The role of the blood-brain barrier in hypertension

Abstract

The blood-brain barrier (BBB) is a critical barrier that provides both metabolic and physical protection to an immune-privileged central nervous system. The BBB has been shown to be disrupted in hypertension. This review addresses the importance of the BBB in maintaining homeostasis in the context of diseases related to autonomic dysfunction such as hypertension. We highlight the potentially important roles of the immune system and neurovascular unit in the maintenance of the BBB, whereby dysregulation may lead to autonomic dysfunction in diseases such as heart failure and hypertension. Circulating leukocytes and factors such as angiotensin II and pro-inflammatory cytokines are thought to ultimately down-regulate endothelial tight junction proteins that are a critical component of the BBB. The specific mechanisms underlying BBB disruption and their role in contributing to autonomic dysfunction is not yet fully understood but is a growing area of interest. A greater understanding of these systems and advances in our knowledge of the molecular mechanisms causing BBB disruption, will allow for the development of future therapeutic interventions in the treatment of autonomic imbalance associated with diseases such as heart failure and hypertension.

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The relationship between sacral slope and symptomatic isthmic spondylolysis in a cohort of high school athletes: a retrospective analysis

Spondylolysis with and without anterolisthesis are the most common causes of structural back pain in children and adolescents, but few predictive factors have been confirmed. An association between abnormal sacro-pelvic orientation and both spondylolysis and spondylolisthesis has been supported in the literature. Sacral slope and other sacro-pelvic measurements are easily accessible variables that could aid clinicians in assessing active adolescents with low back pain, particularly when the diagnosis of spondylolysis is suspected.

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Neuronal activity patterns in the ventral thalamus: comparison between Parkinson’s disease and cervical dystonia

The thalamus plays a crucial role in many brain functions, serving as an information gate for afferent sensory signals, efferent programmes and intercortical interactions. Along with a complex inner structure, the thalamus has widespread connections with subcortical structures (basal ganglia, cerebellum, midbrain and others), different cortical regions and the peripheral nervous system (Jones, 2007; Sherman and Guillery, 2013). Thus, such extensive connectivity implies a complexity and diversity of neuronal activity patterns.

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Progression of adverse effects over consecutive sessions of transcranial direct current stimulation

We read the paper by Antal et al. (2017) with great interest, and felt that it provided an excellent overview of the safety aspects of transcranial electrical stimulation (tES). However, we noticed that while multi-day stimulation studies were discussed, potential changes in adverse effects (AEs) over consecutive sessions were not, and the lack of knowledge on the matter was pointed out by the authors. We recently completed an experiment in which we investigated this issue.

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Super-selective cervical nerve root stimulation in contralateral C7 transfer: an intraoperative study

Intraoperative electrophysiological examination of the healthy brachial plexus in contralateral C7 transfer (cC7) procedures contributed substantially to the anatomical understanding of functional motor innervation of cervical nerve roots (Gu 1997; Gu et al. 2003; Hu et al. 2008; Li et al. 2011; Yin et al. 2012; Zhang et al. 2012). Results of intraoperative cervical nerve root stimulation showed that C5 mainly innervates the deltoid (axillary nerve), C6 the biceps brachii (musculocutaneous nerve), C7 the triceps brachii (radial nerve), and C8 the flexor digitorum superficialis and profundus muscles (median nerve) (Gu 1997).

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iMAX: a new tool to assess peripheral motor axonal hypoexcitability

In routine electrodiagnostic procedures, classical parameters allow assessment of motor unit loss/reinnervation (CMAP amplitude) and motor conduction slowing (motor distal latency, motor conduction velocity, F waves), but none evaluates peripheral motor axon hypoexcitability. Yet everyone has experienced that in a demyelinating neuropathy it is often necessary to increase above normal the amount of current to obtain a supramaximal motor response. Excitability properties of human peripheral nerves can be assessed by various neurophysiological methods (Brismar, 1985; Kiernan et al, 2000; Burke et al, 2001), but they are not often used in daily practice because they are time consuming and they require a specific collection system and software.

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Added clinical value of the inferior temporal EEG electrode chain

In 1958, the standardized 10-20 EEG electrode positioning system was proposed by Herbert H. Jasper and his co-workers (Jasper, 1958), and in 1999 this has been reported as a guideline of the International Federation of Clinical Neurophysiology (Klem et al. 1999). Distances were measured from prominent skull landmarks (nasion, inion, preauricular points) and evenly distributed electrode positions were determined using 10% and 20% segments of these distances (Klem et al. 1999). Jasper's 10-20 system was developed using cadaver skulls.

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