Pure Autonomic Failure

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Chapter 4 endnote 55, from How Emotions are Made: The Secret Life of the Brain by Lisa Feldman Barrett.
Some context is:

Patients with spinal cord damage or Pure Autonomic Failure, a degenerative disease of the autonomic nervous system, have interoceptive predictions but don’t receive sensory inputs from their organs and tissue. These patients likely experience affect based primarily on uncorrected predictions.

Patients with pure autonomic failure have impaired body budgeting (selectively in the autonomic nervous system, or "ANS"), meaning their bodies cannot send ANS prediction errors to the brain.[1] Also they have difficulty mounting heart rate and blood pressure changes during exercise and tasks that require effort, such as doing math problems in their heads.[2] All indications are that these patients have normal affect; or if they have impairments, they are very, very subtle.[3][4] A brain imaging study indicates that they still have increased activation in body-budgeting brain areas that issue predictions[5] and therefore their interoceptive perceptions and associated affective feelings are based primarily on interoceptive predictions.

For other examples of autonomic nervous system impairments, see these references.[6][7][8][9]


Notes on the Notes

  1. Benarroch, Eduardo E. 2014. "The clinical approach to autonomic failure in neurological disorders." Nature Reviews Neurology 10 (7): 396–407.
  2. Mathias, Christopher J. 2000. "Disorders of the Autonomic Nervous System." In Neurology in Clinical Practice: Principles of Diagnosis and Management, edited by Walter G. Bradley, Robert B. Daroff, C. David Marsden, and Gerald M. Fenichel, 2131–2165. Woburn, Massachusetts: Butterworth-Heinemann.
  3. Heims, H. C., H. D. Critchley, R. Dolan, C. J. Mathias, and L. Cipolotti. 2004. "Social and motivational functioning is not critically dependent on feedback of autonomic responses: neuropsychological evidence from patients with pure autonomic failure." Neuropsychologia 42 (14): 1979-1988.
  4. Also, spinal cord lesions (which selectively impair information from the body from reaching the brain) diminish the intensity of affect very little. See for example Cobos, Pilar, María Sánchez, Nieves Pérez, and Jaime Vila. 2004. "Brief report Effects of spinal cord injuries on the subjective component of emotions." Cognition and Emotion 18 (2): 281-287.
  5. Critchley, Mathias, Dolan. 2001. "Neuroanatomical basis for first-and second-order representations of bodily states." Nature Neuroscience 4 (2): 207-212.
  6. Mathias, Christopher J. and R. Bannister. 1999. "Investigation of autonomic disorders." In Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, fourth edition, edited by Christopher J. Mathias and R. Bannister, 169–195. Oxford: Oxford University Press.
  7. Mathias, Christopher J., Rajeev Mallipeddi, and Katharine Bleasdale-Barr. 1999. "Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy." Journal of Neurology 246 (10): 893-898.
  8. Magnifico, F., V. P. Misra, N. M. F. Murray, and C. J. Mathias. 1998. "The sympathetic skin response in peripheral autonomic failure—evaluation in pure autonomic failure, pure cholinergic dysautonomia and dopamine-beta-hydroxylase deficiency." Clinical Autonomic Research 8 (3): 133-138.
  9. Clark, Charles V., and David J. Ewing. 1988. "Ocular autonomic function in progressive autonomic failure." Documenta ophthalmologica 70 (4): 309-321.