Sympathectomy - decreased vascular permeability

The influence of the sympathetic nervous system on capillary permeability was studied in cats. The dye penetration from the blood through the synovial membrane was tested by perfusing the two knee joints, one of which was deprived of its sympathetic nerve supply by unilateral lumbosacral sympathectomy.
Further unpublished experiments seem to support the view that increased blood supply is associated with decreased vascular permeability.

Research in Experimental Medicine D. Engel1

Complications are frequent after ETS

Complications are frequent after surgery for excessive hand sweating. Patient should be informed about the risks

[My paper] G Claes, L Räf

Kirurgiska kliniken, Borås lasarett

Lakartidningen. 1999 Feb 24;96 (8):930-2 10089743

Compensatory Sweating developed in all cases

RESULTS: CS developed in all cases. After completion of ETS, mean blood flow and temperature increased respectively. Significant correlations were found between the range of PCS and increases in palmar temperature (p<0.05) and blood flow (p<0.05). CONCLUSION: Intraoperative monitoring of increases in palmar temperature and blood flow may be useful in patients with primary hyperhidrosis, to predict the range of PCS after ETS.

J Thorac Cardiovasc Surg. 2005 Sep ;53 (9):481-5 16200888

Intraoperative prediction of compensatory sweating for thoracic sympathectomy.

[My paper] Takeo Fujita, Masayuki Mano, Hideyuki Nishi, Nobuyoshi Shimizu

Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.

Sympathectomy induces novel purinergic sensitivity in sciatic afferents

Acta Pharmacol Sin. 2000 Nov;21(11):1002-4.

Chen Y, Zhang YH, Bie BH, Zhao ZQ. Shanghai Institute of Physiology, Chinese Academy of Sciences, Shanghai 200031, China

Twenty eight percent of the spontaneously active afferent fibers from sciatic nerves in the sympathectomized rats responded to ATP, either with an increase or with a decrease in spontaneous firing. However, none of the fibers from the sciatic nerves in the intact rats was activated by ATP. CONCLUSION: Sympathectomy induces novel purinergic sensitivity in A afferents from sciatic nerve.
http://www.ncbi.nlm.nih.gov/pubmed/11501053

Classification of the surgery by the International Society of Sympathetic Surgeons

Here are the basics of our new classifications:
ESB2 (clamp upper end of T2 only): 2.5%, (in Europe 15%)
Facial blushing, Craniofacial sweating, Some psychic disorders, Rosacea, Vibration disorder (?), Parkinsonism (?)...
ESB3: 2.5%, (in Europe 50%)
Hyperhidrosis Palmaris with Craniofacial sweating, blushing, or any other craniofacial sympathetic disorders
ESB4: 95%, (in Europe 20%)
Hyperhidrosis Palmaris with or without axillary hyperhidrosis (Bromidrosis)
Unilateral ESB: (in Europe 15%)
Social phobia, schizophrenia, sleep disorders, addiction, cardiac arrhythmias

Conclusion: The patients are individuals with individual symptom complexes. There does not seem to exist any clear-cut Hyperhidrosis disease, Blushing disease, nor necessarily any social phobia disease, or schizophrenia disease. All these states are symptom complexes of multiple origin, and should be treated individually along the proposed guidelines.

http://www.hyperhidrosis.com/symposium.htm

Mia: If you are not comfortable undergoing the same surgery that treats heart patients and psychiatric disorders (among many), then you are advised to seek other alternative treatment for your condition.

immunoreactivity

Two days following unilateral section of the cervical vagus nerve, there was a dramatic ipsilateral increase in P2X1, P2X2, and P2X4 receptor
immunoreactivity in the cell soma of vagal efferent neurons in the dorsal vagal motor nucleus, but not in the nucleus ambiguous (72). Following
surgical sympathectomy, 28% of the spontaneously active afferent fibers in sciatic nerve responded to ATP, compared with none in intact rats
(343). After nerve injury, P2X4 receptor expression increased strikingly in hyperactive microglia, but not in neurons or astrocytes, in the
ipsilateral spinal cord; this appears to be associated with tactile allodynia (1731 and see sect. XIB9).

The sympathetic nervous system has been shown to modulate macrophage function (331), and
alterations in T- and B-lymphocyte proliferation and differentiation have been described following chemical sympathectomy (1090). Close
contacts between enteric nerves and lymphocytes in mouse intestinal mucosa and submucosa have been reported (402, 630).

