Primer on the Autonomic Nervous System

Primer on the Autonomic Nervous System

4th Edition - September 1, 2022

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  • Editors: Italo Biaggioni, Kirsteen Browning, Gregory Fink, Jens Jordan, Phillip A. Low, Julian F.R. Paton
  • Paperback ISBN: 9780323854924

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Primer on the Autonomic Nervous System, Fourth Edition provides a concise and accessible overview of autonomic neuroscience for students, scientists, and clinicians. The book's 142 chapters draw on the expertise of more than 215 basic scientists and clinicians who discuss key information on how the autonomic nervous system controls the body, particularly in response to stress. This new edition also focuses on the translational crossover between basic and clinical research. In addition to comprehensively covering all aspects of autonomic physiology and pathology, topics such as psychopharmacology decoding and modulating nerve function are also explored.

Key Features

  • Provides concise and practical information on the autonomic nervous system
  • Discusses all aspects of autonomic physiology and pathology
  • Contains new content on psychopharmacology and modulating nerve function


Researchers, clinical practitioners, medical and graduate students in neuroscience and neurology. Researchers and practitioners in cardiology, physiology, and hypertension

Table of Contents

  • I. Introduction
    1. Evolution of the Cardiovascular Autonomic Nervous System in Vertebrates
    2. Central Autonomic Control
    3. Peripheral Autonomic Nervous System

    II. Biochemical and Pharmacological Mechanisms
    4. Noradrenergic Neurotransmission
    5. Antidepressant-Sensitive Norepinephrine Transporters: Structure and Regulation
    6. a1-Adrenergic Receptors
    7. Alpha2-Adrenergic Receptors
    8. b-Adrenergic Receptors
    9. Dopaminergic Neurotransmission
    10. Dopamine Receptors
    11. Cholinergic Neurotransmission
    12. Acetylcholine and Muscarinic Receptors
    13. Nicotinic Acetylcholine Receptors in the Autonomic Nervous System
    14. Neuropeptide Y and the autonomic nervous system
    15. Serotonin Receptors
    16. Purinergic Neurotransmission and Nucleotide Receptors
    17. Nitric Oxide and The Autonomic Nervous System
    18. Glutamatergic Neurotransmission
    19. Pharmacology: GABAergic Neurotransmission
    20. Renin-Angiotensin
    21. Aldosterone, the Mineralocorticoid Receptor and Sympathetic Nervous System
    22. Vasopressin in central autonomic regulation
    23. Calcitonin Gene-Related Peptide and Adrenomedullin
    24. Leptin Signaling and Energy Homeostasis
    25. The Endothelin System
    26. Pharmacology of the neurotransmission of the baro- and chemoreflex in the Nucleus Tractus Solitarius

    III. Autonomic Physiology
    27. Rhythms in Sympathetic Nerve Activity
    28. Circadian Rhythms and Autonomic Function
    29. Cardiorespiratory interactions in health and disease
    30. Baroreceptor reflexes
    31. Cardiac and Other Visceral Afferents
    32. Sympathetic control of the Heart
    33. Cardiac Vagal Ganglia
    34. Physiology of Upright Posture
    35. Cerebral Circulation
    36. Autonomic Control of the Pupil
    37. Gastrointestinal Function
    38. Extrinsic Control of Gastrointestinal Function
    39. The Splanchnic Circulation
    40. Autonomic Control of the Kidney
    41. Autonomic Control of the Lower Urinary Tract
    42. Bladder Function in Health and Disease
    43. Physiology and Pathophysiology of Female Sexual Function
    44. Sweating
    45.  Autonomic Innervation of the Skeleton
    46. Regulation of Metabolism by the Autonomic Nervous System
    47. Sex Differences in Autonomic Function
    48. Autonomic Control During Pregnancy
    49. Ageing and the autonomic nervous system
    50. Autonomic Function in Sleep and Sleep Deprivation
    51. Telemetric autonomic monitoring

    IV. Autonomic Response to Environmental Challenges
    52. Exercise
    53. Psychological Stress and Autonomic Nervous System
    54. Hypoglycemia
    55. Autonomic Response to Hypovolemic Shock
    56. Physiology of thermoregulation: central & peripheral mechanisms
    57. Effects of High Altitude
    58. Space Physiology
    59. Noise, air pollution, and the autonomic nervous system

