Skip to main content
×
×
Home

Selective Unilateral Autonomic Activation: Implications for Psychiatry

  • David S. Shannahoff-Khalsa
Abstract

Research advances have led to three methods for selectively activating one half of the autonomic nervous system in humans.The first method is an ancient yogic technique called unilateral forced nostril breathing (UFNB) that employs forced breathing through only one nostril while closing off the other. The second method works by stimulation of an autonomic reflex point on the fifth intercostal space near the axilla. The most recent method employs unilateral vagus nerve stimulation (VNS) via the mid-inferior cervical branch and requires surgical implantation of a wire and pacemaker. UFNB is non-invasive and seems to selectively activate the ipsilateral branch of the sympathetic nervous system with a possible compensation effect leading to contralateral VNS. UFNB and VNS have been employed to treat psychiatric disorders. While UFNB has been studied for its potential effects on the endogenous ultradian rhythms of the autonomic and central nervous system, and their tightly coupled correlates, VNS has yet to be studied in this regard. This article reviews these three methods and discusses their similarities, putative mechanisms, their studied effects on the endogenous autonomic nervous system and central nervous system rhythms, and their implications for the treatment of psychiatric disorders.

Copyright
Corresponding author
Please direct all correspondence to: David S. Shannahoff-Khalsa, Institute for Nonlinear Science (# 0402), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0402; Tel: 858-534-0154, Fax: 858-534-7664; E-mail: dsk@ucsd.edu, Web site: www.theinternetyogi.com.
References
Hide All
1.Saper, CB, Loewy, AD, Swanson, LW, et al.Direct hypothalamo-autonomic connections. Brain Res. 1976;117:305312.
2.Saper, CB. Organization of cerebral cortical afferent systems in the rat. II. Hypothalamocortical projections. J Comp Neurol. 1985;237:2146.
3.Saper, CB. Hypothalamic connections with the cerebral cortex. Prog Brain Res. 2000;126:3948.
4.Karplus, J, Kreidl, A. Gehirn und sympathicus. I. Zwischenhirnbasis und halssympatheticus [German]. Pfluger Arch Gesamte Physiol. 1909;129:138144.
5.Karplus, J, Kreidl, A. Gehirn und Sympathicus. II. Ein sympathicuszentrum im zwischenhirn [German]. Pfluger Arch Gesamte Physiol. 1910;135:401416.
6.Karplus, J, Kreidl, A. Gehirn und sympathicus. III. Sympathicusleitung im gehirn und halsmark [German]. Pfluger Arch Gesamte Physiol. 1912;143:107127.
7.Karplus, J, Kreidl, A. Uber Totallexstirpationen einer und beider Grosshirnhemispharen an Affen (Macacus rhesus) [German]. Arch Anat Phsyiol (Physiol Abt). 1914:155212.
8.Swanson, LW. The hypothalamus. In: Bjorkland, A., Hokfelt, T., Swanson, L, eds. Handbook of Chemical Neuroanatomy, Vol. 5, Integrated Systems of the CNS. Amsterdam, The Netherlands: Elsevier Science Publishers BV; 1987:1124.
9.Beattie, J. Hypothalamic mechanisms. Can Med Assoc J. 1932;26:400405.
10.Beattie, J, Sheehan, D. The effects of hypothalamic stimulation on gastric motility. J Physiol. 1934;81:218227.
11.Beattie, J, Kerr, A. The effects of diencephalic stimulation on urinary bladder tonus. Brain. 1936;59:302314.
12.Ranson, S, Magoun, H. The hypothalamus. Ergeb Physiol. 1939;41:56163.
13.Hess, WR. Diencephalon, Autonomic and Extrapyridimal Functions. New York, NY: Grune and Stratton; 1954.
14.Shannahoff-Khalsa, D. Lateralized rhythms of the central and autonomic nervous systems. Int J Psychophysiol. 1991;11:225251.
15.Shannahoff-Khalsa, DS. Stress Technology Medicine, A New Paradigm for Stress and Considerations for Self-regulation. New York, NY: Marcel Dekker Inc.; 1991.
