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Recording sympathetic nerve activity in conscious humans and other mammals: guidelines and the road to standardization

TLDR
The goal of the present paper is to put together a summary of "best practices" in several of the most common experimental models and to discuss opportunities and challenges relative to the optimal measurement of SNA across species.
Abstract
Over the past several decades, studies of the sympathetic nervous system in humans, sheep, rabbits, rats, and mice have substantially increased mechanistic understanding of cardiovascular function and dysfunction. Recently, interest in sympathetic neural mechanisms contributing to blood pressure control has grown, in part because of the development of devices or surgical procedures that treat hypertension by manipulating sympathetic outflow. Studies in animal models have provided important insights into physiological and pathophysiological mechanisms that are not accessible in human studies. Across species and among laboratories, various approaches have been developed to record, quantify, analyze, and interpret sympathetic nerve activity (SNA). In general, SNA demonstrates "bursting" behavior, where groups of action potentials are synchronized and linked to the cardiac cycle via the arterial baroreflex. In humans, it is common to quantify SNA as bursts per minute or bursts per 100 heart beats. This type of quantification can be done in other species but is only commonly reported in sheep, which have heart rates similar to humans. In rabbits, rats, and mice, SNA is often recorded relative to a maximal level elicited in the laboratory to control for differences in electrode position among animals or on different study days. SNA in humans can also be presented as total activity, where normalization to the largest burst is a common approach. The goal of the present paper is to put together a summary of "best practices" in several of the most common experimental models and to discuss opportunities and challenges relative to the optimal measurement of SNA across species.Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/guidelines-for-measuring-sympathetic-nerve-activity/.

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Hart, E. C., Head, G. A., Carter, J. R., Wallin, B. G., May, C. N.,
Hamza, S. M., Hall, J. E., Charkoudian, N., & Osborn, J. W. (2017).
Recording sympathetic nerve activity in conscious humans and other
mammals: guidelines and the road to standardization.
AJP - Heart and
Circulatory Physiology
,
312
(5), H1031-H1051.
https://doi.org/10.1152/ajpheart.00703.2016
Peer reviewed version
License (if available):
Unspecified
Link to published version (if available):
10.1152/ajpheart.00703.2016
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This is the author accepted manuscript (AAM). The final published version (version of record) is available online
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University of Bristol - Explore Bristol Research
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H-00703-2016 R2
1
Recording sympathetic nerve activity in conscious humans and other mammals:
guidelines and the road to standardization
Emma C. Hart
1
, Geoffrey A. Head
2
, Jason R. Carter
3
, B. Gunnar Wallin
4
, Clive N.
May
5
, Shereen M. Hamza
6
, John E. Hall
7
, Nisha Charkoudian
8
and John W. Osborn
9
Running title: Guidelines for measuring sympathetic nerve activity
1
University of Bristol, School of Physiology, Pharmacology and Neuroscience, Bristol,
United Kingdom
2
Baker IDI Heart and Diabetes Institute, Melbourne, Australia
3
Michigan Technological University, Houghton, MI, USA
4
University of Gothenburg, Gothenburg, Sweden
5
Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville,
Victoria, Australia
6
University of Alberta, Canada
7
Department of Physiology and Biophysics, Mississippi Center for Obesity Research,
University of Mississippi Medical Center, Jackson, MS, USA
8
US Army Research Institute of Environmental Medicine, Natick, MA, USA
9
University of Minnesota, Department of Integrative Biology and Physiology, Medical
School, Minneapolis, MN, USA
Corresponding author: Dr. Emma C. Hart
School of Physiology Pharmacology and Neurosciences, Biomedical Sciences Building,
University of Bristol, BS8 1TD, UK. Email: emma.hart@bristol.ac.uk
Running title: Measuring and interpreting SNA in mammals

H-00703-2016 R2
2
Contents outline
1. Abstract
2. Introduction to the measurement of sympathetic nerve activity
3. Recording SNA in humans: microneurography
3.1. Multi-unit recordings of SNA
3.2. Single unit recordings
4. Recording SNA in conscious animals
4.1. Multi-unit recordings of SNA in conscious rabbits
4.2 Multi-unit recordings of SNA in conscious sheep
4.3. Recording SNA in conscious rats
4.4 Recording RSNA in conscious mice
4.5. Single unit recordings in animals
5. Similarities and differences between human and animal recordings of SNA
6. Criteria for validating sympathetic nerve activity
7. Overall summary and directions for future work

