Anxiety and hypertension in the COVID-19 era: how is the central autonomic network linked?

Post-COVID dysautonomias: what we know and (mainly) what we don't know

Following on from the COVID-19 pandemic is another worldwide public health challenge that is referred to variously as long COVID, post-COVID syndrome or post-acute sequelae of SARS-CoV-2 infection (PASC). PASC comes in many forms and affects all body organs. This heterogeneous presentation suggests involvement of the autonomic nervous system (ANS), which has numerous roles in the maintenance of homeostasis and coordination of responses to various stressors. Thus far, studies of ANS dysregulation in people with PASC have been largely observational and descriptive, based on symptom inventories or objective but indirect measures of cardiovascular function, and have paid little attention to the adrenomedullary, hormonal and enteric nervous components of the ANS. Such investigations do not consider the syndromic nature of autonomic dysfunction. This Review provides an update on the literature relating to ANS abnormalities in people with post-COVID syndrome and presents a theoretical perspective on how the ANS might participate in common features of PASC.

Gene expression profiling reveals a role of immune system and inflammation in innate and stress-induced anxiety-like behavior

Anxiety is an evolutionarily conserved response that is essential for survival. Pathological anxiety, however, is a maladaptive response to nonthreatening situations and greatly affects quality of life. The recent COVID-19 pandemic has increased the prevalence of anxiety symptoms and highlighted the urge to identify the molecular events that initiate pathological anxiety. To this aim, we investigated the extent of similarity of brain region-specific gene expression patterns associated with innate and stress-induced anxiety-like behavior. We compared the cortico-frontal (FCx) and hippocampal (Hpc) gene expression patterns of five inbred mouse strains with high or low levels of innate anxiety-like behavior with gene expression patterns of mice subjected to chronic social defeat stress. We found significantly large overlap of the Hpc but small overlap of the FCx gene expression patterns in innate and stress-induced anxiety, that however, converged onto common inflammation and immune system canonical pathways. Comparing the gene expression data with drug-gene interaction datasets revealed drug candidates, including medrysone, simvastatin, captopril, and sulpiride, that produced gene expression changes opposite to those observed in innate or stress-induced anxiety-like behavior. Together, our data provide a comprehensive overview of FCx and Hpc gene expression differences between innate and stress-induced anxiety and support the role of inflammation and immune system in anxiety-like behavior.

The Potential of the Remote Monitoring Digital Solutions to Sustain the Mental and Emotional Health of the Elderly during and Post COVID-19 Crisis in Romania

The COVID-19 pandemic amplified the elderly's aging-related dysfunctionalities and vulnerabilities. Research surveys, aimed at evaluating the socio-physical-emotional state of the elderly and obtaining data on their access to medical services and information media services during the pandemic, were carried out on Romanian respondents aged 65+. Identification and mitigation of the risk of emotional and mental long-term decline of the elderly after SARS-CoV-2 infection, based on the implementation of a specific procedure, can be performed through Remote Monitoring Digital Solutions (RMDSs). The aim of this paper is to propose a procedure for the identification and mitigation of the risk of emotional and mental long-term decline of the elderly after SARS-CoV-2 infection that comprises RMDS. The importance of using the knowledge obtained by COVID-19-related surveys corroborating the necessity of including personalized RMDS in the procedure is highlighted. The Non-invasive Monitoring System and Health Assessment of the Elderly in a Smart Environment (RO-SmartAgeing) is an RMDS designed to address the improved preventative and proactive support for diminishing this risk and to provide suitable assistance for the elderly through a safe and efficient smart environment. Its comprehensive functionalities targeted supporting primary healthcare assistance, specific medical conditions-as the mental and emotional disorders post-SARS-CoV-2 infection-and enlarged access to aging-related information, together with customizable features, illustrated the match with the requirements included in the proposed procedure.

Simultaneous measurement of central amygdala neuronal activity and sympathetic nerve activity during daily activities in rats

NEW FINDINGS

What is the central question of this study? The functional relationships between central amygdala neuronal activity and sympathetic nerve activity in daily activities remain unclear. We aimed to measure central amygdala neuronal activity, renal and lumbar sympathetic nerve activity, heart rate, and arterial pressure simultaneously in freely moving rats. What is the main finding and its importance? Central amygdala neuronal activity (CeANA) is significantly related to renal and lumbar sympathetic nerve activity (RSNA and LSNA, respectively) and heart rate (HR) in a behavioural state-dependent and regionally different manner; meanwhile, CeANA was tightly associated with RSNA and HR across all behavioural states. Thus, it is likely that the amygdala is one of the components of neural networks for generating regional differences in renal and lumbar sympathetic nerve activity.

ABSTRACT

The central amygdala (CeA) is involved in generating diverse changes in sympathetic nerve activity (SNA) in response to changes in daily behavioural states. However, the functional relationships between CeA neuronal activity (CeANA) and SNA in daily activities are still unclear. In the present study, we developed a method for simultaneous and continuous measurement of CeANA and SNA in freely moving rats. Wistar rats were chronically instrumented with multiple electrodes (100-μm stainless-steel wire) for the measurement of CeANA, of renal SNA (RSNA) and of lumbar SNA (LSNA), and electroencephalogram, electromyogram (EMG), and electrocardiogram electrodes as well as catheters for measurement of arterial pressure (AP). During the transition from non-rapid-eye movement (NREM) sleep to quiet wakefulness, moving, and grooming states, a significant linear relationship was observed between CeANA and RSNA (P < 0.0001), between CeANA and LSNA (P = 0.0309), between CeANA and heart rate (HR) (P = 0.0123), and between CeANA and EMG (P = 0.0089), but no significant correlation was observed between CeANA and AP (P = 0.5139). During rapid eye movement sleep, the relationships between CeANA and RSNA, LSNA, HR, AP, and EMG deviated from the previously observed linear relationships, but the time course of RSNA and HR changes was the mirror image of that of CeANA, while the time course of changes in LSNA and AP was not related to that of CeANA. In conclusion, CeANA was related to RSNA, LSNA, and HR in a behavioural state-dependent and regionally different manner, while CeANA was tightly associated with RSNA and HR across all behavioural states. This article is protected by copyright. All rights reserved.