Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Neurol. Jan 15, 2023; 9(1): 1-7
Published online Jan 15, 2023. doi: 10.5316/wjn.v9.i1.1
Brachial arteries sympathetic innervation: A contribution to anatomical knowledge
Fahrettin Ege, Omer Kazcı
Fahrettin Ege, Department of Neurology, VM Medical Park Hospital Ankara, Ankara 06120, Turkey
Omer Kazcı, Department of Radiology, VM Medical Park, Ankara 06120, Turkey
Author contributions: Ege F and Kazci Ö both contributed to the preparation of the project, obtained, analysed, and interpreted data of the study, and made a significant contribution to writing of the article.
Institutional review board statement: The studies conformed to the current version of the Declaration of Helsinki, and the protocols were authorized by the Clinical Research Ethics Committee at Ankara City Hospital No. 2 (Approval No. E2-22-1307).
Informed consent statement: Informed written consent was obtained from the patients and their families for the publication of this report and any accompanying images.
Conflict-of-interest statement: All authors report having no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fahrettin Ege, MD, Department of Neurology, VM Medical Park Hospital Ankara, Kentkoop Kent Koop Mah 1868. Sokak No: 15 06370 Yenimahalle/Ankara, Ankara 06120, Turkey. fahrettinege@yahoo.com
Received: August 15, 2022
Peer-review started: August 15, 2022
First decision: October 21, 2022
Revised: November 1, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 15, 2023
Processing time: 149 Days and 8.4 Hours
Abstract
BACKGROUND

The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.

AIM

To observe brachial artery sympathetic innervation.

METHODS

We developed a neurophysiological autonomous test that measured the effects of peripheral sympathetic fibres on peripheral arteries. Our specific objective was to find the sympathetic innervation of the brachial artery. To accomplish this purpose, the brachial artery baseline diameter and flow rate were measured in the right arm of the patients. Afterwards, electrical stimulus was applied to the medial nerve for 5 s. Through electrical sympathetic activation, the vessel diameter and overall flow rate will decrease. After 7 d, a similar experiment was repeated using the ulnar nerve.

RESULTS

The differences in diameter and flow rate of the brachial artery in response to median and ulnar nerve activation were compared. In the total group, no significant difference in diameter was seen between medial and ulnar nerve stimulation (P = 0.648). The difference in absolute slowdown of flow rate between median nerve stimulation and ulnar nerve stimulation was not statistically significant for the entire group (P = 0.733).

CONCLUSION

As a target organ, the brachial artery receives an equal amount of sympathetic innervation from the median and the ulnar nerves.

Keywords: Median nerve; Ulnar nerve; Brachial artery; Sympathetic nervous system; Functional anatomy

Core Tip: These observations imply that a peripheral nerve injury causes vasomotor paralyses and higher blood flow in large and medium arteries of extremities. Conversely, physiological activation of a peripheral nerve causes lower blood flow. Our study depended on this pathophysiological background and aimed to investigate the anatomical innervation of the brachial artery by utilizing a neurophysiological experiment. As a target organ, the brachial artery receives an equal amount of sympathetic innervation from the median and ulnar nerves. Expanding similar neurophysiological research to other arteries in the upper and lower limbs will contribute to the advancement of the field of functional neuroanatomy.