16.Shannahoff-Khalsa, DS. Psychophysiological States: The Ultradian Dynamics of Mind-Body Interactions. In: Bradley, RJ, Harris, RA, Jenner, P, eds. International Review of Neurobiology. vol 80. San Diego, Calif: Academic Press/Elsevier Scientific Publications; In press.
17.Kayser, R. Die exacta messung der luftdurchgangigkeit der nase [German]. Archives of Laryngology and Rhinology. 1895;3:101120.
18.Beickert, P. Halbseitenrhythmus der vegetativen innervation [German]. Arch Ohr Nos Kehl Hdk. 1951;157:404411.
19.Werntz, DA, Bickford, RG, Bloom, FE, Shannahoff-Khalsa, DS. Alternating cerebral hemispheric activity and the lateralization of autonomic nervous function. Hum Neurobiol. 1983;2:3943.
20.Shannahoff-Khalsa, D. The ultradian rhythm of alternating cerebral hemispheric activity. Int J Neurosci. 1993;70:285298.
21.Kayser, R. Uber den Weg der Athmungsluft durch die Nase [German]. Z Ohrerlheilh. 1889;20:96106.
22.Eccles, R. Nasal airflow in health and disease. Acta Otolaryngol. 2000;120:580595.
23.Hasegawa, M, Kern, EB. Variations resistance in man: a rhinomanometric study of cycle in 50 human subjects. Rhinology. 1978;16:2029.
24.Heetderks, DR. Observations on the reaction of the nasal mucous membranes. Am J Med Sci. 1927;174:231244.
25.Stoksted, P. Rhinometric measurements for determination of the nasal cycle. Acta Otolaryngol Suppl. 1953;109:159175.
26.Shannahoff-Khalsa, DS, Kennedy, B, Yates, FE, et al.Ultradian rhythms of autonomic, cardiovascular, and neuroendocrine systems are related in humans. Am J Physiol. 1996;270:R873R887.
27.Shannahoff-Khalsa, DS, Kennedy, B, Yates, FE, et al.Low-frequency ultradian insulin rhythms are coupled to cardiovascular, autonomic, and neuroendocrine rhythms. Am J Physiol. 1997;272:R962R968.
28.Shannahoff-Khalsa, DS, Yates, FE. Ultradian sleep rhythms of lateral EEG, autonomic, and cardiovascular activity are coupled in humans. Int J Neurosci. 2000;101:2143.
29.Shannahoff-Khalsa, DS, Gillin, JC, Yates, FE, et al.Ultradian rhythms of alternating cerebral hemispheric EEG dominance are coupled to rapid eye movement and non-rapid eye movement stage 4 sleep in humans. Sleep Med. 2001;2:333346.
30.Kennedy, B, Ziegler, MG, Shannahoff-Khalsa, DS. Alternating lateralization of plasma catecholamines and nasal patency in humans. Life Sci. 1986;38:12031214.
31.Kleitman, N. The Nature of Dreaming. London, England: Churchill Press; 1961.
32.Kleitman, N. Phylogenetic, Ontogenetic and Environmental Determinants in the Evolution of Sleep-Wakefulness Cycles. Baltimore, Md: The Williams and Wilkins Co.; 1967.
33.Kleitman, N. Basic rest-activity cycle–22 years later. Sleep. 1982;5:311317.
34.Lavie, P, Kripke, DF. Ultradian circa 11/2 hour rhythms: a multioscillatory system. Life Sci. 1981;29:24452450.
35.Foley, J, DuBois, F. Quantitative studies of the vagus nerve in the cat. I. The ration of sensory and motor studies. J Comp Neurol. 1937;67:4967.
36.Henry, TR. Therapeutic mechanisms of vagus nerve stimulation. Neurology. 2002;59(suppl 4):S3S14.
37.Levy, M, Martin, P. Neural Control of the Heart. Bethesda, Md: American Physiological Society; 1979.
38.Levy, MN, Ng, ML, Zieske, H. Functional distribution of the peripheral cardiac sympathetic pathways. Circ Res. 1966;19:650661.
39.Furnival, CM, Linden, RJ, Snow, HM. Chronotropic and inotropic effects on the dog heart of stimulating the efferent cardiac sympathetic nerves. J Physiol. 1973;230:137153.
40.Hondeghem, LM, Mouton, E, Stassen, T, et al.Additive effects of acetylcholine released by vagal nerve stimulation on atrial rate. J Appl Physiol. 1975;38:108113.
