[Small heart syndrome|left ventricular mass]], end-diastolic volume and cardiac output, and increased residual torsion in diastole<ref name="Jones2011">{{Cite journal | last = Jones | first = David E.J. | last2 = Hollingsworth | first2 = Kieren G. | last3 = Jakovljevic | first3 = Djordje G. | last4 = Fattakhova | first4 = Gulnar | last5 = Pairman | first5 = Jessie | last6 = Blamire | first6 = Andrew M. | last7 = Trenell | first7 = Michael I. | last8 = Newton | first8 = Julia L. | date = 2011-07-12 | title = Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case-control study | url = https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2362.2011.02567.x | journal = European Journal of Clinical Investigation|language=en | volume = 42 | issue = 2 | pages = 186–194|doi=10.1111/j.1365-2362.2011.02567.x|issn=0014-2972}}</ref> * [[Nervous system|Neurological]] correlates with ANS dysfunction ** Altered communication between some parts of the [[brain]] that regulate the ANS<ref>{{Cite journal | date = 2016-01-01 | title = Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome | last = Barnden | first = Leighton R. | first2 = Richard | last2 = Kwiatek | first3 = Benjamin | last3 = Crouch | first4 = Richard | last4 = Burnet | first5 = Peter | last5 = Del Fante | url =https://www.sciencedirect.com/science/article/pii/S2213158216300584 | journal = NeuroImage: Clinical|language=en | volume = 11 | pages = 530–537|doi=10.1016/j.nicl.2016.03.017|issn=2213-1582}}</ref> === The vagus nerve hypothesis === {{Main article | page_name = Vagus nerve infection hypothesis}} The [[Vagus nerve infection hypothesis|vagus nerve hypothesis]] suggests that infection and inflammation of the [[vagus nerve]], a prominent nerve within the ANS, would disrupt normal autonomic function. The vagus nerve communicates information between numerous internal organs and the brain. Infection of the vagus nerve could signal an exaggerated sickness response and perpetuate further dysfunction.<ref>{{Cite journal | last = VanElzakker | first = Michael B. | date = Sep 2013 | title = Chronic fatigue syndrome from vagus nerve infection: a psychoneuroimmunological hypothesis |url =https://www.ncbi.nlm.nih.gov/pubmed/23790471 | journal = Medical Hypotheses | volume = 81 | issue = 3 | pages = 414–423|doi=10.1016/j.mehy.2013.05.034|issn=1532-2777|pmid=23790471}}</ref> == See also == *[[Central nervous system]] *[[Nervous system]] *[[Parasympathetic nervous system]] == Learn more == *[https://www.ncbi.nlm.nih.gov/books/NBK539845/ Anatomy, Autonomic Nervous System] - Statpearls book *[https://www.youtube.com/watch?v=71pCilo8k4M Crash Course | Autonomic Nervous System] *[https://www.youtube.com/watch?v=qqU-VjqjczE Crash Course | Parasympathetic Nervous System] *[https://www.youtube.com/watch?v=0IDgBlCHVsA Crash Course | Sympathetic Nervous System] *[https://www.ncbi.nlm.nih.gov/books/NBK538516/ Physiology, Autonomic Nervous System] - Statpearls book == References == {{Reflist}} [[Category:Neurology]] [[Category:Autonomic nervous system disorders]]
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