It’s not unusual to hear people describe themselves as emotionally 'colder'

It’s not unusual to hear people who have undergone sympathectomies describe themselves as feeling emotionally “colder” than before. Among psychologists and neurologists alike there is concern, but no evidence, that the procedure limits alertness and arousal as well as fear, and might affect memory, empathy and mental performance. Professor Ronald Rapee, the director of the Centre of Emotional Health at Sydney’s Macquarie University, says he’s counselled several people who complain of feeling “robot-like” in the long-term wake of the operation. “They’re happy they no longer blush, but they miss the highs and lows they used to feel.”
(John van Tiggelen, Good Weekend Magazine, The Age and the Sydney Morning Herald, 10th March 2012)
https://archive.today/uURge

Monday, 30 November 2015

Individual studies showed that the alterations in skin were related to the changes which occurred in the mental state


Individual studies showed that the alterations in skin resistance which followed prefrontal leucotomy were related to the changes which occurred in the mental state. They were not related to changes in thermo-regulation.

A PERSISTING CHANGE IN PALMAR SWEATING FOLLOWING PREFRONTAL LEUCOTOMY
BY
ALICK ELITHORN, MALCOLM F. PIERCY, and MARGARET A. CROSSKEY From the Neurological Research Unit of the Medical Research Council and the Department ofPsychology,
NationalHospital,QueenSquare,London 
J.Neurol. Neurosurg. Psychiat., 1954, 17, 196.
 

Saturday, 21 November 2015

Patients report that they feel less anxious in stressful situations. Stage fright is reduced.

The results are usually immediate and a surprise to the patient who finds him/herself dry and warm for the first time in many years. The procedure is almost always successful. If the patient has reported plantar (foot) hyperhidrosis, in two out of three cases this is resolved by the surgery also. Patients report that they feel less anxious in stressful situations. Stage fright is reduced. The results are usually permanent. 


Snipping the nerve can stop 'flight-or-fight' stress response impacting heart


What do sweaty palms and abnormal heart rhythms have in common? Both can be initiated by the nervous system during an adrenaline-driven "flight-or-fight" stress reaction, when the body senses danger.

Hyperhidrosis, an abnormal flight-or-fight response of the sympathetic nervous system that causes excessively sweaty palms may also contribute to problems like dangerous irregular rhythms from the lower chambers of the heart, known as ventricular arrhythmias.

UCLA cardiologists have now found that surgery to snip nerves associated with the sympathetic nervous system on both the left and right sides of the chest may be helpful in stopping dangerous, incessant ventricular arrhythmias — known as an "electrical storm" — when other treatment methods have failed. This same type of surgery has been used for years to alleviate hyperhidrosis.

The UCLA team's findings are reported in the Dec. 27–Jan. 3 issue of the Journal of the American College of Cardiology. The study is one of the first to assess the impact of bilateral cardiac sympathetic denervation (BCSD), surgery on both sides of the heart, to control arrhythmias. The research builds on previous work at UCLA in which a similar procedure was performed only on the left side. But for some patients to obtain relief, the researchers said, it must be done bilaterally. 


flight/fright response loss after sympathectomy

Side effects were reported by 42 of 44 (95%). Twenty-nine patients (66%) reported dryness on left side, 26 (59%) a Harlequin-type (unilateral) facial flush, 24 (55%) contralateral hyperhidrosis, 17 (39%) differential hand temperatures, 5 (11%) permanent and 4 (9%) transient ptosis, 5 (11%)thermoregulation difficulties, 4 (9%) a sensation of left arm paresthesia, and 3 (7%) sympathetic flight/fright response loss.

Circ Arrhythm Electrophysiol. 2015 Oct;8(5):1151-8. doi: 10.1161/CIRCEP.115.003159. Epub 2015 Jul 29.
Physical and Psychological Consequences of Left Cardiac Sympathetic Denervation in Long-QT Syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia.