    V. Pathophysiological Mechanisms
    60. The autonomic inflammatory reflex
    61. Reactive Oxygen Species and Oxidative Stress
    62. Endothelial Dysfunction
    63. Insulin Resistance and the autonomic nervous System
    64. Salt Sensitivity of Blood Pressure
    65. Airway Afferent Nerves

    VI. Evaluation of Autonomic Function
    66. Clinical Evaluation of Autonomic Disorders
    67. Autonomic Function Testing
    68. Tilt Table Testing
    69. Patient Symptom and Rating Scales: OHQ, COMPASS, UMSARS
    70. Sympathetic Microneurography and clinical applications
    71. Assessment of the Autonomic Control of the Cardiovascular System by a Frequency Domain Approach
    72. Assessment of Sudomotor Function
    73. Plasma Catechols
    74. Imaging cortical and subcortical sites involved in cardiovascular control
    75. Clinical sympathetic Imaging
    76. Cutaneous Autonomic Innervation: Assessment by Skin Biopsy
    77. Sympatho-effector transduction

    VII. Cardiovascular Disorders
    78. Neurally (Autonomically) Mediated Syncope
    79. Orthostatic Hypotension
    80. Spectrum of orthostatic hypotension
    81. Baroreflex Failure
    82. Essential Hypertension
    83. Obesity-Associated hypertension
    84. Pheochromocytoma and paraganglioma
    85. Autonomic Dysfunction in Heart Failure
    86. Myocardial stunning and Takotsubo Cardiomyopathy
    87. The Autonomic Nervous System and Cardiac Arrhythmias

    VIII. Congenital Autonomic Disorders
    88. Deficiencies of Tetrahydrobiopterin, Tyrosine Hydroxylase and Aromatic L-Amino Acid Decarboxylase
    89. Congenital disorders of noradrenergic neurotransmission
    90. Monoamine Oxidase Deficiency
    91. Congenital Central Hypoventilation Syndrome (CCHS) and PHOX2B Pathogenic Variants
    92. Hereditary Autonomic Neuropathies
    93. Familial Dysautonomia (Riley-Day Syndrome)

    IX. Autonomic Synucleinopathies
    94. a-Synuclein and Neurodegeneration
    95. Multiple System Atrophy
    96. Parkinson’s Disease
    97. Dementia with Lewy Bodies
    98. Pure Autonomic Failure

    X. Peripheral Autonomic Disorders
    99. Small Fiber Neuropathy
    100. Diabetic Autonomic Dysfunction
    101. Amyloidosis and Autonomic Failure
    102. Autoimmune Autonomic Syndromes
    103. Paraneoplastic Autonomic Dysfunction
    104. Autonomic Disturbances Following Spinal Cord Injury
    105. Drug-Induced Autonomic Dysfunction

    XI. Autonomic Syndromes
    106. Postural Tachycardia Syndrome. Pathophysiological Mechanisms
    107. Postural Tachycardia Syndrome (POTS)
    108. Joint Hypermobility and Dysautonomia
    109. Mast Cell Activation and Autonomic Disorders
    110. Chronic Fatigue Syndrome and the Autonomic Nervous System

    XII. Special Clinical Conditions
    111. Neuroleptic Malignant Syndrome
    112. Migraine and the Autonomic Nervous System
    113. Autonomic Regulation in Epilepsy
    114. Autonomic complications of acute brain injury and stroke
    115. Sleep Apnea
    116. Panic Disorder
    117. Disorders of Sweating
    118. Complex Regional Pain Syndrome
    119. Abdominal Pain and Cyclic Vomiting
    120. Male Erectile Dysfunction

    XIII. Management of Neurogenic Orthostatic Hypotension
    121. Management of Orthostatic Hypotension - Introduction
    122. Physical Measures
    123. Dietary Sodium and Fludrocortisone
    124. Water and the Osmopressor Response
    125. Midodrine
    126. Droxidopa
    127. Pyridostigmine in Autonomic Disorders
    128. Norepinephrine Transporter Inhibitors in Autonomic Disorders
    129. Acarbose and octreotide for the treatment of postprandial hypotension
    130. Management of Supine Hypertension of Autonomic Failure
    131. Anesthetic considerations in patients with autonomic dysfunction
    132. Chronic constitutional hypotension

    XIV. Autonomic Neuromodulation as a Treatment Strategy
    133. Renal Denervation as Therapeutic Intervention
    134. Baroreflex amplification by carotid sinus stimulation
    135. Targeting Carotid Body Chemoreceptors as a therapeutic intervention
    136. Bionic Baroreflex
    137. Therapeutic targeting of splanchnic nerves