41.Hamlin, RL, Smith, CR. Effects of vagal stimulation on S-A and A-V nodes. Am J Physiol. 1968;215:560568.
42.Shannahoff-Khalsa, D. Unilateral forced nostril breathing: basic science, clinical trials, and selected advanced techniques. Subtle Energies Energy Med J. 2001;12:79106.
43.Shannahoff-Khalsa, D. Kundalini Yoga Meditation: Techniques Specific for Psychiatric Disorders, Couples Therapy, and Personal Growth. New York, NY: W. W. Norton & Company; 2006.
44.Werntz, DA, Bickford, RG, Bloom, FE, et al. Cerebral Hemispheric Activity and Autonomic Nervous Function. Paper presented at: 10th Annual Meeting of the Society for Neuroscience. November 9-14, 1980; Cincinnati, Oh.
45.Werntz, DA, Bickford, RG, Bloom, FE, et al. Selective cortical activation by altering autonomic function. Abstract presented at: Annual Meeting of the Western EEG Society Meeting. February 21, 1981; Reno, Nev.
46.Werntz, DA, Bickford, RG, Shannahoff-Khalsa, D. Selective hemispheric stimulation by unilateral forced nostril breathing. Hum Neurobiol. 1987;6:165171.
47.Servit, Z, Kristof, M, Strejckova, A. Activating effect of nasal and oral hyperventilation on epileptic electrographic phenomena: reflex mechanisms of nasal origin. Epilepsia. 1981;22:321329.
48.Klein, R, Pilon, D, Prosser, S, et al.Nasal airflow asymmetries and human performance. Biol Psychol. 1986;23:127137.
49.Shannahoff-Khalsa, DS, Boyle, MR, Buebel, ME. The effects of unilateral forced nostril breathing on cognition. Int J Neurosci. 1991;57:239249.
50.Jella, SA, Shannahoff-Khalsa, DS. The effects of unilateral forced nostril breathing on cognitive performance. Int J Neurosci. 1993;73:6168.
51.Telles, S, Raghuraj, P, Maharana, S, et al.Immediate effect of three yoga breathing techniques on performance on a letter-cancellation task. Percept Mot Skills. 2007;104:12891296.
52.Baglio, S, Bucolo, M, Fortuna, L, et al. MEG signals spatial power distribution and gamma band activity in yoga breathing exercises. Paper presented at: Conference Proceedings of the IEEE Engineering in Medicine and Biology Society. October 23-26, 2002; Houston, Tex.
53.Block, RA, Arnott, DP, Quigley, B, et al.Unilateral nostril breathing influences lateralized cognitive performance. Brain Cogn. 1989;9:181190.
54.Sanders, B, Lattimore, C, Smith, K, et al.Forced single-nostril breathing and cognition. Percept Mot Skills. 1994;79:14991506.
55.Schiff, BB, Rump, SA. Asymmetrical hemispheric activation and emotion: the effects of unilateral forced nostril breathing. Brain Cogn. 1995;29:217231.
56.Shannahoff-Khalsa, DS, Beckett, LR. Clinical case report: efficacy of yogic techniques in the treatment of obsessive compulsive disorders. Int J Neurosci. 1996;85:117.
57.Shannahoff-Khalsa, D, Ray, L, Levine, S, et al.Randomized controlled trial of yogic meditation techniques for patients with obsessive compulsive disorders. CNS Spectr. 1999;4:3446.
58.Sercer, A. Research on the homolateral reflex of the nasal cavity on the lung. Acta Otolaryng. 1930;14:8290.
59.Samzelius-Lejdstrom, I. Researches with the bilateral troncopneumograph on the movements of the respiratory mechanisms during breathing. Acta Otolaryng. 1939;35(suppl):3104.
60.Stoksted, P. Obstructions in the nose and their influence on the pulmonary functions. Acta Otorhinolar. 1960;158(suppl):110.
61.Drettner, B. Pathophysiological relationship between the upper and lower airways. Ann Otol Rhinol Laryngol. 1970;79:499505.
62.Wotzilka, G, Schramek, J. Tierexperimentelle Untersuchungen uber den Weg des Inspirationsstromes jeder Nasenseite in die Lunge [German]. Mschr Ohrenheilk. 1930;64:580585.