Sympathetic and sensory nerves innervate bone, and sympathectomy modifies bone development and resorption (see Ref. 166). ATP, probably
released as a cotransmitter with NE, regulates Ca2+ metabolism in osteoblast-like bone cells (979). Evidence has been presented to demonstrate a
role for the sympathetic nervous system in controlling bone density via leptin that activates hypothalamic nerves, which in turn activate the
sympathetic nerves that innervate osteoblasts. ATP has been shown to inhibit bone formation by osteoblasts and to stimulate bone resorption by osteoclasts .
Physiology and Pathophysiology of Purinergic Neurotransmission
Geoffrey Burnstock
Autonomic Neuroscience Centre, Royal Free and University College Medical School, London, UnitedKingdom

Reccurrence of symptoms in 17.6% patients!

TS Chiou

Journal of neurosurgery. Spine 2005 Feb

Overall, 88 patients (96.7%) developed compensatory hyperhidrosis, with the mean initial occurrence at 8.2 weeks. The symptoms of compensatory hyperhidrosis progressively worsened to the maximum degree within another 2 weeks after onset (mean 10.3+/-1.83 weeks). In 19 patients (21.6%), symptoms of compensatory hyperhidrosis improved spontaneously within 3 months after sympathectomy (mean 13.3 weeks). Postoperative compensatory hyperhidrosis occurred in 71.4% of patients within the 1st year. Recurrent sweating occurred in only 17.6% of patients. None of these patients required repeated operation. The earliest onset of recurrent sweating was noted at 2 weeks postoperatively by three patients, and the mean initial postoperative reccurrence was 32.7 weeks after surgery.

Skin blood flow, sympathetic vasoconstrictor reflexes and pain before and after surgical sympathectomy

Changes in vascular sensitivity to cold temperature and circulating catecholamines may be responsible for vascular abnormalities. Alternatively, RSD may be associated with an abnormal (side different) reflex pattern of sympathetic vasoconstrictor neurons due to thermoregulatory and emotional stimuli generated in the central nervous system. (3) After sympathectomy, denervation supersensitivity of blood vessels and intense vasomotion may be associated with recurrence of pain in some patients.
BARON R. ⁽¹⁾ ; MAIER C. ⁽²⁾ ;
⁽¹⁾ Klinik für Neurologie, Christian-Albrechts-Universität Kiel, 24105 Kiel, ALLEMAGNE
⁽²⁾ Klinik für Anästhesiologie, Christian-Albrechts-Universität Kiel, 24105 Kiel, ALLEMAGNE
Elsevier, Amsterdam, PAYS-BAS (1975)

Regulation of adrenal angiotensin receptor subtypes: a possible mechanism for sympathectomy-induced adrenal hypertrophy

Regulation of adrenal angiotensin receptor subtypes: a possible mechanism for sympathectomy-induced adrenal hypertrophy.
Qiu, J., Nelson, S.H., Speth, R.C., Wang, D.H. J. Hypertens. (1999)

Hyperalgesia induced in the rat by the amino-terminal octapeptide of nerve growth factor.

Hyperalgesia induced in the rat by the amino-terminal octapeptide of nerve growth factor.
Taiwo, Y.O., Levine, J.D., Burch, R.M., Woo, J.E., Mobley, W.C.
Proc. Natl. Acad. Sci. U.S.A. (1991)

Heterogeneous atrial denervation creates substrate for sustained atrial fibrillation.

Heterogeneous sympathetic atrial denervation with phenol facilitates sustained AF (atrial fibrillation).
Olgin, J.S. et al.

Baker Institute - Cardiac synthesis, processing, and coronary release of enkephalin-related peptides

Chemical sympathectomy produced an increase in total enkephalin content similar to that observed after 2-h control perfusion. This observation suggested that the normal turnover of myocardial enkephalin may depend in part on continued sympathetic influences.

⁽¹⁾ Institut Universitaire de Technologie, Université d'Auvergne, 63172 Aubière, FRANCE
⁽²⁾ Baker Medical Research Institute, Melbourne, Victoria 8008, AUSTRALIE
⁽³⁾ Cardiovascular Research Institute, University of North Texas Health Science Center, Fort Worth, Texas 76107, ETATS-UNIS
⁽⁴⁾ Laboratory of Cardiovascular Science, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224-6825, ETATS-UNIS
YOUNES Antoine ⁽¹⁾ ; PEPE Salvatore ⁽²⁾ ; BARRON Barbara A. ⁽³⁾ ; SPURGEON Harold A. ⁽⁴⁾ ; LAKATTA Edward G. ⁽⁴⁾ ; CAFFREY James L. ⁽³⁾ ;
American journal of physiology. Heart and circulatory physiology ISSN 0363-6135 CODEN AJPPDI

2000, vol. 48, n^o4, pp. H1989-H1998 (41 ref.)