Excerpts from the full text:

The present study documents high rates of morbidity related to side effects, sometimes associated with significant levels of embarrassment and distress. 
Extent of surgical resection influenced risk of ptosis, but not of other outcomes
Emotional/Psychological Sequelae
Loss of Sympathetic Flight/Fright Response
Three women (7%) reported that they were much calmer in situations that previously would have been alarming or frightening. One also felt detached in sad or angry circumstances. 
(interestingly - but not surprisingly - the authors put a positive spin on this complication. Calmer can be described as numb... but here it is made out to be a positive... Also they are tweaking the detachment issue. Surely, the person did not feel detached ONLY in sad or angry circumstances. What about joyous, exhilarating, feeling full of life circumstances?....

This study describes the unilateral procedure...
and the page archived:

sympathectomized subjects act but do not feel emotional

in the absence of autonomic arousal, behavior that appears emotional will not be experienced as emotional

"In the presence of a barking dog, for example, the sympathectomized cats manifested almost all of the signs of feline rage. Finally, Cannon notes the report of Dana (1921) that a patient with a spinal-cord lesion and almost totally without visceral sensation still manifested emotionality.
For either the Jamesian or the present formulation such data are crucial, since both views demand visceral arousal as a necessary condition for emotional arousal. When faced with this evidence, James's defenders (e.g., Wenger, 1950; Mandler, 1962) have consistently made the point that the apparently emotional behavior manifested by sympathectomizied animals and men is well-learned behavior, acquired long before sympathectomy. There is a dual implication in this position: first, that sympathetic arousal facilitates the acquisition of emotional behavior, and second, that sympathectomized subjects act but do not feel emotional. There is a small but growing evidence supporting these contentions. Wynne and Solomon (1955) have demonstrated that sympathectomized dogs acquire an avoidance response considerably more slowly than control dogs. Further, on extinction trials most of their 13 sympathectomized animals extinguished quickly, whereas not a single one of the 30 control dogs gave any indication of extinction over 200 trials. Of particular interest are two dogs who were sympathectomized after they had acquired the avoidance response. On extinction trials these two animals behaved precisely like the control dogs - giving no indication of extinction. Thus, when deprived of visceral innervation, animals are quite slow in acquiring emotionally-linked avoidance responses and in general, quick to extinguish such responses." (p. 163)

"A line of thought stimulated by the Wynne and Solomon (1955) and the Hohmann (1962) studies may indeed be the answer to Cannon's observations that there can be emotional behavior without visceral activity. From the evidence of these studies, it would appear, first, that autonomic arousal greatly facilitates the acquisition of emotional behavior but it is not necessary for its maintenance if the behavior is acquired prior to sympathectomy; and second, that in the absence of autonomic arousal, behavior that appears emotional will not be experienced as emotional." (p. 167)

Norepinephrine depletion commonly is the desired effect, other neurotransmitters (eg ATP, NPY and enkephalins) are depleted by sympathectomy


The term Sympathectomy used in this discussion refers mainly to the lesioning of postganglionic noradrenergic (NA) neurons and fibers except where noted. Although norepinephrine depletion commonly is the desired effect, other costored neurotransmitters (eg ATP, NPY and enkephalins) are depleted by sympathetic denervation. The multitude of research studying the effects of sympathetic loss is made possible by the morphologically defined anatomy of the postganglionic sympathetic chains, the sensitivity of postganglionic NA neurons to nerve growth factor (NGF) deprivation, and the phenotypic specialty of these neurons that allows for the selective uptake of neurotoxins.

Primer on the Autonomic Nervous System

By David RobertsonPublished 2004

Wednesday, 4 November 2015

"The effect is a normalization (?!) of the threshold to trigger facial blushing especially in social situations.”

"The effect is a normalization (?!) of the threshold to trigger facial blushing especially in social situations.”
Clin Auton Res (2003) 13 [Suppl 1] : I/26 – I/30

Patients with surgical sympathectomies have low plasma levels of DA and NE

Patients with surgical sympathectomies have low plasma levels of DA and NE [49], whereas EPI:NE ratios are increased, suggesting decreased sympathetically mediated exocytosis and compensatory adrenomedullary activation.  
Catecholamines 101, David S. Goldstein Clin Auton Res (2010) 20:331–352