63.Backon, J. Changes in blood glucose levels induced by differential forced unilateral nostril breathing, a technique which affects both brain hemisphericity and autonomic activity. Med Science Res. 1988;16:11971199.
64.Backon, J, Kullok, S. Effect of forced unilateral nostril breathing on blink rates: relevance to hemispheric lateralization of dopamine. Int J Neurosci. 1989;46:5359.
65.Backon, J, Matamoros, N, Ticho, U. Changes in intraocular pressure induced by differential forced unilateral nostril breathing, a technique that affects both brain hemisphericity and autonomic activity. A pilot study. Graefes Arch Clin Exp Ophthalmol. 1989;227:575577.
66.Mohan, SM, Reddy, SC, Wei, LY. Modulation of intraocular pressure by unilateral and forced unilateral nostril breathing in young healthy human subjects. Int Ophthalmol. 2001;24:305311.
67.Chen, JC, Brown, B, Schmid, KL. Effect of unilateral forced nostril breathing on tonic accommodation and intraocular pressure. Clin Auton Res. 2004;14:396400.
68.Benton, LA, Yates, FE. Ultradian adrenocortical and circulatory oscillations in conscious dogs. Am J Physiol. 1990;258:R578R590.
69.Orr, WC, Hoffman, HJ. A 90-min cardiac biorhythm: methodology and data analysis using modified periodograms and complex demodulation. IEEE Trans Biomed Eng. 1974;21:130143.
70.Shannahoff-Khalsa, DS, Kennedy, B. The effects of unilateral forced nostril breathing on the heart. Int J Neurosci. 1993;73:4760.
71.Mohan, S, Wei, L. Modulation of pulse rate by unilateral nostril breathing. J Indian Psychol. 2002;20:3237.
72.Dane, S, Caliskan, E, Karasen, M, et al.Effects of unilateral nostril breathing on blood pressure and heart rate in right-handed healthy subjects. Int J Neurosci. 2002;112:97102.
73.Telles, S, Nagarathna, R, Nagendra, HR. Breathing through a particular nostril can alter metabolism and autonomic activities. Indian J Physiol Pharmacol. 1994;38:133137.
74.Telles, S, Nagarathna, R, Nagendra, HR. Physiological measures of right nostril breathing. J Altern Complement Med. 1996;2:479484.
75.Friedell, A. Automatic attentive breathing in angina pectoris. Minn Med. 1948;31:875881.
76.Konno, A. Air flow and resistance in the nasal cavity. 2. Bilateral rhinometry using a pneumotachometer. Its principles and clinical application [Japanese]. Nippon Jibiinkoka Gakkai Kaiho. 1969;72:4965.
77.Takagi, K, Kobayasi, S. Skin pressure-vegetative reflex. Acta Med et Biol. 1955;4:3157.
78.Takagi, K, Sakurai, T. A sweat reflex due to pressure on the body surface [Japanese]. Jap J Physiol. 1950;1:2228.
79.Rao, S, Potdar, A. Nasal airflow with body in various positions. J Appl Physiol. 1970;28:162165.
80.Haight, JJ, Cole, P. Reciprocating nasal airflow resistances. Acta Otolaryngol. 1984;97:9398.
81.Haight, JS, Cole, P. Unilateral nasal resistance and asymmetrical body pressure. J Otolaryngol Suppl. 1986;16:131.
82.Cole, P, Haight, J. Posture and the nasal cycle. Am Otol Rhinol Laryngol. 1986;95:233237.
83.Cole, P, Haight, JS. Posture and nasal patency. Am Rev Respir Dis. 1984;129:351354.
84.Morris, GL, Mueller, WM. Long-term treatment with vagus nerve stimulation in patients with refractory epilepsy. The Vagus Nerve Stimulation Study Group E01-E05. Neurology. 1999;53:17311735.
85.Ben-Menachem, E, Hamberger, A, Hedner, T, et al.Effects of vagus nerve stimulation on amino acids and other metabolites in the CSF of patients with partial seizures. Epilepsy Res. 1995;20:221227.
86.Handforth, A, DeGiorgio, CM, Schachter, SC, et al.Vagus nerve stimulation therapy for partial-onset seizures: a randomized active-control trial. Neurology. 1998;51:4855.