Sympathectomy eliminates the psychogalvanic reflex

Some Observations on the Psychogalvanic Reflex

ABRAHAM VERGHESE M.D., D.P.M.¹

¹ Department of Psychiatry, Christian Medical College & Hospital, Vellore, India

Some P.G.R. studies in a female subject who had bilateral cervical sympathectomy were described. It was found that sympathectomy abolished P.G.R. and that intra-arterial infusion of acetylcholine evoked marked P.G.R. changes in the sympathectomized limb. These findings support the theory that the P.G.R. is mediated through the cholinergic fibres of the sympathetic nervous system. Submitted on May 22, 1967

Mia: Was told by a heart specialist, jokingly that the patient can gain employment as spy after sympathectomy: it eliminates fear responses, abolishes the psychogalvanic response, and there will be no sudden jump in heart rate. No problems with lie-detectors....ever.

http://bjp.rcpsych.org/cgi/content/abstract/114/510/639

Cardiovascular collapse caused by carbon dioxide insufflation during sympathectomy

Carbon dioxide insufflation into the pleural space during one-lung anaesthesia for thoracoscopic surgery is used in some centres to improve surgical access, even though this practice has been associated with well-described cardiovascular compromise. The present report is of a 35-year-old woman undergoing thoracoscopic left dorsal sympathectomy for hyperhidrosis. During one-lung anaesthesia the insufflation of carbon dioxide into the non-ventilated hemithorax for approximately 60 seconds, using a pressure-limited gas inflow, was accompanied by profound bradycardia and hypotension that resolved promptly with the release of the gas.

Harris, R. J.
Benveniste, G.
Pfitzner, John
Citation: Anaesthesia and Intensive Care, 2002; 30 (1):86-89
Publisher: Australian Society of Anaesthetists

Cervical sympathectomy reduces the heterogeneity of oxygen saturation in small cerebrocortical veins

Sympathectomy significantly reduced this heterogeneity in the anterior cortex through a reduction in the number of low O2 saturation veins (coefficient of variation 11.7%).

H. M. Wei, A. K. Sinha and H. R. Weiss
Department of Anesthesia, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854-5635
J Cereb Blood Flow Metab. 1993 Mar;13(2):269-75

Anterior cingulate cortex: includes both the ventral and dorsal areas of the cingulate cortex, and appears to play a role in a wide variety of autonomic functions like regulation of blood pressure and heart rate, as well as rational cognitive functions, such as reward anticipation, decision-making, empathy and emotion.

Supersensitivity to substance P

The sympathetically denervated parotid gland of the rat develops a supersensitivity to substance P, and VIP injected intravenously. Further, the neuropeptide conttent (VIP and CGRP) of the parasympathetic salivary innervation tends to increase as a a consequence of sympathetic denervation. It has been reported by Harrop and Garrett that little acinar degranulation (or decrease in glandular amylase activity) occurs in the parotid gland in response to food intake in rats if subjected to unilateral sympathetic decentralization before feeding.

Neural Mecahinism of Salivary Gland Secretion By John Raymond Garrett, Jörgen
Published by Karger Publishers, 1999

Parotid Degeneration secretion after sympathectomy

Volume 162, Number 1 / September, 1975

Cell and Tissue Research
Parotid glands of rat have been examined 12, 24 and 48 hours after avulsion of the cervical sympathetic ganglion and compared with the normally innervated left glands. Formaldehyde-induced fluorescence showed a relatively normal complement of adrenergic nerves at 12 hours but most of the nerves had lost their noradrenaline content by 24 hours and no fluorescent nerves were detected at 48 hours.
This loss of granules is considered to be due to sympathetic degeneration secretion caused by the release of noradrenaline from the degenerating adrenergic nerves between 12 and 24 hours after ganglionectomy. This is thought to be the first example of morphological change resulting from degeneration activation to be recorded microscopically.
http://www.springerlink.com/content/n08314p052546477/

Monckeberg Sclerosis following symathectomy

After unilateral sympathectomy the incidence of calcified
arteries on the side of operation was significantly higher than that on the contralateral
side (88% versus 18%, p less than 0.01).

