Genetic, Epigenetic, and Environmental Factors Influencing Neurovisceral Integration of Cardiovascular Modulation: Focus on Multiple Sclerosis.
Thought to be an autoimmune inflammatory CNS disease, multiple sclerosis (MS) involves multiple pathologies with heterogeneous clinical presentations. An impaired neurovisceral integration of cardiovascular modulation, indicated by sympathetic and parasympathetic autonomic nervous system (ANS) dysfunction, is among common MS clinical presentations. ANS dysfunction could not only enhance MS inflammatory and neurodegenerative processes, but can also lead to clinical symptoms such as depression, fatigue, sleep disorder, migraine, osteoporosis, and cerebral hemodynamic impairments. Therefore, factors influencing ANS functional activities, in one way or another, will have a significant impact on MS disease course. This review describes the genetic and epigenetic factors, and their interactions with a number of environmental factors contributing to the neurovisceral integration of cardiovascular modulation, with a focus on MS. Future studies should investigate the improvement in cardiovascular ANS function, as a strategy for preventing and minimizing MS-related morbidities, and improving patients' quality of life.
Department of Neurology, Stroke Center, Buffalo Medical Center, 100 High St., Buffalo, NY, 14203, USA. zs2@buffalo.edu.
Zohara
Z
Sternberg
D000109:Acetylcholine / Q000502:physiology; D000375:Aging / Q000502:physiology; D001341:Autonomic Nervous System / Q000503:physiopathology; D002317:Cardiovascular Agents / Q000494:pharmacology; D044127:Epigenesis, Genetic; D005260:Female; D005583:Fourier Analysis; D059647:Gene-Environment Interaction; D012739:Gonadal Steroid Hormones / Q000502:physiology; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007239:Infections / Q000503:physiopathology; D008297:Male; D009103:Multiple Sclerosis / Q000235:genetics / Q000503:physiopathology* / Q000628:therapy; D009419:Nerve Tissue Proteins / Q000235:genetics; D009638:Norepinephrine / Q000502:physiology; D011110:Polymorphism, Genetic; D044469:Racial Groups / Q000235:genetics; D017981:Receptors, Neurotransmitter / Q000235:genetics; D012907:Smoking / Q000503:physiopathology; D014630:Vagus Nerve / Q000503:physiopathology
D002317:Cardiovascular Agents; D012739:Gonadal Steroid Hormones; D009419:Nerve Tissue Proteins; D017981:Receptors, Neurotransmitter; D000109:Acetylcholine; D009638:Norepinephrine
Depression; Disease modifying drug; Dysautonomia; Epstein–Barr virus; Heart rate variability; Immunomodulation; Neurodegeneration; Smoking; Steroid hormones; Sympathovagal balance