87.Hatton, KW, McLarney, JT, Pittman, T, et al.Vagal nerve stimulation: overview and implications for anesthesiologists. Anesth Analg. 2006;103:12411249.
88.Salinsky, MC, Uthman, BM, Ristanovic, RK, et al.Vagus nerve stimulation for the treatment of medically intractable seizures. Results of a 1-year open-extension trial. Vagus Nerve Stimulation Study Group. Arch Neurol. 1996;53:11761180.
89.DeGiorgio, CM, Schachter, SC, Handforth, A, et al.Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures. Epilepsia. 2000;41:11951200.
90.Physician's Manual. VNS Therapy™ Pulse Model 102 Generator and VNS Therapy™ Pulse Duo Model 102R Generator. Houston, Tex: Cyberonics Inc: 2004.
91.Rush, AJ, George, MS, Sackeim, HA, et al.Vagus nerve stimulation (VNS) for treatment-resistant depressions: a multicenter study. Biol Psychiatry. 2000;47:276286.
92.Sackeim, HA, Rush, AJ, George, MS, et al.Vagus nerve stimulation (VNS) for treatment-resistant depression: efficacy, side effects, and predictors of outcome. Neuropsychopharmacology. 2001;25:713728.
93.Rush, AJ, Sackeim, HA, Marangell, LB, et al.Effects of 12 months of vagus nerve stimulation in treatment-resistant depression: a naturalistic study. Biol Psychiatry. 2005;58:355363.
94.Rush, AJ, Marangell, LB, Sackeim, HA, et al.Vagus nerve stimulation for treatment-resistant depression: a randomized, controlled acute phase trial. Biol Psychiatry. 2005;58:347354.
95.Nahas, Z, Marangell, LB, Husain, MM, et al.Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. J Clin Psychiatry. 2005;66:10971104.
96.Sackeim, HA, Rush, AJ, Marangell, LB, et al. Long-term antidepressant effects of vagus nerve stimulation (VNS) in treatment-resistant depression. Paper presented at: Annual Meeting of the American College of Neuropsychopharmacology. December 12–16, 2004; San Juan, PR.
97.Marangell, LB, Rush, AJ, George, MS, et al.Vagus nerve stimulation (VNS) for major depressive episodes: one year outcomes. Biol Psychiatry. 2002;51:280287.
98.George, MS, Rush, AJ, Sackeim, HA, et al.Vagus nerve stimulation (VNS): utility in neuropsychiatric disorders. Int J Neuropsychopharmacol. 2003;6:7383.
99.Husted, D, Shapira, N. A review of the treatment for refractory obsessive-compulsive disorder: from medicine to deep brain stimulation. CNS Spectr. 2004;9:833847.
100.Pallanti, S, Hollander, E, Goodman, WK. A qualitative analysis of nonresponse: management of treatment-refractory obsessive-compulsive disorder. J Clin Psychiatry. 2004;65(suppl 14):610.
101.Nemeroff, CB, Mayberg, HS, Krahl, SE, et al.VNS therapy in treatment-resistant depression: clinical evidence and putative neurobiological mechanisms. Neuropsychopharmacology. 2006;31:13451355.
102.Group VNSS. A randomized controlled trial of chronic vagus nerve stimulation for treatment of medically intractable seizures. Neurology. 1999;45:224230.
103.George, MS, Sackeim, HA, Marangell, LB, et al.Vagus nerve stimulation. A potential therapy for resistant depression? Psychiatr Clin North Am. 2000;23:757783.
104.Groves, DA, Brown, VJ. Vagal nerve stimulation: a review of its applications and potential mechanisms that mediate its clinical effects. Neurosci Biobehav Rev. 2005;29:493500.
105.Rosenbaum, JF, Heninger, G. Vagus nerve stimulation for treatment-resistant depression. Biol Psychiatry. 2000;47:273275.
106.Dane, S, Balci, N. Handedness, eyedness and nasal cycle in children with autism. Int J Dev Neurosci. 2007;25:223226.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

CNS Spectrums
  • ISSN: 1092-8529
  • EISSN: 2165-6509
  • URL: /core/journals/cns-spectrums
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed