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Intermittent Hypoxia Alters the Function of Cardiovascular Neurons and Reflex Pathways in the Brainstem

  • David D. Kline
  • David MendelowitzEmail author
Chapter

Abstract

Obstructive sleep apnea, and the animal model of this disease, chronic intermittent hypoxia, alters autonomic balance and many different neurobiological functions in the brainstem that likely play an important role in both the initiation and progression of cardiovascular diseases associated with obstructive sleep apnea including hypertension and arrhythmia. Current research suggests the targets of chronic intermittent hypoxia include increased release of the excitatory neurotransmitter glutamate from baroreceptor sensory neurons, likely via altered presynaptic calcium homeostasis and increased spontaneous release of neurotransmitters from these baroreceptor sensory neurons onto brainstem neurons in the nucleus tractus solitarius. Additionally, acute exposures to hypoxia diminish excitatory and enhance inhibitory neurotransmission to parasympathetic cardiac neurons in the nucleus ambiguus that control heart rate and cardiac excitability. Future targets for restoring autonomic balance and increasing survival in these cardiorespiratory diseases require a more thorough understanding of the alterations of synaptic neurotransmission and receptor activation in the brainstem that occur with chronic intermittent hypoxia and obstructive sleep apnea.

Keywords

Obstructive Sleep Apnea Continuous Positive Airway Pressure Carotid Body Obstructive Sleep Apnea Patient Respiratory Sinus Arrhythmia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

5-HT

5-Hydroxytryptamine, serotonin

AP

Action potential

CIH

Chronic intermittent hypoxia

CPAP

Continuous positive airway pressure

CVLM

Caudal ventrolateral medulla

DA

Dopamine

EPSCs

Excitatory postsynaptic currents

IPSCs

Inhibitory postsynaptic currents

NA

Nucleus ambiguus

NMDA

N-methyl-d-aspartate

NO

Nitric oxide

NTS

Nucleus tractus solitarius

OSA

Obstructive sleep apnea

RVLM

Rostral ventrolateral medulla

TH

Tyrosine hydroxylase

Notes

Acknowledgments

Supported by NIH grants HL49965, HL59895, and HL72006 to D.M. and HL085108 to DDK.

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Copyright information

© Springer-Verlag London 2012

Authors and Affiliations

  1. 1.Department of Biomedical Sciences, Dalton Cardiovascular Research CenterUniversity of MissouriColumbiaUSA
  2. 2.Department of Pharmacology and PhysiologyThe George Washington UniversityWashingtonUSA

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