Of 20 patients who had no evidence of calcinosis
pre-operatively, 11 developed medial calcification after unilateral operation exclusively
on the side of sympathectomy. In seven patients calcinosis was detected in both feet after
bilateral operation. In conclusion, sympathetic denervation is one of the causes of
Monckeberg's sclerosis regardless of diabetes mellitus.

Goebel FD, Fuessl HS.
Diabetologia. 1983 May;24(5):347-50.

Post- sympathectomy gustatory sweating has been reported in 28% of patients

Jack Collin, consultant surgeon.
Paul Whatling, higher specialist trainee.

John Radcliffe Hospital, Oxford OX3 9DU

Postsurgery, severe compensatory sweating was experienced in 90% of patients

Video-assisted Transthoracic Sympathectomy in the Treatment of Primary Hyperhidrosis: Friend or Foe?

Main outcome measures included the incidence of dry hands, compensatory sweating, chest pain, upper-limb muscle weakness, shortness of breath, and gustatory phenomena; in addition, patient perception of the success of the surgical procedure was assessed.

Postsurgery, severe compensatory sweating was experienced in 90% of patients.

Because the occurrence of severe compensatory sweating is unpredictable, a reversible sympathectomy may be desirable.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 10(4):226-229, August 2000.
Fredman, Brian MB BCh; Zohar, Edna MD; Shachor, Dov MD; Bendahan, Jose MD; Jedeikin, Robert BSc, MB, ChB, FFA(SA)

New Name for CS: Abnormal Sweating

What are the risks of a sympathectomy?

* Risks from anaesthesia
* Bleeding
* Infection
* Worsening of pain
* Creation of a new pain syndrome
* Abnormal sweating

1. Mailis-Gagnon A, Furlan A. Sympathectomy for neuropathic pain. The Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD002918. DOI: 10.1002/14651858.CD002918.

Recurrent palmar hyperhidrosis occurs

Recurrent palmar hyperhidrosis occurs in 5.4% of cases, but can be cured by a second thoracoscopic sympathectomy. Horner's syndrome is an avoidable complication of thoracoscopic sympathectomy.

Volume 17, Issue 4, Pages 343-346 (April 1999)

The Results of Thoracoscopic Sympathetic Trunk Transection for Palmar Hyperhidrosis and Sympathetic Ganglionectomy for Axillary Hyperhidrosis

Eurpean Journal of Vascular and Endosvascular Surgery

pathologic coupling of sympathetic and afferent activity after a mechanically induced peripheral nerve lesion

Under physiological conditions there is no interaction between the sympathetic and the afferent nociceptive system; stimulation of the sympathetic trunk does not induce any activity in afferent neurons.65,79 However, under pathophysiological conditions the situation dramatically changes.80 Neurophysiological and neuroanatomical experiments in animals show that a pathologic coupling of sympathetic and afferent activity may follow a mechanically induced peripheral nerve lesion. This may take place between sympathetic fibers and regenerating or intact nociceptive C-fibers in the periphery, or between sympathetic vasoconstrictor fibers and afferent somata within the dorsal root ganglion.81 The interaction is chemically via noradrenaline from sympathetic endings and adrenoreceptors that are expressed on afferent neurons under pathophysiological conditions (Figure 4A). Accordingly, mRNA for alpha2A-adrenoceptors is up-regulated in DRG neurons after nerve lesion.82

Complex regional pain syndrome – diagnostic, mechanisms,
CNS involvement and therapy
G Wasner1 (#aff1) , J Schattschneider1 (#aff1) , A Binder1 (#aff1) and R Baron1 (#aff1)
Spinal Cord (2003) 41, 61–75. doi:10.1038/sj.sc.3101404

A partial nerve lesion is the important preceding event in CRPS II

Autonomic disturbances

A partial nerve lesion is the important preceding event in CRPS II (Reflex Regional Pain Syndrome). Therefore, it has generally been assumed that abnormalities in skin blood flow within the territory of the lesioned nerve are due to peripheral impairment of sympathetic function and sympathetic denervation. During the first weeks after transection of vasoconstrictor fibers, vasodilatation is present within the denervated area. Later the vasculature may develop increased sensitivity to circulating catecholamines, probably due to upregulation of adrenoceptors.⁶⁶ Similar observations were recently described in the chronic nerve constriction injury model in rats.^67,68 The skin on the lesioned side was abnormally warm for about the first post-operative week and then evolved to a chronically cold status. The late-stage cold skin was present despite a complete absence of fluorescence for norepinephrine. Thus, in this animal model, the skin is cold due to denervation supersensitivity of adrenoceptors rather than excessive sympathetic vasoconstrictor activity.

