Comparison of muscle sympathetic nerve activity during exercise in dominant and nondominant forearm

Control of exercise hyperpnoea: Contributions from thin-fibre skeletal muscle afferents

NEW FINDINGS

What is the topic of this review? In this review, we examine the evidence for control mechanisms underlying exercise hyperpnoea, giving attention to the feedback from thin-fibre skeletal muscle afferents, and highlight the frequently conflicting findings and difficulties encountered by researchers using a variety of experimental models. What advances does it highlight? There has been a recent resurgence of interest in the role of skeletal muscle afferent involvement, not only as a mechanism of healthy exercise hyperpnoea but also in the manifestation of breathlessness and exercise intolerance in chronic disease.

ABSTRACT

The ventilatory response to dynamic submaximal exercise is immediate and proportional to metabolic rate, which maintains isocapnia. How these respiratory responses are controlled remains poorly understood, given that the most tightly controlled variable (arterial partial pressure of CO₂ /H⁺ ) provides no error signal for arterial chemoreceptors to trigger reflex increases in ventilation. This review discusses evidence for different postulated control mechanisms, with a focus on the feedback from group III/IV skeletal muscle mechanosensitive and metabosensitive afferents. This concept is attractive, because the stimulation of muscle mechanoreceptors might account for the immediate increase in ventilation at the onset of exercise, and signals from metaboreceptors might be proportional to metabolic rate. A variety of experimental models have been used to establish the contribution of thin-fibre muscle afferents in ventilatory control during exercise, with equivocal results. The inhibition of afferent feedback via the application of lumbar intrathecal fentanyl during exercise suppresses ventilation, which provides the most compelling supportive evidence to date. However, stimulation of afferent feedback at rest has no consistent effect on respiratory output. However, evidence is emerging for synergistic interactions between muscle afferent feedback and other stimulatory inputs to the central respiratory neuronal pool. These seemingly hyperadditive effects might explain the conflicting findings encountered when using different experimental models. We also discuss the increasing evidence that patients with certain chronic diseases exhibit exaggerated muscle afferent activation during exercise, resulting in enhanced cardiorespiratory responses. This might provide a neural link between the well-established limb muscle dysfunction and the associated exercise intolerance and exertional dyspnoea, which might offer therapeutic targets for these patients.

Heterogeneity in the vasodilatory function of individual extremities

Objectives

Heterogeneity and homogeneity in the flow-mediated dilation of the human body's individual extremities are not fully understood, and the relationship between flow-mediated dilation and local muscle activity is unclear. We assessed the flow-mediated dilation of four individual extremities and sought to determine the contribution of local muscle activity (evaluated as muscle strength) to the flow-mediated dilation in each extremity.

Methods

Thirteen healthy young right-handed nonactive males participated. The flow-mediated dilation in the brachial and popliteal arteries at both arms and legs was assessed by ultrasound Doppler. Muscle strength was evaluated as the grip strength and knee extension.

Results

There was a significant difference in the brachial artery (BA)-FMD values between the subjects' dominant and non-dominant sides (8.0 ± 2.8 vs. 5.5 ± 2.2%, p < 0.05), whereas the two sides showed similar popliteal artery (PA)-FMD values. There was no significant correlation in flow-mediated dilation between the dominant brachial artery and popliteal artery. The BA-FMD was significantly correlated with the grip strength in both upper extremities (dominant: r = 0.562, non-dominant: r = 0.548; p < 0.05, respectively).

Conclusion

These results demonstrated heterogeneity in the flow-mediated dilation of individual extremities. We observed that local muscle activity can affect the local vascular function. Measurements of vasodilatory function in individual extremities should thus be carefully considered.

Muscle metaboreflex control of the circulation during exercise

This review covers the control of blood pressure, cardiac output and muscle blood flow by the muscle metaboreflex which involves chemically sensitive nerves located in muscle parenchyma activated by metabolites accumulating in the muscle during contraction. The efferent response to metaboreflex activation is an increase in sympathetic nerve activity that constricts the systemic vasculature and also evokes parallel inotropic and chronotropic effects on the heart to increase cardiac output. The metaboreflex elicits a significant blood pressure elevating response during exercise and functions to redistribute blood flow and blood volume. Regional specificity in the efferent response to the metaboreflex activated from either the leg or the arm is seen in the balance between signals for vasoconstriction to curtail blood flow and signals to increase cardiac output. The metaboreflex has dual functions. It can both elevate and decrease muscle blood flow depending on (1) the intensity and mode of contraction, (2) the limb in which the reflex is evoked, (3) the strength of the signal defined by the muscle mass, (4) the extent to which blood flow is redistributed from inactive vascular beds to increase central blood volume and (5) the extent to which cardiac output can be increased.