H-00703-2016 R2
3
1. Abstract
Over the past several decades, studies of the sympathetic nervous system in humans,
sheep, rabbits, rats and mice have substantially increased mechanistic understanding of
cardiovascular function and dysfunction. Recently, interest in sympathetic neural
mechanisms contributing to blood pressure control has grown, due in part to the
development of devices or surgical procedures, which treat hypertension by
manipulating sympathetic outflow. Studies in animal models have provided important
insights into physiological and pathophysiological mechanisms, which are not accessible
in human studies. Across species and among laboratories, various approaches have
been developed to record, quantify, analyze and interpret sympathetic nerve activity
(SNA). In general, SNA demonstrates “bursting” behavior, where groups of action
potentials are synchronized and linked to the cardiac cycle via the arterial baroreflex. In
humans, it is common to quantify SNA as bursts/minute or bursts/100 heartbeats. This
type of quantification can be done in other species, but is only commonly reported in
sheep, which have heart rates similar to humans. In rabbits, rats and mice, SNA is often
recorded relative to a maximal level elicited in the laboratory to control for differences in
electrode position among animals or on different study days. SNA in humans can also
be presented as total activity, where normalization to the largest burst is a common
approach. The goal of the present paper is to put together a summary of “best
practices” in several of the most common experimental models, and to discuss
opportunities and challenges relative to the optimal measurement of SNA across
species.
Keywords: blood pressure, autonomic nervous system, nerve recording, rat, rabbit,
sheep, mouse, human

H-00703-2016 R2
4
2. Introduction
Over the past several decades, the importance of sympathetic nerve activity (SNA) in
the control of human cardiovascular function has become increasingly clear. Elevations
in SNA have important roles in the pathophysiology of essential and renovascular
hypertension, as well as chronic kidney disease and congestive heart failure. From a
physiological perspective, the sympathetic nervous system is of considerable interest, as
it transmits patterns of information embedded in frequencies of nerve firing that provide
fine regulation of blood flow, perfusion pressure, cardiac output, and release of
hormones such as renin.
From the earliest recordings of postganglionic sympathetic nerves in anesthetized
rabbits and decerebrate cats by Adrian, Bronk and Phillips in the 1930’s, the distinctive
patterns of respiratory and cardiac coupling revealed that adaptation of brain centers
controlling SNA occurred at a rapid rate and that SNA was never really “steady” (1).
Importantly, different vascular beds receive levels of activity influenced by different
afferent and central signals. Thermoregulatory information controls SNA to skin as does
the level of oxygen, whereas baroreceptor input appears to have less influence (103). By
contrast, muscle, renal, splanchnic and cardiac SNA are strongly influenced by
baroreceptors and chemoreceptors (56). Thus recordings of sympathetic nerves were
recognized to reveal a dynamic window into the workings of the cardiovascular and
thermoregulatory systems.
While many studies extended these findings to other species, including rats and mice,
the impact of anesthesia on cardiovascular and autonomic function has limited the
usefulness of the technique. Kirchner described the first recordings from an
unanesthetized cat by means of chronically implanted electrodes embedded into a

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References
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Norepinephrine spillover to plasma in patients with congestive heart failure: evidence of increased overall and cardiorenal sympathetic nervous activity.

TL;DR: There is marked regional variation, inapparent from measurements of plasma norepinephrine concentration, in sympathetic nerve activity in patients with congestive heart failure.
Journal ArticleDOI

General Characteristics of Sympathetic Activity in Human Skin Nerves

TL;DR: The sympathetic activity was not pulse synchronous as in muscle nerves and the spontaneous sympathetic volleys occurred largely independently of spontaneous blood pressure variations, indicating a relative lack of baroreflex control of the vasoconstrictor outflow to the skin.
Journal ArticleDOI

Manoeuvres affecting sympathetic outflow in human skin nerves.

TL;DR: It was concluded that most manoeuvres had different effects in the two nerve types, thereby confirming earlier indirect evidence for selective regional control of the sympathetic outflow.
Journal ArticleDOI

Activity from skin mechanoreceptors recorded percutaneously in awake human subjects.

TL;DR: A technique is described which allows recording of multi-fiber discharge and single-unit activity from intact peripheral nerves of awake human subjects and it was possible to judge when afferent nerve fibers of cutaneous origin lay close to the electrode tip by the quality of the insertion paresthesias and the type of peripheral stimuli required to induce afferent responses.
Journal ArticleDOI

Influence of the Menstrual Cycle on Sympathetic Activity, Baroreflex Sensitivity, and Vascular Transduction in Young Women

TL;DR: The present study suggests that the hormonal fluctuations that occur during the normal menstrual cycle may alter sympathetic outflow but not the transduction of sympathetic activity into vascular resistance.
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