Further important signs of sympathetic dysfunction in CRPS are unilateral sweating abnormalities.⁷⁸ Quantitative measurements of sudomotor activity show enhanced sweat production in the disturbed limb in the acute and chronic stage of the disease in many CRPS patients.^23,26 This unilateral hyperhidrosis indicates enhanced sympathetic sudomotor activity.

In conclusion, the combination of increased sudomotor and decreased cutaneous sympathetic vasoconstrictor outflow is a well known centrally regulated thermoregulatory function to keep body core temperature constant in different environments. However, under physiological conditions all extremities are involved. Therefore, the unilateral activation of sudomotor and inhibition of cutaneous sympathetic vasoconstrictor neurons indicates a centrally located thermoregulatory dysfunction in CRPS.

Complex regional pain syndrome – diagnostic, mechanisms,
CNS involvement and therapy
G Wasner1 (#aff1) , J Schattschneider1 (#aff1) , A Binder1 (#aff1) and R Baron1 (#aff1)
Spinal Cord (2003) 41, 61–75. doi:10.1038/sj.sc.3101404

A critical analysis and long-term results

Permanent side effects included compensatory sweating in 67.4%, gustatory sweating in 50.7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfied, and a 26.7% partially satisfied. Compensatory and gustatory sweating were the most frequently stated reasons for dissatisfaction. Individuals operated for axillary hyperhidrosis without palmar involvement were significantly less satisfied (33.3% and 46.2%, respectively).

F Herbst, E G Plas, R Függer, and A Fritsch

Department of Surgery, University of Vienna, Austria.
Ann Surg. 1994 July; 220(1): 86–90.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1234291

Sympathectomy was never evaulated for effectiveness or safety

No systematic reviews, meta-analyses, or clinical trials that evaluated the
effectiveness of endoscopic thoracic sympathectomy for treating facial
blushing were identified. However, we have identified four case series
related to the request (Drott et al. 1998, Rex et al. 1998, Telaranta 1998,
Yilmaz et al. 1996). These studies were conducted in three countries
(Sweden, Finland and the Netherlands).

The four case series were not critically appraised because they are prone
to bias and have significant methodological problems. These studies
represent level IV evidence according to the NHMRC criteria and one
should not draw firm conclusions from their findings.

To date, the benefits or side effects associated with endoscopic thoracic
sympathectomy for treating facial blushing have not been properly
evaluated and reported.

Centre for Clinical Effectiveness

Omar Ahmed PhD,
Monash University, 2001

retarded adaptation of hemodynamics to a sudden start of exercise following sympathectomy

E. Bassenge¹, J. Holtz¹, W. v. Restorff¹ and K. Oversohl¹

(1)	Physiologisches Institut der Ludwig-Maximilian-Universität München, Germany

Received: 18 April 1973

The exercise capacity and the increase of coronary and systemic hemodynamics under treadmill exercise were studied in 5 dogs, chemically sympathectomized with 6-hydroxy-dopamine.

Completeness of adrenergic denervation was verified by stimulation of the right stellate ganglion, by intravenous administration of tyramine, and by demonstration of supersensitivity to exogenous norepinephrine.

These dogs demonstrated a retarded adaptation of hemodynamics to a sudden start of exercise. A fall in mean arterial pressure below 45 mmHg within 10 to 15 sec lead to collapse. After a recovery period of 60–90 sec, moderate treadmill exercise could be continued; steady state attainment of hemodynamic parameters was considerably delayed.

Mean arterial pressure and total peripheral resistance were significantly reduced at rest and during steady state of exercise as compared to controls prior to sympathectomy identical .

The significant fall in left circumflex coronary flow was proportional to the decline in external heart work due to sympathectomy both at rest and under exercise.

Effect of chemical sympathectomy on coronary flow and cardiovascular adjustment to exercise in dogs

http://www.springerlink.com/content/k2n6j4555g16x773/

	Pflügers Archiv European Journal of Physiology
	Springer Berlin / Heidelberg

Relationship between sympathovagal tone and personality traits

E. Schweiger, W. Wittling^, , S. Genzel and A. Block

Department of Physiological and Clinical Psychology, Catholic University of Eichstaett, D-85071, Eichstaett, Germany

Received 27 August 1997.