Modulation of muscle sympathetic nerve activity to muscle heating during dynamic exercise

Previous studies from our laboratory have demonstrated that altering muscle temperature of the exercising forearm can elicit changes in muscle sympathetic nerve activity (MSNA) during ischemic isometric handgrip. The purpose of the current study was to determine the interactive effect of muscle temperature and blood flow on MSNA responses during dynamic handgrip (DHG). Eight subjects performed two bouts of graded DHG to fatigue followed by 2 min of postexercise muscle ischemia (PEMI). Local heating of the forearm increased muscle temperature from 33.6 +/- 0.3 to 38.3 +/- 0.5 degrees C (P < 0.05). Mean arterial pressure and heart rate increased in a linear fashion during graded DHG (P < 0.05) but were not affected by muscle temperature. MSNA (burst frequency and total activity) at fatigue and PEMI were elevated in all conditions (P < 0.05). However, MSNA responses were not different between temperature conditions. To ascertain the effect of blood flow, eight additional subjects completed two trials of ischemic DHG under control or warm conditions followed by 2 min of PEMI. MSNA, expressed as burst frequency and total activity, was significantly greater in warm compared with the control trial (Delta14 +/- 3 and Delta9 +/- 2 bursts/30 s, and Delta1,234 +/- 260 and Delta751 +/- 199 units/30 s, respectively). This finding supports the concept that muscle heating sensitizes skeletal muscle afferents during muscle contractions and augments MSNA in humans. However, on the basis of these findings, we conclude that muscle blood flow modulates the effect of muscle temperature on MSNA during exercise.

Ventilatory and circulatory responses at the onset of dominant and non-dominant limb exercise

We compared the ventilatory and circulatory responses during 20 s of light dynamic leg and arm exercises performed separately using dominant and non-dominant limbs. Seventeen subjects performed a 20-s single-leg knee extension-flexion exercise with a load of 5% of maximal muscle strength attached to the ankle. Fifteen of the seventeen subjects also did a single-arm elbow flexion-extension exercise in which a load was attached to the wrist in the same way as in the leg exercise. Similar movements were passively performed on the subjects by experimenters to avoid the effects of central command. The magnitude of change from rest (gain) in minute ventilation during passive movement (PAS) was significantly smaller in the dominant limbs than in the non-dominant limbs, though a significant difference was not detected during voluntary exercise (VOL). In contrast, heart rate and blood pressure responses did not show any differences between the dominant and non-dominant limbs during either VOL or PAS. In conclusion, the initial ventilatory response to PAS in the dominant limbs was lower than that of the non-dominant limbs, though the ventilatory response to VOL was not. Circulatory responses were not different between the dominant and non-dominant limbs. These results suggest that peripheral neural reflex during exercise could be different between dominant and non-dominant limbs and that ventilatory response at the onset of exercise might be controlled by the dual neural modulation of central command and peripheral neural reflex, resulting in the same ventilatory response to both dominant and non-dominant limb exercise.

Acute sympathetic vasoconstriction at rest and during dynamic exercise in cyclists and sedentary humans

The impact of exercise training on sympathetic activation is not well understood, especially across untrained and trained limbs in athletes. Therefore, in eight sedentary subjects (maximal oxygen consumption = 40 ± 2 ml·kg−1·min−1) and eight competitive cyclists (maximal oxygen consumption= 64 ± 2 ml·kg−1·min−1), we evaluated heart rate, blood pressure, blood flow, vascular conductance, and vascular resistance in the leg and arm during acute sympathetic stimulation [cold pressor test (CPT)]. The CPT was also performed during dynamic leg (knee extensor) or arm (handgrip) exercise at 50% of maximal work rate (WRmax) with measurements in the exercising limb. At rest, the CPT decreased vascular conductance similarly in the leg and arm of sedentary subjects (−33 ± 8% leg, −38 ± 6% arm) and cyclists (−34 ± 4% leg, −31 ± 9% arm), and during exercise CPT-induced vasoconstriction was blunted (i.e., sympatholysis) in both the leg and arm of both groups. However, the magnitude of sympatholysis was significantly different between the arm and leg of the sedentary group (−47 ± 11% arm, −25 ± 8% leg), and it was less in the arm of cyclists (−28 ± 11%) than sedentary controls. Taken together, these data provide evidence that sympathetically mediated vasoconstriction is expressed equally and globally at rest in both sedentary and trained individuals, with a differential pattern of vasoconstriction during acute exercise according to limb and exercise training status.

