Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 3 complete abstracts (556 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Nervous Systems, Sympathetic; Nervous System, Sympathetic; Sympathetic Nervous Systems; Systems, Sympathetic Nervous; System, Sympathetic Nervous.
Where it fits in the MeSH classification
- Broader topics
- Autonomic Nervous System
- Narrower topics
- Ganglia, Sympathetic; Splanchnic Nerves; Sympathoadrenal System; Vasomotor System
- See also
- Chromaffin System; Sympathectomy; Sympatholytics; Sympathomimetics
Research landscape
PubMed indexes 67,405 records tagged with the MeSH heading “Sympathetic Nervous System” (counts retrieved 2026-10-29). 3,144 of them (4.7%) were published from 2020 onward, and the busiest period so far is through 1999 with 45,850 records.
Reviews account for 7,424 records (11.0%) and meta-analyses for 78. Randomized controlled trials number 1,339 (2.0%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 45,850 |
| 2000-2009 | 10,284 |
| 2010-2019 | 8,127 |
| 2020 onward | 3,144 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 7,424 | 11.0% |
| Meta-analyses | 78 | 0.1% |
| Randomized controlled trials | 1,339 | 2.0% |
Method: PubMed query "Sympathetic Nervous System"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in neuroscience
Neuroscience draws on tools with different strengths: cellular and animal work can manipulate circuits directly, while human imaging and electrophysiology observe the living brain at lower resolution. Small imaging studies are prone to false positives, and findings in animals do not always carry over to people. Clinical neurology and psychiatry rely on trials and cohort studies whose outcomes are often symptom scales. Check the species, the sample size, how the outcome was measured and whether results were replicated.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Sympathetic and parasympathetic subtypes of body-first Lewy body disease observed in postmortem tissue from prediagnostic individuals | 2025 | Research article Design not recorded in structured metadata | 63 | cc by PMID 40082617 · DOI · PMC12081295 |
| Tumour-brain crosstalk restrains cancer immunity via a sensory-sympathetic axis | 2026 | Research article Design not recorded in structured metadata | 35 | cc by PMID 41639447 · DOI · PMC12935554 |
| Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain | 2025 | Research article Design not recorded in structured metadata | 26 | cc by PMID 39762209 · DOI · PMC11704193 |
Sympathetic and parasympathetic subtypes of body-first Lewy body disease observed in postmortem tissue from prediagnostic individuals [1]
Abstract reading summary — source excerpts
- Opening excerpt
- Recent studies suggest the existence of brain-first and body-first subtypes within the Lewy body disorder (LBD) spectrum, including Parkinson's disease.
- Closing excerpt
- Our study supports the existence of three prediagnostic LBD subtypes and highlights the sympathetic nervous system alongside the parasympathetic system in LBD onset and progression.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (151 words)
Recent studies suggest the existence of brain-first and body-first subtypes within the Lewy body disorder (LBD) spectrum, including Parkinson's disease. These studies primarily focused on α-synuclein propagation through the parasympathetic vagal and olfactory bulb routes, leaving the possibility of a sympathetic nervous system spreading route unexplored. In the present study, we analyzed two postmortem datasets, which included 173 and 129 cases positive for Lewy pathology. We observed a clear distinction between brain-first and body-first subtypes in early prediagnostic cases with mild Lewy pathology. Brain-first cases displayed minimal peripheral organ pathology in prediagnostic phases, contrasting with marked autonomic involvement in prediagnostic body-first cases. Utilizing the SuStaIn machine learning algorithm, we identified two distinct body-first subtypes, one with vagal predominance and another with sympathetic predominance, in equal proportions. Our study supports the existence of three prediagnostic LBD subtypes and highlights the sympathetic nervous system alongside the parasympathetic system in LBD onset and progression.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40082617 · DOI · PMC12081295
Tumour-brain crosstalk restrains cancer immunity via a sensory-sympathetic axis [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Body-brain communication has emerged as a key regulator of tissue homeostasis1-5.
- Closing excerpt
- Collectively, these results reveal a bidirectional tumour-brain communication involving vagal sensory input and sympathetic output that cooperatively regulate anti-cancer immunity; targeting this tumour-brain circuit may provide new treatments for visceral organ cancers.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (196 words)
Body-brain communication has emerged as a key regulator of tissue homeostasis1-5. Solid tumours are innervated by different branches of the peripheral nervous system and increased tumour innervation is associated with poor cancer outcomes6-8. However, it remains unclear how the brain senses and responds to tumours in peripheral organs, and how tumour-brain communication influences cancer immunity. Here we identify a tumour-brain axis that promotes oncogenesis by establishing an immune-suppressive tumour microenvironment. Combining genetically engineered mouse models with neural tracing, tissue imaging and single-cell transcriptomics, we demonstrate that lung adenocarcinoma induces innervation and functional engagement of vagal sensory neurons, a major interoceptive system connecting visceral organs to the brain. Mechanistically, Npy2r-expressing vagal sensory nerves transmit signals from lung tumours to brainstem nuclei, driving elevated sympathetic efferent activity in the tumour microenvironment. This, in turn, suppresses anti-tumour immunity via β2 adrenergic signalling in alveolar macrophages. Disruption of this sensory-to-sympathetic pathway through genetic, pharmacological or chemogenetic approaches significantly inhibited lung tumour growth by enhancing immune responses against cancer. Collectively, these results reveal a bidirectional tumour-brain communication involving vagal sensory input and sympathetic output that cooperatively regulate anti-cancer immunity; targeting this tumour-brain circuit may provide new treatments for visceral organ cancers.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41639447 · DOI · PMC12935554
Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain [3]
Abstract reading summary — source excerpts
- Opening excerpt
- Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease often accompanied by pain, seriously affecting physical and mental health of patients.
