Parasympathetic and Sympathetic Nervous System Monitoring and Anxiety Like Symptoms: Improved Differentiation and Improved Outcomes
Abstract
Colombo J, Murray GL, Pinales JM, Acosta C, Lill R, Friedman MJ, DePace NL
Anxiety disorders (DSM-5) and disorders having anxiety laden symptoms (e.g., PTSD and attention disorders) often include several physiologic symptoms which involve the Parasympathetic and Sympathetic nervous systems (P&S). Our research has identified four P&S disorders that are associated with these symptoms: 1) Sympathetic Excess (SE) secondary to Parasympathetic Excess (PE) as an abnormal stress response, 2) Sympathetic Withdrawal (SW) upon assuming headup posture (standing) associated with Orthostatic Dysfunction, 3) SE upon standing associated with Syncope, and 4) Autonomically mediated cardiac arrhythmia, including Sinus Arrhythmia. All four disorders involve poor brain profusion which is known to contribute to Anxiety-like symptoms. They also contribute to (sub-clinical) depression, another frequent co-morbidity. Resting and challenge P&S responses were assessed noninvasively using the ANSAR Medical Technologies, Inc. (Philadelphia, PA) software (ANX 3.0 autonomic function monitor). Patients diagnosed with Anxiety or Anxiety-like symptoms from a large cardiology practice serving both urban and rural areas were followed with more than one assessment over four years (an average of 3.3 assessments per patient; 50.5% Female; average age of 57 years). Patients diagnosed with Anxiety or Anxiety-like symptoms, with one of the four P&S disorders were also treated for their P&S disorder. Relieving P&S dysfunction within this cohort reduced Anxiety or Anxiety-like symptoms by over 45%. P&S guided therapy for patients with Anxiety or Anxiety-like symptoms, may reduce the burden of Anxiety, improve patient outcomes and quality of life, reduce the risk of suicide, aid the psychiatrist in focusing on the etiology of Anxiety, and reduce healthcare costs.