Physiological Interpretation of ANS Categories

1. PSNS prevalence with the average level of SNS activity: 
This category represents PSNS dominance. This state is usually noted when a patient is resting or in the first stage of sleep (specifically, dreamless sleep). In the second stage of sleep, SNS activity is generally increased, at times markedly. thus this category is differentiated into four grades, dependent on the state of the PSNS. This category is somewhat limited, since it can only be noticed in patients with strictly median values of SNS activity
.

2. Increase in PSNS and SNS activity: 
This category is subdivided into sixteen different possible combinations of PSNS/SNS activity. It is characteristic of most healthy subjects.

3. SNS Prevalence:
This category represents an increase in SNS compared to a median value of the PSNS. From the physiological standpoint, this category represents a transitional stage between the second and the fourth categories.

4. PSNS decrease with SNS increase:
This category can apply to both clinically ill. and clinically healthy individuals (defined as those not requiring hospitalisation). However, the use of the term "healthy" is not always appropriate because functional imbalance, from stress, physical exhaustion, nervous tension, infections, intoxication (drug or alcoholic). exacerbation of chronic conditions, and many other conditions may still be present. In such cases a decrease in PSNS due to depressed PSNS nerve centres can be observed, along with a simultaneous sympathetic adrenergic activation, which is triggered by the struggle of the nervous system to achieve balance.

5. PSNS decrease with an average level SNS:
This category, like the third, is transitional. Everything that pertains to the fourth category can be related to it, but here, the SNS activity is within average values. This means that stress, exhaustion, or nervous overload is unlikely This category may often reflect a depression in the receptors of the PSNS, indicating the possibility of pathology.

6. SNS and PSNS decrease: 
The sixth category, especially at points 3 and 4, reflects a general involuntary degeneration of both the SNS and PSNS nervous centers. The majority of cases found in this category are either very old patients or those with diseases, which cause a significant decrease in the sensitivity of the entire receptor system along with a partial degeneration of nervous centers.

NOTE: Point (-1, -1) on the coordinate. is an exception to this category. It represents an/insignificant, general decrease in ANS and approximates the point of autonomic Balance T can be interpreted as a borderline value of autonomic balance. At the same time, this point, along; with (-1, -2), is characteristic of patients with increased K+ levels (hyperkalemia)

 

7. Autonomic Balance:
This category, although formally just one point, and all points in its vicinity that belong to other categories can be interpreted as borderline values of the Autonomic Balance.

8. SNS decrease with PSNS increase:
This category is an exception to all others because the normal physiology of a person gives prevalence to the PSNS with average or increased SNS. A dramatic decrease in the SNS here is unusual. But it is representative of persons with special training, such as scuba divers for whom a depressed SNS level is of foremost importance.

NOTE: Point (0, -1) is and intermediate value between point (1, -1) of group 8 and point (-1, - 1) of group 6. Of course, a proper physiological interpretation of these eight categories is only possible within the context of a standard, general assessment of the patient's overall condition.

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