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Psychosocial Aspects of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Underlying mechanisms of panic attacks or panic disorder involve the hippocampus, anterior cingulate cortex, insula, amygdala, lateral prefrontal cortex, and periaqueductal gray matter. In a panic attack, there is usually elevated blood flow or metabolism. Insula hyperactivity is likely related to irregular norepinephrine activity. The periaqueductal gray matter is implicated in generating fear responses. There is an abnormally functioning “brain circuit” made up of the amygdala, central gray matter, ventromedial nucleus of the hypothalamus, and locus coeruleus. Often, there are lower than normal levels of gamma-aminobutyric acid (GABA). Hyperventilation is a component of panic, and results in the exhalation of excessive carbon dioxide. There may be a feeling of being unable to “catch their breath.” The partial pressure of carbon dioxide is another mediator of panic disorder. Panic attacks may begin and worsen in association with diabetes progressing, increased complications, and loss of normal functioning. They are also accompany with depression in many patients.
The Hypothalamic-Pituitary-Adrenal Axis in Fibromyalgia: Where Are We in 2001?
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Corticotropin-releasing hormone [CRH] is a principal neuropeptide regulator of the ΗΡΑ axis activity by virtue of its localization to the paraventricular nucleus of the hypothalamus. Corticotropin-releasing hormone receptors are, however, localized to many other brain regions and in those locations mediates other biological effects (4). In the prefrontal, cingulate, and insular cortices CRH plays a role in the affective response to stress. The behavioral and autonomic responses to stress are associated with CRH in the central nucleus of the amygdala. The interplay between the ΗΡΑ axis and the sympathetic nervous sys-tern is localized to the locus coeruleus, dorsal raphe nucleus, and ventral tegmental areas. Corticotropin-releasing hormone may also play a role in the descending modulation of pain perception as coordinated in the periaqueductal gray (5). Corticotropin-releasing hormone actions are mediated by two receptors, CRHR1 and CRHR2. They share approximately 71 percent amino acid homology, and are differentially localized to different central and peripheral sites (6).
Endocrine Functions of Brain Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
The output of the MPOA include a major projection to the VMN, where lesions have prevented both male (mounting) and female (lordosis) sexual behavior. The two nuclei have projections to the lateral periaqueductal gray, which mediates motor and autonomic patterns associated with sexual behavior. The PVN also plays modulatory roles, especially with respect to penile erection in males and the onset of maternal behavior and responses to social stimuli in females. Other important hypothalamic nuclei include the VMN, particularly in the context of female sexual behavior, and the SON in terms of sexual interactions.
Effectiveness of spinal mobilization and postural correction exercises in the management of cervicogenic headache: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2023
The present study suggests that SM is effective in the management of patient with CGH. The primary cause of CGH is the impairment in the cervical spine especially the upper cervical spine (C1-C3) (Govind and Bogduk, 2021). SM technique was used for upper cervical segments. Upper cervical translatoric glide was applied for the C1 vertebra. We found only one published randomized controlled trial investigating the effect of upper cervical translatoric glide in patients suffering from CGH. This study assessed the immediate effects of SM on CGH (Malo-Urries et al., 2017). The possible mechanism behind the positive effect could be the activation of descending pain inhibition system via corticospinal projections from the periaqueductal gray matter (Wright, 1995).
Pro-nociceptive pain modulation profile in patients with acute and chronic shoulder pain: a hypothesis-generating topical review
Published in Physical Therapy Reviews, 2021
Rani Othman, Nicola Swain, Steve Tumilty, Prasath Jayakaran, Ramakrishnan Mani
Descending control mechanisms that influence the neuronal activity of the dorsal horn arises from several supra-spinal sites [61]. In particular, periaqueductal grey matter and nuclei of the rostral ventral medulla are the key midbrain structures that are interconnected with the higher brain centres and limbic areas, and they receive direct inputs from the spinomesencephalic tract [52, 59, 61, 62]. The periaqueductal grey matter project to rostral ventral medulla, which projects onto the dorsal horn of the spinal cord [61]. The descending facilitatory or inhibitory control mechanisms of the periaqueductal grey matter and rostral ventral medulla are mainly coordinated by the activities of the higher brain centres [52, 62]. One aspect of descending control is associated with diffuse noxious inhibitory controls [59, 61]. Diffuse noxious inhibitory controls is a phenomenon that refers to a reduction in the nociceptive inputs produced by supra-spinally generated inhibition of wide dynamic range neurons and nociceptive-specific neurons in the dorsal horn of the spinal cord [63–65]. On the contrary, it is also evident that periaqueductal grey matter and rostral ventral medulla projections can facilitate nociceptive inputs at the dorsal horn of the spinal cord [52, 61]. Evidence suggests that descending facilitation of spinal nociception is a major contributor to the development of central sensitization, a key contributing mechanism linked to the chronic pain experience [52, 61].
Spinal cord involvement in Lewy body-related α-synucleinopathies
Published in The Journal of Spinal Cord Medicine, 2020
Raffaele Nardone, Yvonne Höller, Francesco Brigo, Viviana Versace, Luca Sebastianelli, Cristina Florea, Kerstin Schwenker, Stefan Golaszewski, Leopold Saltuari, Eugen Trinka
Urinary symptoms usually affect the PD patients late in the course of the disease and their pathogenesis is likely to be multifactorial. Due to the dopaminergic cell loss in the substantia nigra the most accepted hypothesis is the disinhibition of the pontine micturition center,55 which projects to the sacral spinal cord, is involved in the regulation of the peripheral reflexes and is inhibited during the storage phase. Its activity is regulated by the periaqueductal gray (PAG), the anterior cingulate gyrus, the insula, and the prefrontal cortex. The activation of these brain regions during the micturition determines the activation of the pontine micturition center and finally of the sacral segments of the spinal cord. In cats, the bladder projects afferent inputs by the lateral funiculus to the PAG that in turn sends excitatory inputs to the pontine micturition center.