- Closing excerpt
- It sheds light on a new mechanism of abnormal innervation at the osteochondral junction and the regional crosstalk between peripheral nerves, providing a potential target for treating TMJ-OA pain.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (209 words)
Temporomandibular joint osteoarthritis (TMJ-OA) is a common disease often accompanied by pain, seriously affecting physical and mental health of patients. Abnormal innervation at the osteochondral junction has been considered as a predominant origin of arthralgia, while the specific mechanism mediating pain remains unclear. To investigate the underlying mechanism of TMJ-OA pain, an abnormal joint loading model was used to induce TMJ-OA pain. We found that during the development of TMJ-OA, the increased innervation of sympathetic nerve of subchondral bone precedes that of sensory nerves. Furthermore, these two types of nerves are spatially closely associated. Additionally, it was discovered that activation of sympathetic neural signals promotes osteoarthritic pain in mice, whereas blocking these signals effectively alleviates pain. In vitro experiments also confirmed that norepinephrine released by sympathetic neurons promotes the activation and axonal growth of sensory neurons. Moreover, we also discovered that through releasing norepinephrine, regional sympathetic nerves of subchondral bone were found to regulate growth and activation of local sensory nerves synergistically with other pain regulators. This study identified the role of regional sympathetic nerves in mediating pain in TMJ-OA. It sheds light on a new mechanism of abnormal innervation at the osteochondral junction and the regional crosstalk between peripheral nerves, providing a potential target for treating TMJ-OA pain.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39762209 · DOI · PMC11704193
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Intravascular hemolysis and the pathophysiology of sickle cell disease [4]
- Research article Obesity, kidney dysfunction and hypertension: mechanistic links [5]
- Research article Sympathetic nervous system regulation of the tumour microenvironment [6]
- Research article Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence [7]
- Research article Primary angle closure glaucoma: What we know and what we don't know [8]
- Research article Hypothalamic AMPK: a canonical regulator of whole-body energy balance [9]
References
- Andersen KB, Krishnamurthy A, Just MK, Van Den Berge N, Skjærbæk C, Horsager J, et al.. Sympathetic and parasympathetic subtypes of body-first Lewy body disease observed in postmortem tissue from prediagnostic individuals. . 2025. PMID 40082617 · DOI · PMC12081295
- Wei HK, Yu CD, Hu B, Zeng X, Ichise H, Li L, et al.. Tumour-brain crosstalk restrains cancer immunity via a sensory-sympathetic axis. . 2026. PMID 41639447 · DOI · PMC12935554
- Ma Z, Wan Q, Qin W, Qin W, Yan J, Zhu Y, et al.. Effect of regional crosstalk between sympathetic nerves and sensory nerves on temporomandibular joint osteoarthritic pain. . 2025. PMID 39762209 · DOI · PMC11704193
- Kato GJ, Steinberg MH, Gladwin MT. Intravascular hemolysis and the pathophysiology of sickle cell disease. J Clin Invest. 2017. PMID 28248201 · DOI · PMC5330745
- Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity, kidney dysfunction and hypertension: mechanistic links. Nat Rev Nephrol. 2019. PMID 31015582 · DOI · PMC7278043
- Cole SW, Nagaraja AS, Lutgendorf SK, Green PA, Sood AK. Sympathetic nervous system regulation of the tumour microenvironment. Nat Rev Cancer. 2015. PMID 26299593 · DOI · PMC4828959
- Turner AI, Smyth N, Hall SJ, Torres SJ, Hussein M, Jayasinghe SU, et al.. Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence. Psychoneuroendocrinology. 2020. PMID 32045797 · DOI
- Sun X, Dai Y, Chen Y, Yu DY, Cringle SJ, Chen J, et al.. Primary angle closure glaucoma: What we know and what we don't know. Prog Retin Eye Res. 2017. PMID 28039061 · DOI
- López M, Nogueiras R, Tena-Sempere M, Diéguez C. Hypothalamic AMPK: a canonical regulator of whole-body energy balance. Nat Rev Endocrinol. 2016. PMID 27199291 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.