What happens when we pass out? Researchers ID new brain and heart connections

Nearly 40 percent of people experience syncope, or fainting spells, at least once in their lives. These brief losses of consciousness, whether brought by pain, fear, heat, hyperventilation or other causes, account for a significant portion of hospital emergency room visits. Yet the exact root mechanisms at play when people “pass out” largely have remained a mystery.

Publishing a new report in Nature, University of California San Diego researchers, along with colleagues at The Scripps Research Institute and other institutions, have for the first time identified the genetic pathway between the heart and brain tied to fainting.

One of their unique approaches was to think of the heart as a sensory organ rather than the longstanding viewpoint that the brain sends out signals and the heart simply follows directions. School of Biological Sciences Assistant Professor Vineet Augustine, the paper’s senior author, applies a variety of approaches to better understand these neural connections between the heart and brain.

“What we are finding is that the heart also sends signals back to the brain, which can change brain function,” said Augustine. Information resulting from the study could be relevant to better understanding and treating various psychiatric and neurological disorders linked with brain-heart connections, the researchers note in their paper. “Our study is the first comprehensive demonstration of a genetically defined cardiac reflex, which faithfully recapitulates characteristics of human syncope at physiological, behavioral and neural network levels.”

Augustine, along with Biological Sciences Staff Research Associate Jonathan Lovelace and Graduate Student Jingrui Ma, the first authors of the paper, and their colleagues studied neural mechanisms related to Bezold-Jarisch reflex (BJR), a cardiac reflex first described in 1867. For decades researchers have hypothesized that the BJR, which features reduced heart rate, blood pressure and breathing, may be associated with fainting. But information lacked in proving the idea since the neural pathways involved in the reflex were not well known.

The researchers focused on the genetics behind a sensory cluster known as the nodose ganglia, which are part of the vagus nerves that carry signals between the brain and visceral organs, including the heart. Specifically, vagal sensory neurons, or VSNs, project signals to the brainstem and are thought to be associated with BJR and fainting. In their search for a novel neural pathway they discovered that VSNs expressing the neuropeptide Y receptor Y2 (known as NPY2R) are tightly linked to the well-known BJR responses.

Studying this pathway in mice, the researchers were surprised to find that when they proactively triggered NPY2R VSNs using optogenetics, a method of stimulating and controlling neurons, mice that had been freely moving about immediately fainted. During these episodes they recorded from thousands of neurons in the brains of the mice, as well as heart activity and changes in facial features including pupil diameter and whisking. They also employed machine learning in several ways to analyze the data and pinpoint features of interest. Once NPY2R neurons were activated, they found, mice exhibited rapid pupil dilation and the classic “eye-roll” seen during human fainting, as well as suppressed heart-rate, blood pressure and breathing rate. They also measured reduced blood flow to the brain, an area of collaboration with Professor David Kleinfeld’s laboratory in the UC San Diego Departments of Neurobiology and Physics.

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“We were blown away when we saw how their eyes rolled back around the same time as brain activity rapidly dropped,” the researchers reported in a paper summary. “Then, after a few seconds, brain activity and movement returned. This was our eureka moment.”

Further testing showed that when NPY2R VSNs were removed from mice, the BJR and fainting conditions vanished. Previous studies had shown that fainting is caused by a reduction in brain blood flow, which the new study also found to be true, but the new evidence indicated that brain activity itself could be playing an important role. The findings therefore implicate the activation of the newly genetically identified VSNs and their neural pathways not only with BJR, but more centrally in overall animal physiology, certain brain networks and even behavior.

Such findings were difficult to tease out previously because neuroscientists study the brain and cardiologists study the heart, but many do so in isolation of the other. “Neuroscientists traditionally think the body just follows the brain, but now it is becoming very clear that the body sends signals to the brain and then the brain changes function,” said Augustine.

As a result of their findings, the researchers would like to continue tracking the precise conditions under which vagal sensory neurons are triggered into action.

“We also hope to more closely examine cerebral blood flow and neural pathways in the brain during the moment of syncope, to better understand this common but mysterious condition,” they note.