Muscle afferent contributions to the cardiovascular response to isometric exercise

The cardiovascular response to isometric exercise is governed by both central and peripheral mechanisms. Both metabolic and mechanical stresses on the exercising skeletal muscle produce cardiovascular change, yet it is often overlooked that the afferent signal arising from the muscle can be modified by factors other than exercise intensity. This review discusses research revealing that muscle fibre type, muscle mass and training status are important factors in modifying this peripheral feedback from the active muscles. Studies in both animals and humans have shown that the pressor response resulting from exercise of muscle with a faster contractile character and isomyosin content is greater than that from a muscle of slower contractile character. Athletic groups participating in training programmes that place a high anaerobic load on skeletal muscle groups show attenuated muscle afferent feedback. Similarly, longitudinal studies have shown that specific local muscle training also blunts the pressor response to isometric exercise. Thus it appears that training may decrease the metabolic stimulation of muscle afferents and in some instances chronic exposure to the products of anaerobic metabolism may blunt the sensitivity of the muscle metaboreflex. There may be surprising parallels between the local muscle conditions induced in athletes training for longer sprint events (e.g. 400 m) and by the low-flow conditions in, for example, the muscles of chronic heart failure patients. Whether their similar attenuations in muscle afferent feedback during exercise are due to decreased metabolite accumulation or to a desensitization of the muscle afferents is not yet known.

Cardiovascular and sympathetic neural responses to handgrip and cold pressor stimuli in humans before, during and after spaceflight

Astronauts returning to Earth have reduced orthostatic tolerance and exercise capacity. Alterations in autonomic nervous system and neuromuscular function after spaceflight might contribute to this problem. In this study, we tested the hypothesis that exposure to microgravity impairs autonomic neural control of sympathetic outflow in response to peripheral afferent stimulation produced by handgrip and a cold pressor test in humans. We studied five astronauts approximately 72 and 23 days before, and on landing day after the 16 day Neurolab (STS-90) space shuttle mission, and four of the astronauts during flight (day 12 or 13). Heart rate, arterial pressure and peroneal muscle sympathetic nerve activity (MSNA) were recorded before and during static handgrip sustained to fatigue at 40 % of maximum voluntary contraction, followed by 2 min of circulatory arrest pre-, in- and post-flight. The cold pressor test was applied only before (five astronauts) and during flight (day 12 or 13, four astronauts). Mean (+/- S.E.M.) baseline heart rates and arterial pressures were similar among pre-, in- and post-flight measurements. At the same relative fatiguing force, the peak systolic pressure and mean arterial pressure during static handgrip were not different before, during and after spaceflight. The peak diastolic pressure tended to be higher post- than pre-flight (112 +/- 6 vs. 99 +/- 5 mmHg, P = 0.088). Contraction-induced rises in heart rate were similar pre-, in- and post-flight. MSNA was higher post-flight in all subjects before static handgrip (26 +/- 4 post- vs. 15 +/- 4 bursts min(-1) pre-flight, P = 0.017). Contraction-evoked peak MSNA responses were not different before, during, and after spaceflight (41 +/- 4, 38 +/- 5 and 46 +/- 6 bursts min(-1), all P > 0.05). MSNA during post-handgrip circulatory arrest was higher post- than pre- or in-flight (41 +/- 1 vs. 33 +/- 3 and 30 +/- 5 bursts min(-1), P = 0.038 and 0.036). Similarly, responses of MSNA and blood pressure to the cold pressor test were well maintained in-flight. We conclude that modulation of muscle sympathetic neural outflow by muscle metaboreceptors and skin nociceptors is preserved during short duration spaceflight.

