Cortical control of the autonomic nervous system.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing animal neuroanatomy and human neuroimaging literature without new human data.
PubMed 24121283 · doi:10.1113/expphysiol.2013.075192
What was done
This is a narrative review synthesizing findings from animal models (rats and cats) and human functional magnetic resonance imaging (fMRI) studies examining the pathways by which visceral and cardiopulmonary afferents ascend to the cerebral cortex and influence descending cardiovascular control.
What was found
The abstract reports no numerical metrics or effect sizes. It describes a viscerotopically organized ascending pathway passing from the nucleus of the solitary tract via the parabrachial nucleus and the ventroposterior parvocellular nucleus of the thalamus to the insular cortex in animals. Human fMRI studies confirm cardiopulmonary afferent stimulation activates the insular cortex and anterior cingulate cortex. The insular and infralimbic cortices participate in descending cardiovascular regulation, and individuals classified as cardiovascular responders to mental stress show altered cortical activation patterns that may relate to past experiences including childhood trauma.
Why it matters
Synthesizes neuroanatomical and functional imaging evidence linking visceral sensory feedback to cognitive-emotional cortical regions, explaining central mechanisms underlying cardiovascular reactivity to stress.
Limits
The abstract describes a narrative review with no systematic search criteria, sample sizes, or quantitative data. Findings rely heavily on animal tracing models and correlational neuroimaging paradigms.
Cited by
- contradicts The insula is the only known brain region containing a viscerotopic map representing different autonomic organs in distinct geographic locations.