They also hope to use their research as a model to develop targeted treatments for fainting-associated conditions.

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What happens when cats get fat? Scientists weigh in

Cat owners want Kitty to be happy, but providing an abundance of food and snacks can have unintended consequences. Feline obesity is on the rise, impacting the health, longevity, and wellbeing of cats. A new study from the University of Illinois Urbana-Champaign looks at what happens in the digestive system and gut microbiota when cats eat too much.

“About 60% of cats in the U.S. are overweight, which can lead to health problems such as diabetes and chronic inflammation. While many studies have investigated feline weight loss, there has been little focus on the opposite process, which is also important. In this study, we wanted to learn more about the metabolic and gastrointestinal changes that occur as a result of overeating and weight gain in cats,” says study co-author Kelly Swanson, professor in the Department of Animal Sciences and interim director of the Division of Nutritional Sciences (DNS), part of the College of Agricultural, Consumer and Environmental Sciences (ACES) at U. of I.

The study included 11 adult spayed female cats. They were fed a standard dry cat food and after two weeks of baseline measurements, they were allowed to eat as much as they wanted. The researchers collected blood and fecal samples at regular intervals and monitored physical activity.

Once the cats were able to overeat, they immediately increased their food intake substantially and started to gain weight. At the onset of the study, their average body condition score (BCS) was 5.41 on a 9-point scale. After 18 weeks of overfeeding, it had increased to 8.27, corresponding to being 30% overweight. BCS is equivalent to body mass index (BMI) for humans, and 6 or above is considered overweight, Swanson said.

The researchers analyzed changes in fecal output, gastrointestinal transit time, digestive efficiency (nutrient digestibility), and microbiota bacterial composition over the 20-week duration of the study.

“We found that as cats ate more and gained weight, gastrointestinal transit time was reduced, and so was digestive efficiency. When the body gets less food, it will be more efficient in extracting nutrients. But when the amount of food increases, it passes through the digestive system faster and fewer nutrients are extracted in the process,” Swanson explained.

The researchers also found significant changes in gut microbial composition between the lean cats at baseline and after 18 weeks of weight gain. The relative abundance of Bifidobacterium, which has antimicrobial activity, inhibits pathogens, and stimulates the immune system, increased, while Collinsella, which degrades fiber and has been linked to pro-inflammatory diseases, decreased. These results are opposite to what has been measured in overweight humans and suggest that their association to weight gain is complex, Swanson noted.

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“The change in the gastrointestinal transit time was a novel finding and a potential reason for the change in fecal microbiota. Future studies should consider measuring transit time to better explain modifications to the microbiome of pets,” he added.

As the cats’ food consumption grew, so did their fecal output. In other words, as they ate more, they also pooped more. At the same time, fecal pH decreased, meaning that the stool became more acidic.

“In humans, a low fecal pH indicates poor absorption of carbohydrates and fat. Our findings correlate with this, as reduced fecal pH aligned with higher food intake and reduced digestibility,” Swanson said.

The researchers also measured the cats’ activity level with a monitor attached to a collar. The cats were housed in a group setting where they were able to interact with each other and play with toys, except for the days when stool samples were collected.

“We expected that weight gain might lead to decreased physical activity, but we did not observe any consistent changes in activity level. However, this could vary with individual cats and their environment, and how much their owners interact with them,” Swanson stated.

Understanding the metabolic and gastrointestinal changes that occur with weight gain and obesity in pets may help with future prevention and treatment plans, the researchers conclude.

Pet owners who want to help their cats lose weight can employ various strategies. In another new study, Swanson and his co-authors showed that restricted feeding can promote safe weight and fat loss in cats. The researchers also suggest pet parents encourage activity in their feline companions. For example, they can stimulate foraging by placing food around the home, or use food puzzles during mealtime to promote engagement and mental enrichment.

After the conclusion of the weight gain study, the 11 cats were put on a restricted-feeding diet that helped them return to normal weight.

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Humans are disrupting natural ‘salt cycle’ on a global scale, new study shows

The planet’s demand for salt comes at a cost to the environment and human health, according to a new scientific review led by University of Maryland Geology Professor Sujay Kaushal. Published in the journal Nature Reviews Earth & Environment, the paper revealed that human activities are making Earth’s air, soil and freshwater saltier, which could pose an “existential threat” if current trends continue.

