EVALUATION OF AUTONOMIC DYSFUNCTION UTILIZING ACETYLCHOLINE CHALLENGES

Both types of receptors are involved in memory, including long-term and working memory, memory formation, consolidation and retrieval Within your brain, acetylcholine is also involved in motivation, arousal, attention, learning and promoting rapid eye movement (REM) sleep

The rate-limiting steps in ACh synthesis are the availability of choline and acetyl-CoA. During increased neuronal activity the availability of acetyl-CoA from the mitochondria is upregulated as is the uptake of choline into the nerve ending from the synaptic cleft. Ca2+ appears to be involved in both of these regulatory mechanisms. As will be described later, the inactivation of ACh is converted by metabolism to choline and acetic acid.

Consequently much of the choline used for ACh synthesis comes from the recycling of choline from metabolized ACh Another source is the breakdown of the phospholipid, phosphatidylcholine One of the strategies to increase ACh neurotransmission is the administration of choline in the diet However, this has not been effective, probably because the administration of choline does not increase the availability of choline in the CNS

Causes of Diminished Acetylcholine include:

Oxidative stress

• Insulin resistance

• Mitochondrial dysfunction

• High cortisol

• Cofactors

• Brain injury

• Reproductive hormones

The clinical question is how can a physician determine if these neurophysiological functions are working properly? This is the profound reality of Diagnostic Muscle Testing With few exceptions, all activities of the CNS, receiving, processing, and integrating information, ultimately finds expression in contraction of a muscle (Color Atlas of Physiology, A Despopoulos, S Silberange, Year Book Medical Publishers, Georg Thieme Verlag)

Numerous members of the USA chapter of ICAK (Drs. Wally Schmitt, Michael Allen, Richard Belli) have documented that ‘all muscle testing ultimately tests the central integrative state of the ventral horn’.

Sherrington called the lower motor neurons of the spinal cord the “final common pathway” that controls behavior. These motor neurons, also called the somatic motor neurons, directly command muscle contraction. They are the output of the motor system. Inputs to lower motor neurons include the sensory afferents entering the dorsal horn (providing information about muscle length), the upper motor neurons in the motor cortex, and the interneurons within the spinal cord that participate in spinal motor programs.