    XV. Novel Approaches in Autonomic Neuroscience
    138. Modeling the Autonomic Nervous System
    139. Optogenetics: Application to central autonomic regulatory pathways.
    140. Mapping the Autonomic Nervous System: The SPARC project
    141. Autonomic Nervous System-Gut-Microbiome Axis in Chronic Diseases
    142. Novel Fluid Biomarkers in Synucleinopathies
    143. Novel Disease-Modifying Treatments for Synucleinopathies

Product details

  • No. of pages: 924
  • Language: English
  • Copyright: © Academic Press 2022
  • Published: September 1, 2022
  • Imprint: Academic Press
  • Paperback ISBN: 9780323854924

About the Editors

Italo Biaggioni

Dr. Biaggioni has almost 40 years’ experience investigating the interaction between neural (autonomic) metabolic (renin- angiotensin, insulin) and local (adenosine, nitric oxide) factors involved in cardiovascular regulation. He has had continued NIH funding that has resulted in over 330 peer-reviewed publications. Dr. Biaggioni directs the Vanderbilt Autonomic Dysfunction Center, a multidisciplinary program dedicated to applying clinical research to development novel treatment strategies. His group has discovered 4 novel congenital autonomic disorders and has participated in the development of new medications, have repurposed many approved drugs, and developed novel devices.

Affiliations and Expertise

Director, Vanderbilt Autonomic Dysfunction Center; David Robertson Professor of Autonomic Disorders, Professor of Medicine and Pharmacology, Vanderbilt University Medical Center, Nashville, TN, United States

Kirsteen Browning

Dr. Kirsteen Browning is a Professor of Neural and Behavioral Science at Penn State University. She is also Associate Director of the MD/PhD Medical Scientist Training Program. Her research interest is in the regulation of gastrointestinal vagal neurocircuits and vagally mediated peripheral sensation and signaling.

Affiliations and Expertise

Professor of Neural and Behavioral Science and Associate Director, MD/PhD Medical Scientist Training Program, Penn State University College of Medicine, Hershey, PA, United States

Gregory Fink

Dr. Gregory Fink is a Professor in Pharmacology and Toxicology at Michigan State University. His research continues to concern central and peripheral mechanisms of blood pressure regulation in hypertension, but other important interests are the renin-angiotensin system, endothelin and the role of venous function and body fluid volume distribution in control of blood pressure. Fink has served on the executive committee and as treasurer for the Inter-American Society of Hypertension, as chairman of the National Institutes of Health, or NIH , Experimental Cardiovascular Sciences Study Section and he just recently finished a two-year term as chair of the American Heart Association Council on Hypertension.

Affiliations and Expertise

Professor in Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States

Jens Jordan

Jens Jordan is Head of the Institute of Aerospace Medicine at the German Aerospace Center and the University of Cologne in Germany. Previously, he directed the Institute for Clinical pharmacology at Hannover Medical School. His group pursues cardiovascular control mechanisms and molecular mechanisms responsible for premature cardiovascular and metabolic disease in human beings. The overall goal is to find ways of extending the healthy lifespan on earth and in space.

Affiliations and Expertise

Head of the Institute of Aerospace Medicine, German Aerospace Center and University of Cologne, Cologne, Germany

Phillip A. Low

Dr. Phillip Low is a Neurologist at the Mayo Clinic focusing on Autonomic Disorders. Phillip A. Low, M.D. has a long-standing research focus on clinical and laboratory research into the cause and treatment of autonomic disorders. Efforts have been concentrated on following major areas: multiple system atrophy; development of novel biomarkers and tests and instruments to study autonomic disorders; diagnosis and treatment of autonomic neuropathies; conducting randomized clinical trials. Dr. Low's research has been continuously funded by the National Institutes of Health (NIH) for over the past 30 years.

Affiliations and Expertise

Neurologist at the Mayo Clinic focusing on Autonomic Neuropathy

Julian F.R. Paton

Professor Paton is the Director of Manaaki Manawa – the Centre for Heart Research in Auckland. Through modulation of the autonomic nervous system, his research aims to inform new potential ways to control blood pressure in the condition of hypertension and to alleviate heart failure and sleep apnoea. He uses an inter-disciplinary approach involving mathematical modelling, pre-clinical and first-in-human studies incorporating novel drugs and device based therapeutic strategies.

Affiliations and Expertise

Professor of Translational Physiology, Manaaki Manawa – The Centre for Heart Research, Department of Physiology, University of Auckland, Auckland, New Zealand

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