Parkinson’s disease (PD) presents with blood pressure circulatory dysregulation (BPCD), including orthostatic hypotension (OH), postprandial hypotension (PPH), supine hypertension (SH) and nocturnal hypertension (NH). OH has an impact on falls and prognosis. PPH is also a poor prognostic factor. SH is present in about 50% of PD and is more common in older, patients of akinetic form with reduced cognitive function. NH is found in 16% of PD and is associated with cognitive impairment. It is important to assess BPCD status by measuring 24-hour blood pressure variability and to respond frequently and stabilize blood pressure by combining fluid intake, dietary adjustments, caffeine intake, medications for elevated blood pressure, upper body elevation while supine, short-acting antihypertensive medications before bedtime, back heat therapy while sleeping and abdominal bandages during the day, depending on the situation.

The bone marrow is located inside the hard bone tissue and is the organ most active in producing new cells in the body. It has been elucidated that bone marrow hematopoiesis and bone metabolism function in tandem regulated by the autonomic nervous system. In this review, mechanistic insights into the nervous system-regulated bone marrow function, including an example of clinical application in the field of hematology, are introduced.

We introduce an occupational stress assessment method which utilizes autonomic nerve function fluctuations recorded by a Holter electrocardiograph. The method uses a 24-hour ECG, but instead of so-called long-time analysis, a continuous short-time analysis method in which a long-time recorded ECG is divided into 1 or 2-minute segments and all of them are analyzed, is used. In a stress video test, significant correlations were found between a video in which the subjects felt stressed and a video in which the low-frequency component/high-frequency component ratio (LF/HF) increased. There are also stress reactions such as in roller coaster rides which occur without subject’s awareness. Case reports where there is difficulty in calculating LF/HF such as Formula car drivers whose heart rates increase excessively are presented, and we introduce actual cases of work-related stress reaction assessment of physicians, nurses, and care workers. However, it was found that some problems remain, such as the difficulty in discriminating between mental stress and exercise load, and the complexity of filling out work diaries. Several papers on stress assessment by long-time analysis of internal and external heart rate variability are also presented.

We have elucidated the regulatory mechanism of colorectal motility by the central nervous system in rats. We found that noxious stimuli in the colon are transmitted via the spinal cord to the brain, and that colorectal motility is enhanced through the activation of descending pain modulatory pathways, the release of monoamines in the defecation center of the lumbosacral spinal cord, and the activation of pelvic nerves. The importance of the medullary raphe nuclei and hypothalamus A11 region as the origin of the descending nerves was also clarified. In addition, pharmacogenetic inhibition of the activity of the nerves descending from these nuclei to the spinal cord was also found to suppress defecation induced by water avoidance stress. In this article, we summarize our findings on the central regulatory mechanism of colorectal motility.

Constipation is common in elderly patients. Among neurological disorder, constipation is especially common in Parkinson’s disease. Recently, several new laxatives have become available and guidelines regarding constipation have been published. Treatments for constipation have changed dramatically. This symposium will explore the definition of constipation, its frequency in Parkinson’s disease, and new laxatives.

The pathology of thermoregulation includes hyperthermia, hypothermia, and poikilothermia. Hyperthermia occurs when the body’s core temperature rises above the normal regulatory range, resulting from an imbalance of heat production exceeding heat loss. This condition arises due to the weakening of the autonomic response to heat or as a result of exposure to elevated environmental temperatures. As an example, central hyperthermia occurs when the preoptic area of the hypothalamus gets damaged. The brain is particularly affected by high temperature, causing severe heatstroke. Hypothermia is defined as a core temperature below 35℃, resulting from a condition in which heat loss exceeds heat production. This is caused by a decrease in the autonomic response to cold or exposure to cold environments, among other factors. The response to cold disappears when the core temperature markedly decreases. Poikilothermia is a condition in which the core temperature changes by 2℃ or more in response to environmental temperature changes, resulting in marked hypothermia due to disturbances in the posterior hypothalamic or brainstem functions. Abnormal body temperature is life-threatening and requires immediate treatment, including the restoration of normal temperature while monitoring vital signs.

Epipharyngeal abrasive therapy (EAT) is used to treat chronic epipharyngitis. This study aimed to elucidate the effects of EAT on autonomic nervous system function over time. Thirty-nine patients with chronic epipharyngitis performed an active standing test and their heart rate variability was analyzed. Phase 1 of the active standing test was conducted in the resting sitting position, phases 2 and 3 in the standing position, and phase 4 in the sitting position. In each of the four phases, the assessment items were: heart rate (HR), coefficient of variance of R-R intervals (CVRR), coefficient of component variance high frequency (ccvHF), low frequency/ccvHF ratio (L/H), systolic blood pressure (SBP), mean arterial pressure (MAP), and diastolic blood pressure (DBP). Statistical analysis was performed to compare the items' values before and after initiating the EAT treatment. The results show that EAT suppressed parasympathetic activity over time. A comparison of blood pressure fluctuations suggested that EAT exhibits a homeostatic effect by improving baroreceptor reflexes, suggesting that the autonomic and immunostimulatory effects of EAT interacted with one another to exert their effects.