The Central Autonomic Network: Functional Organization, Dysfunction, and Perspective

Benarroch, Eduardo E.

doi:10.1016/s0025-6196(12)62272-1

Cited by 1,174 publications

(872 citation statements)

References 79 publications

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“…The PBN is an important viscerosensory nucleus, relaying information from the NTS to a wide array of target regions including the PAG, hypothalamus, amygdala, and other forebrain nuclei (Gauriau et al 2002). The LC is the source of noradrenergic input in the brain and is associated with arousal and the hypothalamic-pituitary-axis (HPA) stress response, relaying afferent signaling to the hypothalamus and amygdala (Benarroch 1993;Ziegler et al 1999). Thus, a negative correlation to HF in the LC would be consistent with decreased stress response during increased cardiovagal modulation.…”

Section: Discussionmentioning

confidence: 99%

“…Afferent-efferent integration and central command of efferent activity is managed by the brain via the purported Central Autonomic Network (CAN) (Loewy et al 1990;Benarroch 1993;Saper 2002;Janig 2006). Afferent (visceral) sensations are carried via cranial, sacral (parasympathetic), and thoracolumbar (sympathetic) nervous pathways to the nucleus tractus solitarius (NTS) in the medulla.…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, efferent regions can also be modulated by excitatory and inhibitory inputs (e.g. central command) from a set of regions including the rostral ventromedial medulla (rVMM), midbrain periaqueductal gray (PAG), hypothalamus, amygdala, and dorsomedial prefrontal and anterior cingulate cortices (Loewy et al 1990;Benarroch 1993;Saper 2002;Janig 2006). While these regions have been well described in animal models, it is not clear if analogous and/or different connections exist in the human.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Brain correlates of autonomic modulation: Combining heart rate variability with fMRI

Napadow¹,

Dhond²,

Conti³

et al. 2008

NeuroImage

296

221

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The central autonomic network (CAN) has been described in animal models but has been difficult to elucidate in humans. Potential confounds include physiological noise artifacts affecting brainstem neuroimaging data, and difficulty in deriving non-invasive continuous assessments of autonomic modulation. We have developed and implemented a new method which relates cardiac-gated fMRI timeseries with continuous-time heart rate variability (HRV) to estimate central autonomic processing. As many autonomic structures of interest are in brain regions strongly affected by cardiogenic pulsatility, we chose to cardiac-gate our fMRI acquisition to increase sensitivity. Cardiac-gating introduces T1-variability, which was corrected by transforming fMRI data to a fixed TR using a previously published method (Guimaraes et al. 1998). The electrocardiogram was analyzed with a novel point process adaptive-filter algorithm for computation of the high-frequency (HF) index, reflecting the time-varying dynamics of efferent cardiovagal modulation. Central command of cardiovagal outflow was inferred by using the HF timeseries resampled at as a regressor to the fMRI data. A grip task was used to perturb the autonomic nervous system. Our combined HRV-fMRI approach demonstrated HF correlation with fMRI activity in the hypothalamus, cerebellum, parabrachial nucleus/locus ceruleus, periaqueductal gray, amygdala, hippocampus, thalamus, and dorsomedial/dorsolateral prefrontal, posterior insular, and middle temporal cortices. While some regions consistent with central cardiovagal control in animal models gave corroborative evidence for our methodology, other mostly higher cortical or limbic-related brain regions may be unique to humans. Our approach should be optimized and applied to study the human brain correlates of autonomic modulation for various stimuli in both physiological and pathological states.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Brain correlates of autonomic modulation: Combining heart rate variability with fMRI

Napadow¹,

Dhond²,

Conti³

et al. 2008

NeuroImage

296

221

View full text Add to dashboard Cite

show abstract

“…The functions of the CAN are organized in four hierarchical levels that are closely interconnected: spinal, bulbopontine, pontomesencephalic, and forebrain levels [70,71].…”

