The Autonomic Brain: An Activation Likelihood Estimation Meta-Analysis for Central Processing of Autonomic Function

Abstract

The autonomic nervous system (ANS) is of paramount importance for daily life. Its regulatory action on respiratory, cardiovascular, digestive, endocrine, and many other systems is controlled by a number of structures in the CNS. While the majority of these nuclei and cortices have been identified in animal models, neuroimaging studies have recently begun to shed light on central autonomic processing in humans. In this study, we used activation likelihood estimation to conduct a meta-analysis of human neuroimaging experiments evaluating central autonomic processing to localize (1) cortical and subcortical areas involved in autonomic processing, (2) potential subsystems for the sympathetic and parasympathetic divisions of the ANS, and (3) potential subsystems for specific ANS responses to different stimuli/tasks. Across all tasks, we identified a set of consistently activated brain regions, comprising left amygdala, right anterior and left posterior insula and midcingulate cortices that form the core of the central autonomic network. While sympatheticassociated regions predominate in executive-and salience-processing networks, parasympathetic regions predominate in the default mode network. Hence, central processing of autonomic function does not simply involve a monolithic network of brain regions, instead showing elements of task and division specificity.

A Brain Phenotype for Stressor‐Evoked Blood Pressure Reactivity

“…In these regards, the present findings agree with, and extend extant results from, meta‐analytic neuroimaging reviews of human autonomic and cardiovascular control 12, 18, 19…”

“…The functional neuroanatomy of the insula has been extensively reviewed, particularly with respect to its involvement in stress‐related cardiovascular pathophysiology and clinical outcomes (eg, Takotsubo cardiomyopathy) 16, 57. Based on existing evidence, it has been proposed that areas within the left insula may exhibit a stronger association with parasympathetic cardiovascular control, whereas areas in the right insula may exhibit a stronger association with sympathetic cardiovascular control 16, 19, 58. Such autonomic control influences are enabled by dense insula connectivity with areas of the prefrontal cortex, anterior cingulate, hypothalamus, thalamus, medial temporal lobe (eg, amygdala, hippocampus), and cell groups within the midbrain and brainstem 16.…”

“…In this regard, brain areas for visceral control may provide a substrate for centrally orchestrating behavioral and stress‐related influences on CVD risk through autonomic and hemodynamic mechanisms. An expanding corpus of research supports this possibility: Patterns of functional activity within brain areas for visceral control have been related in meta‐analyses of human neuroimaging studies to stressor‐evoked cardiovascular reactivity, as well as indicators of autonomic cardiovascular control and other systemic physiological markers of CVD risk 12, 13, 18, 19. Thus, individual differences in the functionality of brain areas for visceral control may correspond to a central nervous system source of variability in stressor‐evoked cardiovascular reactivity and possible vulnerability to stress‐related CVD risk.…”

Cardiac responses to viewing facial emotion differentiate frontotemporal dementias

“…We hypothesized that cardiac modulation would be attenuated in bvFTD and nfvPPA due to degeneration of fronto‐insular networks in these diseases, but relatively preserved (and separable from emotion identification) in syndromes targeting the anterior temporal lobes (svPPA and rtvFTD) 18, 20, 21. We further hypothesized that emotion recognition ability but not cardiac reactivity would be associated with semantic knowledge, while cardiac reactivity would correlate with atrophy in components of the central autonomic regulatory network (ACC, insula, OFC) 15, 16, 24…”

“…Stimulus onset induces a cardiac orienting deceleration, which is modulated by affective content, with greater cardiac deceleration accompanying higher emotional valence 12, 13, 14. This central regulation of cardiac function is mediated by a distributed brain network including anterior cingulate cortex (ACC), insula, and orbitofrontal cortex (OFC) 15, 16. Cardiac afferent information informs affective valuation,17 and visceral autonomic responses may support emotional contagion and empathy 9…”