Geologic and hydrologic processes bring salts to Earth’s surface over time, but human activities such as mining and land development are rapidly accelerating the natural “salt cycle.” Agriculture, construction, water and road treatment, and other industrial activities can also intensify salinization, which harms biodiversity and makes drinking water unsafe in extreme cases.

“If you think of the planet as a living organism, when you accumulate so much salt it could affect the functioning of vital organs or ecosystems,” said Kaushal, who holds a joint appointment in UMD’s Earth System Science Interdisciplinary Center. “Removing salt from water is energy intensive and expensive, and the brine byproduct you end up with is saltier than ocean water and can’t be easily disposed of.”

Kaushal and his co-authors described these disturbances as an “anthropogenic salt cycle,” establishing for the first time that humans affect the concentration and cycling of salt on a global, interconnected scale.

“Twenty years ago, all we had were case studies. We could say surface waters were salty here in New York or in Baltimore’s drinking water supply,” said study co-author Gene Likens, an ecologist at the University of Connecticut and the Cary Institute of Ecosystem Studies. “We now show that it’s a cycle — from the deep Earth to the atmosphere — that’s been significantly perturbed by human activities.”

The new study considered a variety of salt ions that are found underground and in surface water. Salts are compounds with positively charged cations and negatively charged anions, with some of the most abundant ones being calcium, magnesium, potassium and sulfate ions.

“When people think of salt, they tend to think of sodium chloride, but our work over the years has shown that we’ve disturbed other types of salts, including ones related to limestone, gypsum and calcium sulfate,” Kaushal said.

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When dislodged in higher doses, these ions can cause environmental problems. Kaushal and his co-authors showed that human-caused salinization affected approximately 2.5 billion acres of soil around the world — an area about the size of the United States. Salt ions also increased in streams and rivers over the last 50 years, coinciding with an increase in the global use and production of salts.

Salt has even infiltrated the air. In some regions, lakes are drying up and sending plumes of saline dust into the atmosphere. In areas that experience snow, road salts can become aerosolized, creating sodium and chloride particulate matter.

Salinization is also associated with “cascading” effects. For example, saline dust can accelerate the melting of snow and harm communities — particularly in the western United States — that rely on snow for their water supply. Because of their structure, salt ions can bind to contaminants in soils and sediments, forming “chemical cocktails” that circulate in the environment and have detrimental effects.

“Salt has a small ionic radius and can wedge itself between soil particles very easily,” Kaushal said. “In fact, that’s how road salts prevent ice crystals from forming.”

Road salts have an outsized impact in the U.S., which churns out 44 billion pounds of the deicing agent each year. Road salts represented 44% of U.S. salt consumption between 2013 and 2017, and they account for 13.9% of the total dissolved solids that enter streams across the country. This can cause a “substantial” concentration of salt in watersheds, according to Kaushal and his co-authors.

To prevent U.S. waterways from being inundated with salt in the coming years, Kaushal recommended policies that limit road salts or encourage alternatives. Washington, D.C., and several other U.S. cities have started treating frigid roads with beet juice, which has the same effect but contains significantly less salt.

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Kaushal said it is becoming increasingly important to weigh the short- and long-term risks of road salts, which play an important role in public safety but can also diminish water quality.

“There’s the short-term risk of injury, which is serious and something we certainly need to think about, but there’s also the long-term risk of health issues associated with too much salt in our water,” Kaushal said. “It’s about finding the right balance.”

The study’s authors also called for the creation of a “planetary boundary for safe and sustainable salt use” in much the same way that carbon dioxide levels are associated with a planetary boundary to limit climate change. Kaushal said that while it’s theoretically possible to regulate and control salt levels, it comes with unique challenges.

“This is a very complex issue because salt is not considered a primary drinking water contaminant in the U.S., so to regulate it would be a big undertaking,” Kaushal said. “But do I think it’s a substance that is increasing in the environment to harmful levels? Yes.”

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