Available online 15 September 1998.

Results of two-factor ANOVAs revealed substantial differences in personality characteristics depending on the level of sympathetic and parasympathetic tone respectively.
Correlational analysis showed remarkable relationships between sympathetic tone and some prominent personality traits. By introducing one of these personality traits (anxiety) as a covariate into two-factor ANCOVAs the originally obtained results were markedly altered.

PERSONALITY, AFFECT, AND CARDIOVASCULAR RESPONSE

Symposium 10

PERSONALITY, AFFECT, AND CARDIOVASCULAR RESPONSE: EVIDENCE FOR MOTIVATIONAL GAINS AND DEFICITS

Copyright Copyright © 2007 Society for Psychophysiological Research

Headache Following Cervical Sympathectomy - Harvard Medical School

Headache Following Cervical Sympathectomy and Results of a Blood Flow Study in the Cat

Egilius L. H. Spierings, MD, PhD

Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

Address all correspondence to Dr. Egilius L. H. Spierings, 25 Walnut Street, Suite 102, Wellesley Hills, MA 02481-2106.

Background.—A patient developed severe, continuous, unilateral headache that was "vascular" in nature, following cervical sympathectomy.

Objective.—To determine the changes in cranial blood flow in the cat following lesioning and stimulation of the cervical sympathetic nerve.

Method.—Carotid blood flow was determined by electromagnetic flowmetry and its tissue distribution by intra-arterial injection of 15-μm radioactive microspheres.

Results.—Following sympathetic lesioning, an increase in carotid blood flow was observed and reversed with stimulation. The distribution of carotid blood flow changed for the brain only, maintaining relatively constant tissue perfusion.

Conclusion.—An increase in cerebral blood flow could not have accounted for the sympathectomy-induced headache. Dilation of major cerebral arteries and cranial noncerebral vasodilation probably constitutes its mechanism.

Accepted for publication October 6, 2002

Cervical sympathectomy reduces the heterogeneity of oxygen saturation in small cerebrocortical veins

H. M. Wei, A. K. Sinha and H. R. Weiss

Department of Anesthesia, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway 08854-5635.

This study evaluated the hypothesis that the peripheral sympathetic nervous system is one of the factors increasing the heterogeneity of venous O2 saturation in selective brain regions. Regional cerebral blood flow and O2 saturation were determined in the anterior cortex, posterior cortex, and medulla of either sham-operated or bilaterally sympathectomized Long-Evans rats. Cerebral venous O2 saturations, indicating the balance between local O2 supply and consumption, were found to be significantly more heterogeneous in the sham-operated group. In the anterior cortex, the coefficient of variation [100(SD/mean)] for the sham-operated animals was 22.4%. Sympathectomy significantly reduced this heterogeneity in the anterior cortex through a reduction in the number of low O2 saturation veins (coefficient of variation 11.7%). Blood flow and O2 consumption in the anterior cortex were not different between groups. The effects of sympathectomy in the posterior cortex were similar to those in the anterior cortex. However, sympathectomy did not alter any measured variables in the medulla. Thus, bilateral superior cervical ganglionectomy reduced the heterogeneity of cerebrocortical venous O2 saturation by reducing the number of low O2 saturation veins in the rostral part of the brain.
Journal of Applied Physiology, Vol 74, Issue 4 1911-1915, Copyright © 1993 by American Physiological Society
http://jap.physiology.org/cgi/content/abstract/74/4/1911

Sympathectomy - basal ganglia - functions

In the brain (part of the central nervous system), the "basal ganglia" is a group of nuclei interconnected with the cerebral cortex, thalamus and brainstem, associated with a variety of functions: motor control, cognition, emotions and learning.

The Unbalanced Autonomic Nervous System Causes the Symptoms of the Metabolic Syndrome

The metabolic syndrome consists of visceral obesity, hyperglycemia, hyperinsulinemia, dyslipidemia, and cardiovascular diseases. A common pathophysiological denominator underlying these epidemiological correlations has not been identified. However, the autonomic nervous system was shown to play a role in the metabolic syndrome. Recently, a prospective cohort study in 8,000 patients from 1987-1998 revealed a high relative risk to develop type 2 diabetes if autonomic dysfunction is present in healthy subjects independent from other risk factors, such as body weight.^[42]

Diabetes. 2003;52(11):2652-2656. ©2003 American Diabetes Association, Inc.