Landmark Article Transforms Traditional View of the Autonomic Nervous System
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Christopher L. Hoehmann
On November 18, 2016, Science published a landmark article titled “The Sacral Autonomic Outflow Is Sympathetic” by Espinosa-Medina et al.1 The authors used immunofluorescence and immunohistochemistry to define distinguishing genetic features between parasympathetic and sympathetic pre- and postganglionic neurons in mice. Fifteen morphologic and morphogenetic features that differentiate these segments of the autonomic nervous system were observed. For each feature identified, sacral outflow was identical to thoracolumbar outflow and distinct from cranial outflow. Furthermore, the authors demonstrated that (1) sacral preganglionic neurons mature as sympathetic neurons do, (2) all pelvic ganglionic cells express sympathetic transcription factors, and (3) the pelvic ganglion develops independently of the pelvic nerve as sympathetics do. Therefore, the authors concluded that the sacral autonomic nervous system is sympathetic in nature. These data demonstrate that the sympathetic nervous system derives input via spinal nerves from the thoracic to the sacral spine and that the parasympathetic nervous system derives input solely from the cranial nerves. Indeed, organs once thought to derive parasympathetic innervation from sacral autonomics (eg, left part of colon, lower ureter, bladder, uterus, prostate, genitals) instead derive sympathetic innervation from this system.
These data transform our traditional view of the autonomic nervous system as well as the current osteopathic manipulative treatment modalities that address sacral autonomic nerves (eg, sacralinhibition). In fact, sacral techniques previously intended to target the parasympathetic nervous system may have been addressing the sympathetic nervous system. Such modalities should now be reconsidered in light of this scientific discovery. Moreover, these findings suggest a new potential of osteopathic manipulative treatment techniques, particularly those applied to the cranium, in influencing the parasympathetic nervous system in the human body.
References
1. Espinosa-Medina I , SahaO, BoismoreauF, et al. The sacral autonomic outflow is sympathetic. Science. 2016;354(6314):893-898.10.1126/science.aah5454Search in Google Scholar PubMed PubMed Central
© 2017 American Osteopathic Association
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Articles in the same Issue
- LETTERS TO THE EDITOR
- Landmark Article Transforms Traditional View of the Autonomic Nervous System
- AOA COMMUNICATION
- JAOA Peer Reviewers, 2016
- ORIGINAL CONTRIBUTION
- Use of Patient-Authored Prehistory to Improve Patient Experiences and Accommodate Federal Law
- BRIEF REPORT
- Somatic Dysfunction in the Diagnosis of Uncommon Ectopic Pregnancies: Surgical Correlation and Comparison With Related Pathologic Findings
- REVIEW
- Common Foot and Ankle Injuries: What Not to Miss and How Best to Manage
- CLINICAL PRACTICE
- Pectus Excavatum: A Review of Diagnosis and Current Treatment Options
- MEDICAL EDUCATION
- Comparison of Basic Science Knowledge Between DO and MD Students
- SPECIAL COMMUNICATION
- Buerger Test for Erythromelalgia Revisited
- CASE REPORT
- Ruptured Primary Omental Pregnancy Mimicking Adnexal Implantation
- Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging
- CLINICAL IMAGES
- Diffuse Idiopathic Skeletal Hyperostosis
