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Neuroendocrine Responses to Transvascular Autonomic Modulation: A Modified Balloon Angioplasty in Multiple Sclerosis
1Autonomic Specialists, 4501 Birch Street, Newport Beach, USA.
Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|March 20, 2015
Summary
Transvascular Autonomic Modulation (TVAM), a modified balloon angioplasty, unexpectedly reduced stress hormones (ACTH and cortisol) in multiple sclerosis patients with chronic cerebrospinal venous insufficiency. This suggests TVAM may positively impact autonomic nervous system and hormonal balance.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Endocrinology
Background:
- Multiple sclerosis (MS) patients often exhibit chronic cerebrospinal venous insufficiency (CCSVI).
- Balloon angioplasty (BA) is used to treat vascular lesions in MS patients.
- Clinical benefits of BA may involve improvements in cardiovascular autonomic nervous system (ANS) function.
Purpose of the Study:
- To investigate the effects of Transvascular Autonomic Modulation (TVAM), a modified BA, on ANS and Hypothalamic-Pituitary-Adrenal (HPA) axis function in MS patients.
- To determine the relationship between ANS function and HPA axis activity post-TVAM.
- To explore TVAM's impact on adrenocorticotropic hormone (ACTH) and cortisol levels.
Main Methods:
- TVAM procedure involved dilation of multiple vascular beds (IJVs, azygos, renal veins) and manual compression.
- Measured serum ACTH and cortisol, blood pressure (BP), and heart rate variability (HRV) in 72 MS patients before and 24 hours after TVAM.
- Analyzed correlations between changes in ANS parameters and HPA axis hormones.
Main Results:
- TVAM significantly reduced ACTH and cortisol levels (p<0.001), contrary to expected stress responses.
- ACTH reduction was more pronounced in males than females (p<0.001).
- Post-TVAM BP showed varied responses: increased in hypotensive patients, decreased in hypertensive patients.
- Changes in ACTH correlated with diastolic BP changes (r=-0.265, p=0.03).
- Changes in cortisol correlated with systolic BP changes (r=-0.283, p=0.01).
Conclusions:
- TVAM induced an unexpected decrease in HPA axis hormones (ACTH, cortisol) in MS patients.
- The findings suggest a potential modulation of the stress response and ANS function by TVAM.
- Further research is needed to understand the clinical implications of these hormonal changes.
