Peripheral, autonomic regulation of locus coeruleus noradrenergic neurons in brain: putative implications for psychiatry and psychopharmacology

the new data seem to allow a better understanding of how autonomic vulnerability or visceral dysfunction may precipitate or aggravate mental symptoms and disorder.

T. H. Svensson¹

(1)	Department of Pharmacology, Karolinska Institute, Box 60 400, S-104 01 Stockholm, Sweden

Received: 20 June 1986 Revised: 25 November 1986
Psychopharmacology

"Locus coeruleus (LC) is located in the ventrallateral side of the fourth ventricle in the pontine, most of which are noradrenergic neurons projecting to the cortex, cingulate cortex, amygdala nucleus, thalamus, hypothalamus, olfactory tubercles, hippocampus, cerebellum, and spinal cord (Swanson and Hartman, 1975). Norepinephrine (NE) released from the nerve terminal of LC neurons contributes to about 70% of the total extracellular NE in primates brain (Svensson, 1987). It plays important roles not only in arousal, attention, emotion control, and stress (reviewed in Aston-Jones and Cohen, 2005; Berridge and Waterhouse, 2003; Bouret and Sara, 2005; Nieuwenhuis et al., 2005; Sara and Devauges, 1989; Valentino and Van Bockstaele, 2008), but also in sensory information processing (Svensson, 1987). LC directly modulates the somatosensory information from the peripheral system. Under the stress condition, LC could completely inhibit the input from painful stimuli through the descending projection to the spinal cord (Stahl and Briley, 2004). Dys-regulations of LC neurotransmission have been suggested to be involved in physical painful symptoms, attention deficit hyperactivity disorder (ADHD), sleep/arousal disorder, post-traumatic stress disorder, depression, schizophrenia, and Parkinson's disease (reviewed in Berridge and Waterhouse, 2003; Grimbergen et al., 2009; Mehler and Purpura, 2009)."
http://journal.frontiersin.org/Journal/10.3389/fnmol.2012.00029/full

Patients complain of emotional blunting following endoscopic thoracic sympathectomy for hyperhidrosis and blushing

Hohmann, G.W. : The effect of dysfunction of the autonomic nervous system on experienced feelings and emotions

Paper read at Conference on Emotions and Feelings at New School for Social Research, New York, Oct 1962.

Sherrington, C.S.: Experiments on the value of vascular and visceral factors for the genesis of emotion 

Proc. Roy.Soc., 1900, 66, 390-403

Wenger, M.A.: Emotion as visceral action: an extension of Lange's theory. In Reymert, M.L., Feelings and emotions: the Moosehart ymposium, New York: McGraw-Hill, 1950. Pp.3-10.

Wynne, L.C., and Solomon, R.L.: Traumatic avoidance learning: acquisition and extinction in dogs deprived of normal peripheral autonomic function. 

Genet. psychol. Monogr., 1955, 52, 241-84

Landis, C., and Hunt, W. A. Adrenalin and emotion. 

Psychol. Rev., 1932, 39, 467-85.

Schachter, S., and Wheeler, L.: Epinephrine, chlorpromazine, and amusement. 

J. of abnorm. soc. Psychol., 1962, 65, 121-28.

Limbic-cortical dysregulation: a proposed model of depression

cognition and reward processing

Recent functional magnetic resonance imaging (fMRI) investigations of the interaction between cognition and reward processing have found that the lateral prefrontal cortex (PFC) areas are preferentially activated to both increasing cognitive demand and reward level. Conversely, ventromedial PFC (VMPFC) areas show decreased activation to the same conditions, indicating a possible reciprocal relationship between cognitive and emotional processing regions. We report an fMRI study of a rewarded working memory task, in which we further explore how the relationship between reward and cognitive processing is mediated. We not only assess the integrity of reciprocal neural connections between the lateral PFC and VMPFC brain regions in different experimental contexts but also test whether additional cortical and subcortical regions influence this relationship. Psychophysiological interaction analyses were used as a measure of functional connectivity in order to characterize the influence of both cognitive and motivational variables on connectivity between the lateral PFC and the VMPFC.

