Powley · Annals of the New York Academy of Sciences 2019 · narrative review · n=?

Vagal innervation of the stomach reassessed: brain-gut connectome uses smart terminals.

Cited 66 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of neuroanatomical and morphological mechanisms without new empirical human data.

PubMed 31268562 · doi:10.1111/nyas.14138 · record verified 2026-08-28

What was done

This narrative review synthesized recent morphological observations regarding autonomic and vagal innervation of the stomach and gastrointestinal tract to explain how brain-gut communication operates despite a numerical disparity between vagal axons and intrinsic enteric neurons.

What was found

The abstract notes that afferents account for approximately 80% of vagal neurites. Despite the vagus containing thousands of axons relative to millions of enteric neurons, terminal arbors are extensive, regionally specialized, polymorphic, polytopic, and polymodal with multiple receptor types ("smart terminals"). These morphological specializations provide one-to-many efferent projections and many-to-one afferent convergences, enabling complex peripheral integration. No additional quantitative data were reported.

Why it matters

Recognizing that vagal terminals perform peripheral signal integration clarifies the functional architecture of the brain-gut connectome and may guide the development of targeted neuromodulation therapies for gastrointestinal disorders.

Limits

This is a narrative review rather than an empirical trial or systematic review. The abstract does not provide quantitative effect measures, sample sizes, or specific experimental species details.

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