Disorders of the noradrenergic system essay

Central nervous system (CNS)- noradrenaline acting as a neurotransmitter in CNS also in places of brain and spinal cord they are used. The neurons for which noradrenaline acts as a neurotransmitter are called noradrenergic neurons. Noradrenergic neurons are scanty and confined to few places of the brain and spinal cord. The noradrenergic system present in CNS consists of two ascending projections namely, dorsal and ventral noradrenergic bundle (DNB & VNB). These bundles originated from the brainstem. The DNB is the predominant site for noradrenaline production in the CNS. It originates from the A6 locus cerulean and projects into the cerebral cortex, hippocampus, and cerebellum. These projections overlap with VNB projections which together innervates the amygdala, hypothalamus, and spinal cord. The release of noradrenaline in CNS will affect some functions of brain sensory inputs, memory, attention, alertness, vigilance, etc.

Peripheral nervous system (PNS)- adrenal medulla is the place of medullary hormone synthesis. It releases adrenaline and noradrenaline for para-sympathetic and sympathetic impulse transmission on behalf of PNS. Postganglionic sympathetic neurons present here and lack axons. These neurons directly release the hormone into the bloodstream rather than secreting it as a neurotransmitter. Chromaffin cells of the adrenal medulla synthesize adrenaline and noradrenaline in unequal proportions- 80% adrenaline and 20% noradrenaline.

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In case of emergency conditions such as injury, pain, fear, etc sympathetic preganglionic neurons are stimulated by the hypothalamus which further stimulates chromaffin cells to secrete the two hormones. Thus they are called emergency or fight-flight hormones. The sympathetic effects of noradrenaline include-

Increase in the heart output thus increasing systolic blood pressure.

The release of noradrenaline may cause increased blood flow to some organs like the heart, liver, skeletal muscles, and adipose tissue (here it causes calories to burn thus increasing body temperature).

Ir raises glucose and fatty acid level in the blood.

Dilate lung airways.

Retention of sodium by the release of renin by kidneys, and many more.

Disorders of the noradrenergic system:
Dysfunction of the noradrenaline in the body results in various medical problems-

Hyperactivation of the sympathetic nervous system is seen in many physiological conditions or as a result of the intake of sympathomimetic drugs. Conditions resulting in the hyperactivity of the sympathetic nervous system include brain injury, heart failure, spinal cord damage, stress, kidney disease, high blood pressure, etc. Symptoms include rapid heartbeat, elevated blood pressure, anxiety, headache, marked weight loss, sweating, etc.

Pheochromocytoma- tumor of the adrenal medulla. It is a rare disorder. It results in excessive release of adrenaline and noradrenaline and results in elevated blood pressure, anxiety, headache, etc.

Stress- stress affects the major organs of the body. stress will cause an adverse effect on the hypothalamic-adrenal axis so influence the secretion and function of all other pituitary hormones also. Stress causes an increase in noradrenaline activity to meet the threat. Chronic stress causes sustained noradrenaline release resulting in sleepiness, loss of libido, depression, decreased growth in children, impaired immunity, etc.

Attention deficit hyperactivity disorder (ADHD)- the noradrenaline levels increased in this condition are due to the drugs whose main aim is to lower the dopamine levels. However, the clinical significance of noradrenaline is not known. Drugs directly lowering noradrenaline levels are successful in treating ADHD.

Autonomic failure- loss of noradrenergic neurons of ANS is generally known as autonomic failure. It is associated with-

– Alzheimer’s disease: One of the several causes for this disease includes decreased noradrenaline levels and impaired noradrenaline transmission in the hippocampus. In Alzheimer’s disease, the affected person will face gradual memory loss with the problem in cognition.

– Parkinson’s disease: although dopamine dysfunction is the major cause of the disease, though evidence suggests that impairment in the noradrenergic system also contributes to the disease.

– Schizophrenia- a mental illness characterized by hallucinations, delusions, unorganized thoughts, and loss of attention. Impaired dopaminergic and glutaminergic signaling is the leading cause of schizophrenia. However, evidence suggests that there is the involvement of the noradrenergic system as elevated levels of noradrenaline are seen in blood plasma and CSF of patients experiencing paranoia. Also, the post-mortem brains of the schizophrenic patient show increased noradrenaline markers.

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