These findings provide evidence for a dynamic interplay between lateral PFC and VMPFC regions and are consistent with an emotional gating role for the VMPFC during cognitively demanding tasks. Our findings also support neuropsychological theories of mood disorders, which have long emphasized a dysfunctional relationship between emotion/motivational and cognitive processes in depression.
http://dl.acm.org/citation.cfm?id=1480468

depression that may occur as part of stress system dysfunction

Stress precipitates depression and alters its natural history. Major depression and the stress response share similar phenomena, mediators and circuitries. Thus, many of the features of major depression potentially reflect dysregulations of the stress response. The stress response itself consists of alterations in levels of anxiety, a loss of cognitive and affective flexibility, activation of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system, and inhibition of vegetative processes that are likely to impede survival during a life-threatening situation (eg sleep, sexual activity, and endocrine programs for growth and reproduction).
http://www.nature.com/mp/journal/v7/n3/full/4001032a.html

Limbic-cortical dysregulation: a proposed model of depression

A working model of depression implicating failure of the coordinated interactions of a distributed network of limbic-cortical pathways is proposed. Resting state patterns of regional glucose metabolism in idiopathic depressed patients, changes in metabolism with antidepressant treatment, and blood flow changes with induced sadness in healthy subjects were used to test and refine this hypothesis. Dorsal neocortical decreases and ventral paralimbic increases characterize both healthy sadness and depressive illness; concurrent inhibition of overactive paralimbic regionsand normalization of hypofunctioning dorsal cortical sites characterize disease remission. Normal functioning of the rostral anterior cingulate, with its direct connections to these dorsal and ventral areas, is postulated to be additionally required for the observed reciprocal compensatory changes, since pretreatment metabolism in this region uniquely predicts antidepressant treatment response. This model is offered as an adaptable framework to facilitate continued integration of clinical imaging findings with complementary neuroanatomical, neurochemical, andelectrophysiological studies in the investigation of the pathogenesis of affective disorders.
http://neuro.psychiatryonline.org/cgi/content/short/9/3/471

ELECTRICAL STIMULATION OF THE SYMPATHETIC NERVE CHAIN

The present invention provides a method of affecting physiological disorders by stimulating a specific location along the sympathetic nerve chain. Preferably, the present invention provides a method of affecting a variety of physiological disorders or pathological conditions by placing an electrode adjacent to or in communication with at least one ganglion along the sympathetic nerve chain and stimulating the at least one ganglion until the physiological disorder or pathological condition has been affected.

[0009] A number of treatment regiments utilizing electrical stimulation can be employed for a vast array of physiological disorders or pathological conditions associated with the sympathetic and parasympathetic nervous system. Physiological disorders that may be treated include, but are not limited to, hyperhydrosis, complex regional pain syndrome and other pain syndromes such as headaches, cluster headaches, abnormal cardiac sympathetic output, cardiac contractility, excessive blushing condition, hypertension, renal disease, heart failure, angina, hypertension, and intestinal motility disorders, dry eye or mouth disorders, sexual dysfunction, asthma, liver disorders, pancreas disorders, and heart disorders, pulmonary disorders, gastrointestinal disorders, and biliary disorders. The number of disorders to be treated is limited only by the number, variety, and placement of electrodes (or combinations of multiple electrodes) along the sympathetic nervous system.

http://www.faqs.org/patents/app/20110098762

An absence of afferent feedback concerning autonomically generated bodily states was associated with subtle impairments of emotional responses

 Neuroanatomical basis for first- and second-order representations of bodily states

H. D. Critchley1,2, C. J. Mathias2,3 and R. J. Dolan1

nature neuroscience • volume 4 no 2 • february 2001

The use of stellate ganglion block in the treatment of panic/anxiet... - PubMed - NCBI

Pain Pract. 2010 Jul-Aug;10(4):359-65. doi: 10.1111/j.1533-2500.2010.00373.x. Epub 2010 Apr 20.

http://www.ncbi.nlm.nih.gov/pubmed/20412504



Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients.

Mulvaney SW, Lynch JH, Hickey MJ, Rahman-Rawlins T, Schroeder M, Kane S, Lipov E.Mil Med. 2014 Oct; 179(10):1133-40.
In search of an effective treatment for combat-related post-traumatic stress disorder (PTSD): can the stellate ganglion block be the answer?

Lipov E.Pain Pract. 2010 Jul-Aug; 10(4):265-6.
Stellate ganglion block improves refractory post-traumatic stress disorder and associated memory dysfunction: a case report and systematic literature review.

Lipov EG, Navaie M, Brown PR, Hickey AH, Stedje-Larsen ET, McLay RN.Mil Med. 2013 Feb; 178(2):e260-4.
[Three paradigms in the treatment of posttraumatic stress disorder].

Martényi F.Neuropsychopharmacol Hung. 2005 Mar; 7(1):11-21.

Limbic System: Amygdala (Section 4, Chapter 6) Neuroscience Online: An Electronic Textbook for the Neurosciences | Department of Neurobiology and Anatomy - The University of Texas Medical School at Houston

Limbic System: Amygdala (Section 4, Chapter 6) Neuroscience Online: An Electronic Textbook for the Neurosciences | Department of Neurobiology and Anatomy - The University of Texas Medical School at Houston:



"Amygdala is the integrative center for emotions, emotional behavior, and motivation"

Limited heart rate variability, autonomic nervous system imbalance implicated in the aetiology of CFS

The Conversation: "The stress-response neural systems of chronic fatigue syndrome (CFS) patients remain on high alert even when they sleep, signalling that it’s not safe to relax, researchers have found.

Researchers also discovered that reduced heart rate variability, or changes in heart beat timing, are the best predictors of cognitive disturbances, such as concentration difficulties commonly reported by CFS sufferers. This adds to the growing body of evidence linking autonomic nervous system imbalance to this disorder.

The findings could lead to new ways to improve cognitive difficulties in people with CFS, which remains a poorly understood condition."

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0049518  

ETS results in reduced heart rate variability and alters the ANS (sympathetic and parasympathetic balance). This article might provide some insight into the cases where ETS resulted in a variety of unwelcome and detrimental side-effects, including fatigue, altered cognitive function ('brain fog'), etc.

Sympathetic chain ganglia are responsible for delivering information to the rest of the body regarding stress situations and the fight or flight response

Sympathetic chain ganglia are responsible for delivering information to the rest of the body regarding stress situations and the fight or flight response. These sympathetic ganglia are the structures that are destroyed during a sympathectomy

http://www.ast.org/publications/Journal%20Archive/2009/9_September_2009/CE.pdf

The stellate ganglion has shown to have second and third order neurons that connect with hypothalamus, amygdala, infralimbic, insular and ventromedial temporal cortical regions

Stellate ganglion block: "In the course of mapping the sympathetic nervous system to the related regions of the cerebral cortex, Westerhaus and Loewy used pseudorabies virus injections to identify connections of the stellate ganglion. Pseudorabies virus allows identification of neural pathway connections that are 2–3 synapses from the point of injection of the virus. In this manner, the use of pseudorabies virus injection is used to identify cortical areas connected to the stellate ganglion.

The stellate ganglion has shown to have second and third order neurons that connect with hypothalamus, amygdala, infralimbic, insular and ventromedial temporal cortical regions.

These data provides objective, anatomical support for the stellate ganglion interaction with several key structures known to modulate core body temperature, CRPS and PTSD."



http://flipper.diff.org/app/items/info/7052

"Similar low values are observed in patients with sympathectomy and in patients with tetraplegia"

"Patients with progressive autonomic dysfunction (including diabetes) have little or no increase in plasma noradrenaline and this correlates with their orthostatic intolerance (Bannister, Sever and Gross, 1977). In patients with pure autonomic failure, basal levels of noradrenaline are lower than in normal subjects (Polinsky, 1988). Similar low values are observed in patients with sympathectomy and in patients with tetraplegia. (p.51)

The finger wrinkling response is abolished by upper thoracic sympathectomy. The test is also abnormal in some patients with diabetic autonomic dysfunction, the Guillan-Barre syndrome and other peripheral sympathetic dysfunction in limbs. (p.46)

Other causes of autonomic dysfunction without neurological signs include medications, acute autonomic failure, endocrine disease, surgical sympathectomy . (p.100)

Anhidrosis is the usual effect of destruction of sympathetic supply to the face. However about 35% of patients with sympathetic devervation of the face, acessory fibres (reaching the face through the trigeminal system) become hyperactive and hyperhidrosis occurs, occasionally causing the interesting phenomenon of alternating hyperhidrosis and Horner's Syndrome (Ottomo and Heimburger, 1980). (p.159)



Disorders of the Autonomic Nervous System
By David Robertson, Italo Biaggioni
Edition: illustrated
Published by Informa Health Care, 1995
ISBN 3718651467, 9783718651467"

"Most patients note an immediate "calming effect" once the injection is done"

Stellate ganglion blocks have traditionally been done for pain conditions.  However, there is evidence showing some benefits for other conditions such as hyperhydrosis (excessive sweating), hot flashes,  and  painful conditions such as complex regional pain syndrome and atypical facial pain.  The stellate ganglion is the fusion of the inferior cervical ganglion and the first thoracic ganglion that mediate sympathetic fibers, also known as the adrenaline (fight or flight) nerves.  It is thought that PTSD may have sympathetically mediated pathways that are amenable to blocking this nerve structure.  Most patients note an immediate "calming effect" once the injection is done.  Some are even able to stop medications and have social interactions in public that they otherwise would not have been able to do.

http://www.painhonolulu.com/services/stellate-ganglion-blocks-for-ptsd/

HRV, mood disorders

Int J Psychophysiol. 2013 Sep;89(3):288-96. doi: 10.1016/j.ijpsycho.2013.06.018. Epub 2013 Jun 22.

The relationship between mental and physical health: insights from the study of heart rate variability.

Kemp AH1, Quintana DS.

Author information

• 1SCAN Research & Teaching Unit, School of Psychology, University of Sydney, Australia; Discipline of Psychiatry, University of Sydney, Australia; Hospital Universitário, University of São Paulo, São Paulo, Brazil. Electronic address: andrew.kemp@sydney.edu.au.

Abstract

Here we review our recent body of work on the impact of mood and comorbid anxiety disorders, alcohol dependence, and their treatments on heart rate variability (HRV), a psychophysiological marker of mental and physical wellbeing. We have shown that otherwise healthy, unmedicated patients with these disorders display reduced resting-state HRV, and that pharmacological treatments do not ameliorate these reductions. Other studies highlight that tricyclic medications and the serotonin and noradrenaline reuptake inhibitors in particular may have adverse cardiovascular consequences. Reduced HRV has important functional significance for motivation to engage social situations, social approach behaviours, self-regulation and psychological flexibility in the face of stressors. Over the longer-term, reduced HRV leads to immune dysfunction and inflammation, cardiovascular disease and mortality, attributable to the downstream effects of a poorly functioning cholinergic anti-inflammatory reflex. We place our research in the context of the broader literature base and propose a working model for the effects of mood disorders, comorbid conditions, and their treatments to help guide future research activities. Further research is urgently needed on the long-term effects of autonomic dysregulation in otherwise healthy psychiatric patients, and appropriate interventions to halt the progression of a host of conditions associated with morbidity and mortality.

Stellate ganglion block - a form of chemical sympathectomy - alleviates anxiety, depression

Among veterans with post-traumatic stress disorder, treatment with a single stellate ganglion block could help alleviate anxiety, depression and psychological pain rapidly and for long-term use, according to results presented at the American Society for Anesthesiologists Annual Meeting.

See Also

• Experts propose nerve blocks to treat PTSD
• DSM-5 PTSD screening may miss previously diagnosed ...
• Amygdala activation could predict PTSD susceptibility ...

Researchers performed a single right-sided stellate ganglion block (SGB) using 7 mL of 2% lidocaine and 0.25% bupivacaine under fluoroscopic guidance on 12 veterans with military-related, chronic extreme post-traumatic stress disorder (PTSD) with hyperarousal symptoms. At baseline, 1 week, 1 month, 3 months and 6 months post-block, PTSD symptoms were assessed using the Clinician Administered PTSD Scale (CAPS) score and the Post-traumatic Stress Self Report (PSS-SR) scale. Depressive symptoms were assessed with the Beck Depression Inventory version 2. Anxiety related symptoms with a generalized anxiety scale score and the State-Trait Anxiety Index and psychological pain with the Mee-Bunney scale.

Study results showed the block was greatly effective in 75% of participants, with a positive effects taking effect often within minutes of SGB. At week 1, there was significant reduction of both CAPS and PSS-SR and researchers found CAPS approached normal-to-mild PTSD levels by 1 month. Anxiety, depression and psychological pain scores also were significantly reduced by the block, according to study results. Overall, positive effects remained evident at 3 months, but were generally gone by 6 months.

Reference:

Alkire MT. A1046. Presented at: American Society for Anesthesiologists Annual Meeting;  Oct. 11-15, 2014; New Orleans.

http://www.healio.com/psychiatry/ptsd/news/online/%7B14e0a858-100a-43b1-a0e0-47c6376cb885%7D/stellate-ganglion-block-alleviates-anxiety-depression-for-veterans-with-ptsd

The hypothalmus also regulates body temperature

Question:

1. Does sympathectomy affect the hypothalamus?

The hypothalamus controls hunger, thirst, [1] fatigue, anger, and circadian cycles.It also regulates body temperature. 

2. Can the subsequent Compensatory Sweating that follows after Sympathectomy be a symptom of the dysregulated hypotalamus? 

Research suggests that T2 sympathectomy affects melatonin levels.

see: Influence of sympathectomy in humans on the rhythmicity of 6-sulphatoxymelatonin urinary excretion. / Møller, Morten; Osgaard, Ole; Grønbech-Jensen, Michael.

In: Molecular and Cellular Endocrinology, Vol. 252, No. 1-2, 2006, p. 40-5.

"The amount of 6-sulphatoxymelatonin, the chief metabolite of melatonin, in the urine was measured in nine patients, who were subjected to bilateral sympathectomy at the second thoracic ganglionic level for treatment of hyperhidrosis of the palms. All patients showed before surgery a normal 6-sulphatoxymelatonin excretion with a peak in the excretion during the night time. After the sympathectomy, the high night time excretion was clearly abolished in five patients but remained high in four patients. This indicates that the segmental locations of the preganglionic sympathetic perikarya in the spinal cord, stimulating the melatonin secretion in the pineal gland in humans, vary between individuals. An increase in daytime melatonin excretion was observed in the patients responding to the sympathectomy with an abolished 6-sulphatoxymelatonin rhythm. This increase could indicate that the final sympathetic neurons innervating the pineal gland might have a both stimulatory and inhibitory function."
and:

J Clin Endocrinol Metab. 1991 Apr;72(4):819-23.

Sequential cerebrospinal fluid and plasma sampling in humans: 24-hour melatonin measurements in normal subjects and after peripheral sympathectomy.

Bruce J1, Tamarkin L, Riedel C, Markey S, Oldfield E.

Author information

Abstract

Simultaneous measurements of plasma and cerebrospinal fluid (CSF) melatonin and urinary excretion of 6-hydroxymelatonin were performed in four normal volunteers and one patient before and after upper thoracic sympathectomy for the control of essential hyperhidrosis. For normal individuals, hourly 24-h melatonin concentrations in plasma and CSF exhibited similar profiles, with low levels during the day and high levels at night. Peak plasma levels varied from 122-660 pmol/L, and the peak CSF levels from 94-355 pmol/L. The onset of the nocturnal increase in melatonin did not occur at the same time for each individual. Urinary 6-hydroxymelatonin levels also exhibited a daily rhythm, with peak excretion at night. The individual with the lowest nocturnal levels of circulating melatonin also had the lowest excretion of 6-hydroxymelatonin. In the patient with hyperhidrosis, a prominent melatonin rhythm was observed preoperatively in the CSF and plasma. After bilateral T1-T2 ganglionectomy, however, melatonin levels were markedly reduced, and the diurnal rhythm was abolished. These results provide direct evidence in humans for a diurnal melatonin rhythm in CSF and plasma as well as regulation of this rhythm by sympathetic innervation.

Altered dopamine beta-hydroxylase (DBH) activity has been reported in mood disorders. Plasma DBH is reduced in major depression with psychosis

Recognition and treatment of comorbid chronic psychotic symptoms in post-traumatic stress disorder (PTSD) has become of increasing clinical interest. Altered dopamine beta-hydroxylase (DBH) activity has been reported in mood disorders. Plasma DBH is reduced in major depression with psychosis and elevated in bipolar disorder with psychosis compared with their respective non-psychotic diagnostic groups. DBH is likely a trait marker with interindividual variations secondary to genetic polymorphism. We therefore evaluated DBH activity in PTSD patients with and without psychotic features and compared these groups with age- and gender-matched control subjects. Vietnam combat veterans with PTSD (n=19) (including patients with and without psychotic features) and normal control subjects (n=22) had plasma DBH enzyme activity assayed photometrically. DBH was significantly higher in patients with PTSD with psychotic features than in patients without psychotic features (80.6±13.4 vs. 42.1±7.3 mM/min, P<0.01)>P<0.01).>

Plasma dopamine beta-hydroxylase activity in psychotic and non-psychotic post-traumatic stress disorder

Authors: Hamner M.B.¹; Gold P.B.

Source: Psychiatry Research, Volume 77, Number 3, 27 February 1998 , pp. 175-181(7)

1. Serum Dopamine-β-Hydroxylase: Decrease after Chemical Sympathectomy

Science 3 September 1971: 

Vol. 173 no. 4000 pp. 931-934DOI:10.1126/science.173.4000.931
2. After sympathectomy we have studied the re-appearence of nerve fibers showing catecholaminergic characteristics in the uvea of the guinea pig. Immunoreactivities for two catecholamine symthetizing enzymes, tyrosine hydroxylase (TH) and dopaminebeta-hydroxylase (DBH), were used as markers. Both TH-like and DBH-like immunoreactive nerve fibers disappeared after the extirpation of ipsilateral superior cervical ganglion. In the choroid the TH-like and DBH-like immunoreactive nerve fibers re-appeared within 2 weeks. In the iris and the ciliary body both of these types of immunoreactive nerve fibers re-appeared 10 weeks after the denervation. The morphological appearence of these re-appearing nerve fibers was not similar to those in the non-denervated uvea.

Nerve fibers showing immunoreactivities for thyrosine hydroxylase and dopamine-beta-hydroxylase re-appear in the guinea pig uvea after sympathectomy

1. J. Lehtosalo^*, 
2. L. Eränkö, 
3. A. Palkama and
4. H. Uusitalo

Article first published online: 27 MAY 2009

DOI: 10.1111/j.1755-3768.1988.tb04034.x

Acta Ophthalmologica

Volume 66, Issue 4, pages 419–426, August 1988

3. We speculate from these data that low brain DBH activity may produce a type of vulnerability to psychotic decompensation and thereby influence the clinical course, although it does not cause schizophrenia, in general. Low CSF DBH activity may delineate a "reactive" subgroup from the heterogenous population of patients with diagnoses of schizophrenia.

CSF Dopamine β-Hydroxylase in Schizophrenia

Arch Gen Psychiatry. 1983;40(7):743-747. doi:10.1001/archpsyc.1983.01790060041005.

Sympathectomy and parasympathectomy leads to the hyperfunction of the serotoninergic system and pathology

We studied the balance of activity of sympathetic, parasympathetic, and serotoninergic divisions of the autonomic nervous system in the regulation of the heart function in rabbits. High activities of the sympathetic and parasympathetic system are associated with antagonistic interactions between them. Moderation of activity of these systems could be accompanied by activation of the serotoninergic system. Physiological sympathectomy and parasympathectomy lead to hyperfunction of the serotoninergic system and pathology.

Bulletin of Experimental Biology and Medicine, Vol. 140, No. 5, 2005 PHYSIOLOGY

Disturbances in brain serotonergic systems result in a range of phenotypes such as depression, suicide and anxiety disorders.
http://www.biomedcentral.com/1471-2202/10/50

Sympathetic chain ganglia are responsible for delivering information to the rest of the body regarding stress situations and the fight or flight response

Sympathetic chain ganglia are responsible for delivering information to the rest of the body regarding stress situations and the fight or flight response. These sympathetic ganglia are the structures that are destroyed during a sympathectomy.
http://www.ast.org/publications/Journal%20Archive/2009/9_September_2009/CE.pdf

from: SURGICAL TECHNOLOGY FOR THE SURGICAL TECHNOLOGIST, A POSITIVE CARE APPROACH

Author: Association of Surgical Technologists
Edition: 003
Product Type: Book w/Multimedia (CD, DVD or Electronic)
ISBN 13: 9781418051686
ISBN 10: 1418051683
Copyright: 2008

distinct patterns of peripheral physiological activity are associated with different emotion

The existence of specific somatic states associated with different emotions remains controversial. In this study, we investigated the profile of cardiorespiratory activity during the experience of fear, anger, sadness and happiness. ECG and respiratory activity was recorded in 43 healthy volunteers during the recall and experiential reliving of one or two potent emotional autobiographical episodes and a neutral episode. Univariate statistics indicated that the four emotions differed from each other and from the neutral control condition on several linear and spectral indices of cardiorespiratory activity. Dependent variables were further reduced to five physiologically meaningful factors using an exploratory principal component analysis (PCA). Multivariate analyses of variance and effect size estimates calculated on those factors confirmed the differences between the four emotion conditions. A stepwise discriminant analyses predicting emotions using the PCA factors led to a classification rate of 65.3% for the four emotions (chance=25%; p=0.001) and of 72.0-83.3% for pair-wise discrimination (chance=50%; p's<0.05). These findings may be considered preliminary in view of the small sample on which the multivariate approach has been applied. However, this study emphasizes the need to better characterize the multidimensional factors involved in cardio-respiratory regulation during emotion. These results are consistent with the notion that distinct patterns of peripheral physiological activity are associated with different emotions. 

http://www.ncbi.nlm.nih.gov/pubmed/16439033

In 1965, Schildkraut postulated that noradrenaline may play a pivotal role in the aetiology of depression

In favour of this hypothesis was the observation that the antihypertensive drug reserpine, which depletes central and peripheral vesicular stores of catecholamines such as noradrenaline, can precipitate depression in patients in remission. The experimental drug {alpha}-methyl-paratyrosine that blocks the synthesis of noradrenaline and dopamine by inhibiting the rate-limiting enzyme tyrosine hydroxylase also precipitates depression in patients during remission. Such findings are only indirect indicators that noradrenaline plays an important role in human behaviour, and may be defective in depression – more direct evidence is needed to substantiate the hypothesis. In depression, it should be emphasised that the reduced growth hormone response to clonidine cannot be accounted for by the drug treatment, age or gender of the patient, which supports the view that the noradrenergic system is dysregulated. Lastly, determination of the urine or plasma concentrations of MHPG (an indicator of central noradrenergic activity), suggests that central noradrenergic function is sub-optimal in depression. Taken together, these results suggest that central noradrenergic function is decreased in depression, an event leading to an increase in the density of the post-synaptic ß-adrenoceptors (Leonard, 1986; Dinan, 1994). The role of serotonin (5-hydroxytryptamine, 5-HT) has also been extensively studied in patients with depression. Whereas the overall psychophysiological effects of noradrenaline in the central nervous system appear to be linked to drive and motivation, 5-HT is primarily involved in the expression of mood (see Charney et al, 1991). The main 5-HT metabolite, 5-hydroxyindole acetic acid (5-HIAA), is reduced in the cerebrospinal fluid (CSF) of patients with severe depression, as are 5-HT and 5-HIAA in the limbic regions of the brain of suicide victims (Agren, 1980). Serotonin receptor function is also abnormal in depression with an increase in the density of cortical 5-HT2a receptors in the brains of suicide victims and also on the platelet membrane of patients with depression. Dopaminergic function Studies on platelets, lymphocytes, changes in cerebrospinal fluid metabolites of brain monoamines and post-mortem studies suggest that a major abnormality in both noradrenergic and serotonergic function occurs in depression, and that such changes could be causally related to the disease process. Less attention has been paid to the possible involvement of dopamine in this disorder. However, anhedonia is a characteristic feature of major depression, and a defect in dopaminergic function is thought to be causally involved in this symptom (Willner, 1983). The concentration of the main dopamine metabolite, homovanillic acid (HVA), is decreased in the CSF of patients with depression, particularly those with psychomotor retardation.

