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Cechetto DF (2014) Cortical control of the autonomic nervous system. Exp Physiol. 99:2:326-31. doi: 10.1113/expphysiol.2013.075192.
ABSTRACT
What is the topic of this review?
The pathways in the brain by which visceral information, in particular cardiopulmonary
afferents, ascend to the cerebral cortex have been delineated in animal models. Studies using
functional magnetic resonance imaging in humans have confirmed what was known from the
animal studies and established the critical sites in the cerebral cortex of humans for autonomic
control and the significance of these sites for cognitive emotional function.
What advances does it highlight?
Stimulation of cardiopulmonary afferents in humans has consistently resulted in activation
in the insular cortex and the anterior cingulate cortex. It has been shown that individuals
who are characterized as cardiovascular responders to mental stress have a different pattern
of activity in the cortex related to the cardiac changes.
A number of animal studies in the rat and cat have been particularly useful for determining the
pathways and the sites in the forebrain and cortex that are responsible for autonomic control.
For example, these experiments have demonstrated that there is a viscerotopically organized
pathway,with the first site of termination in the nucleus of the solitary tract andwith subsequent
relays in the parabrachial nucleus and the ventroposterior parvocellular nucleus of the thalamus
before final visceral afferent inputs inthe insular cortex. Several neuroimaging studies inhumans,
using cardiopulmonary manipulations, have confirmed the importance of the insular cortex as
a site of for visceral afferent inputs. The anterior cingulate cortex has also been implicated in
cardiopulmonary control. Both the insular cortex and the infralimbic cortex have been shown to
be involved in descending control of the cardiovascular system. Neuroimaging with functional
magnetic resonance imaging has demonstrated that the cortical autonomic control pathways
are different in individuals who are characterized as cardiovascular reactors to mental stress.
There is evidence that this alteration in pathways in the cortex may be due to past experiences,
including childhood trauma.
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