Section: Functional Organization Of Autonomic Nervous Systemmentioning

confidence: 99%

Nociception and autonomic nervous system

et al. 2013

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The International Association for the Study of Pain (IASP) defines pain as ''an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage''. Pain may also be experienced in absence of noxious stimuli and together with temperature and other bodily feelings constitute the interoception redefined as the sense of the physiological condition of the entire body, not just the viscera. The main characteristic of these feelings is the affective aspect. Emotion, motivation, and consequent behavior connected with these feelings characterize their homeostatic role. This implies an interaction between neural structures involved in pain sensation and autonomic control. The aim of this review is to focus on pain perception, mainly on pain matrix structures' connections with the autonomic nervous system.

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“…El sistema nervioso humano tiene dos componentes básicos, separados anatómica-mente, que trabajan interconectados: el sistema nervioso central (SNC), formado por el cerebro y la médula espinal, y el sistema nervioso periférico, conformado por un grupo de neuronas conectadas a los ganglios y a los nervios que se encuentran fuera del sistema nervioso central (1). El sistema nervioso periférico se subdivide en dos porciones: somática y autonómica.…”

Section: Sistema Nervioso Autónomounclassified

Síndromes de disfunción autonómica asociados con intolerancia ortostática.

Grubb¹,

Vesga²,

Guzmán³

et al. 2003

biomedica

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Los síndromes de disfunción autonómica asociados con la intolerancia ortostática son una de las alteraciones cuya fisiopatología fue reconocida hace sólo pocos años, lo que ha llevado a un mejor reconocimiento clínico. Entre las manifestaciones clínicas, el síncope y el presíncope asociados con ortostatismo son muy frecuentes. El espectro de la presentación clínica de estos síndromes varía desde la fatiga crónica hasta el síncope neurocardiogénico recurrente. En este artículo se revisa la fisiopatología y clasificación actual de los síndromes de disfunción autonómica asociados a intolerancia ortostática, así como las causas de disautonomía primaria y secundaria, y su enfoque diagnóstico y terapéutico.Palabras clave: intolerancia ortostática, disfunción autonómica, función autonómica, síncope mediado neuralmente, síncope vasovagal. Recent advances in diagnosis of autonomic disfunction syndromes associated with orthostatic intoleranceIn recent years increased interest has focused on the nature and pathophysiology of orthostatic intolerance and syndromes associated with autonomic disorders. Understanding the pathophysiology underlying these syndromes has led to the recognition of several distinct clinical entities with overlapping features and the associated need to reclassify many of the previously unrecognized syndromes. Among the clinical manifestations, syncope and near syncope are frequently associated with orthostatic intolerance. In addition, however, a wide spectrum of symptoms have been described ranging from chronic fatigue to recurrent neurally mediated vasodepressor reactions. The present review focuses on the pathophysiology and classification of syndromes of autonomic dysfunction associated with orthostatic intolerance. Primary and secondary causes of dysautonomia as well as therapeutic approach to these frequently unrecognized syndromes is presented.Key words: orthostatic intolerance, autonomic failure, autonomic function, neurally mediated syncope, vasovagal syncope. El sistema nervioso autónomo (SNA) como eje central del control cardiovascular modula los reflejos relacionados con el control de la presión arterial y la frecuencia cardíaca, lo que permite mantener un gasto cardíaco adecuado en respuesta al ortostatismo. El estudio fisiopatológico y la caracterización clínica de los síndromes de disfunción autonómica que se manifiestan con intoleracia ortostática han sido un reto para los investigadores de las áreas básicas y clínicas debido a su frecuente presentación y a la falta de herramientas terapéuticas que permitan su adecuado manejo.

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The Central Autonomic Network: Functional Organization, Dysfunction, and Perspective

Cited by 1,174 publications

References 79 publications

Brain correlates of autonomic modulation: Combining heart rate variability with fMRI

Brain correlates of autonomic modulation: Combining heart rate variability with fMRI

Nociception and autonomic nervous system

Síndromes de disfunción autonómica asociados con intolerancia ortostática.

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