Advances in Psychiatric Treatment (2000) 6: 178-186 © 2000 The Royal College of Psychiatrists  Clinical implications of mechanisms of action of antidepressants  Brian Leonard

sympathectomy (ETS or ESB) can alleviate social phobia and common fears such as fear of flying, heights, open spaces, or the darkness

Is sympathectomy the new lobotomy?

"ESB may also alleviate social phobia and common fears such as fear of flying, heights, open spaces, or the darkness. In addition, it can be used to decrease trembling of the body, hands, and voice, even stuttering. It may help in alcoholism or drug withdrawal, because these are often linked with social anxiety. 
Sympathetic block is a gentle and exact endoscopic procedure. It is performed as day surgery under light anesthesia."

http://www.sympatix.fi/?lang=en
or
https://archive.today/1V5nX

Depletion of peripheral sympathetic noradrenaline led to significant decrements in escape and avoidance responding

PsycNET - Option to Buy: "Chemical sympathectomy and avoidance learning in the rat.

By Di Giusto, E. L.; King, M. G.
Journal of Comparative and Physiological Psychology, Vol 81(3), Dec 1972, 491-500.
Abstract
Reports results of 5 experiments with male Wistar rats (N = 108). Depletion of peripheral sympathetic noradrenaline induced by administration of 6-hydroxydopamine, ip, led to significant decrements in escape and avoidance responding when the required response was difficult, but not when it was relatively easy to acquire. Results are similar to previous findings obtained with adrenal-demedullated Ss. Findings clarify the role of the sympathetic nervous system in the motivation of behavior elicited by aversive stimulation. Implications for 2-process theory and the "Kamin effect," or "learned helplessness," are discussed. (40 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)"

significant associations between heart rate and regional cerebral blood flow

The HRV analysis showed a significant change of indices reflecting sympatho-vagal balance indicating significantly reduced sympathetic (LF) and increased vagal (HF, rMSSD) tone. These changes still persisted after 2 years. Global HRV increased over time with significant elevation of SDANN after 2 years. QT dispersion was significantly reduced 1 month after surgery and the dispersion was further diminished 2 years later.

http://www.sciencedirect.com/science/article/pii/S0167527399001011

significant associations between heart rate and regional cerebral blood flow:

Neurosci Biobehav Rev. 2012 Feb;36(2):747-56. doi: 10.1016/j.neubiorev.2011.11.009. Epub 2011 Dec 8.

A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health.

The intimate connection between the brain and the heart was enunciated by Claude Bernard over 150 years ago. In our neurovisceral integration model we have tried to build on this pioneering work. In the present paper we further elaborate our model and update it with recent results. Specifically, we performed a meta-analysis of recent neuroimaging studies on the relationship between heart rate variability and regional cerebral blood flow. We identified a number of regions, including the amygdala and ventromedial prefrontal cortex, in which significant associations across studies were found. We further propose that the default response to uncertainty is the threat response and may be related to the well known negativity bias. Heart rate variability may provide an index of how strongly 'top-down' appraisals, mediated by cortical-subcortical pathways, shape brainstem activity and autonomic responses in the body. If the default response to uncertainty is the threat response, as we propose here, contextual information represented in 'appraisal' systems may be necessary to overcome this bias during daily life. Thus, HRV may serve as a proxy for 'vertical integration' of the brain mechanisms that guide flexible control over behavior with peripheral physiology, and as such provides an important window into understanding stress and health.

http://www.ncbi.nlm.nih.gov/pubmed/22178086