Lateral dominance of legs in maximal muscle power, muscular endurance, and grading ability

The purpose of this study was to examine lateral dominance in maximal muscle power, muscular endurance, and grading ability, using isokinetic mulscular strength in knee extension and flexion. The subjects were 50 healthy male students whose ages ranged from 19 to 23 years (M height: 173.6+/-6.2 cm, M weight: 67.2+/-6.8 kg). Their dominant legs for power exertion and for functional use were based on questionnaire items selected from those used in previous studies. The angular velocities of extension and flexion for exerting maximal muscle power were 60, 180, and 300 x sec.(-1). A continuous exertion 30 times at an angular velocity of 180 sec.(-1) was used as the load for muscular endurance. For grading ability, 25%, 50% and 75% of the maximal muscle strength at angular velocities of 60 and 180 x sec.(-1) were the required values, and the difference between these values and the exerted muscular strength was evaluated. The dominant leg and nondominant leg were compared for both power exertion and functional use. There was no lateral dominance in maximal muscle power and muscular endurance. In muscular endurance, especially, some subjects showed one leg superior in power exertion and some superior in functional use. Lateral dominance was noted across maximal muscle power and muscular endurance in grading ability. The dominant leg tended to be better than the nondominant leg in functional use. However, lateral dominance was not remarkable for flexing motion and in exertion for a short time.

Exercise-induced sympathetic activation is correlated with cerebral hemisphere laterality, but not handedness

To investigate whether sympathetic responses are correlated with central laterality or handedness, muscle sympathetic nerve activity (MSNA), heart rate (HR) and blood pressure (BP) were compared between right (RA) and left arm (LA) grip exercise with volitional maximum effort (MVHG) for 2 min and post-exercise arterial occlusion (PEAO) in right- and left-handed volunteers. MVHG and PEAO led to a greater increase in MSNA in RA than in LA exercise (180 vs. 150%, P=0.004; 140 vs. 85%, P=0.005). MVHG elevated HR to a significantly lesser extent in RA than in LA (35 vs. 46%, P=0.030), and the difference was maintained during PEAO. The BP rise during MVHG and PEAO was the same in RA and in LA. Muscle sympathetic nerve activity, HR and BP responses during MVHG and PEAO showed no difference between the dominant and non-dominant arm. These results suggested that the effects of central motor command and metaboreflex on sympathetic outflow to the vasculature and the heart may be selectively modulated partly by hemispherical laterality.

Sympathetic adaptations to one-legged training

The purpose of the present study was to determine the effect of leg exercise training on sympathetic nerve responses at rest and during dynamic exercise. Six men were trained by using high-intensity interval and prolonged continuous one-legged cycling 4 day/wk, 40 min/day, for 6 wk. Heart rate, mean arterial pressure (MAP), and muscle sympathetic nerve activity (MSNA; peroneal nerve) were measured during 3 min of upright dynamic one-legged knee extensions at 40 W before and after training. After training, peak oxygen uptake in the trained leg increased 19 +/- 2% (P < 0.01). At rest, heart rate decreased from 77 +/- 3 to 71 +/- 6 beats/min (P < 0.01) with no significant changes in MAP (91 +/- 7 to 91 +/- 11 mmHg) and MSNA (29 +/- 3 to 28 +/- 1 bursts/min). During exercise, both heart rate and MAP were lower after training (108 +/- 5 to 96 +/- 5 beats/min and 132 +/- 8 to 119 +/- 4 mmHg, respectively, during the third minute of exercise; P < 0.01). MSNA decreased similarly from rest during the first 2 min of exercise both before and after training. However, MSNA was significantly less during the third minute of exercise after training (32 +/- 2 to 22 +/- 3 bursts/min; P < 0.01). This training effect on MSNA remained when MSNA was expressed as bursts per 100 heartbeats. Responses to exercise in five untrained control subjects were not different at 0 and 6 wk. These results demonstrate that exercise training prolongs the decrease in MSNA during upright leg exercise and indicates that attenuation of MSNA to exercise reported with forearm training also occurs with leg training.

Sympathetic neural adaptations to exercise training in humans: insights from microneurography

Sympathetic nerve activity has long been regarded as an important regulator of blood flow and blood pressure. Its importance has been especially recognized during exercise. The present review examines sympathetic neural adaptations to exercise training in humans obtained by sympathetic nerve recordings to nonactive skeletal muscle. Little evidence exists from both cross-sectional and longitudinal studies indicating that training alters resting muscle sympathetic nerve activity (MSNA). However, MSNA responses during exercise appear to be attenuated after training. This attenuation of MSNA seems to be specific to the trained muscle and not generalizable to other muscle groups. The mechanisms for the decrease in exercise-induced MSNA have been attributed to changes in both the muscle metaboreflex and muscle mechanoreflex. In addition to exercise, training has generally not altered MSNA responses to other stressors such as cold pressor test, lower body negative pressure, and upright tilting. However, the effect of training on baroreflex control of MSNA is equivocal. These conclusions are based on few studies. More comprehensive training studies are needed to better understand the role of training on sympathetic neural outflow.