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Rocha I, González-García M, Carrillo-Franco L, Dawid-Milner MS, López-González MV. Influence of Brainstem's Area A5 on Sympathetic Outflow and Cardiorespiratory Dynamics. BIOLOGY 2024; 13:161. [PMID: 38534431 DOI: 10.3390/biology13030161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
Area A5 is a noradrenergic cell group in the brain stem characterised by its important role in triggering sympathetic activity, exerting a profound influence on the sympathetic outflow, which is instrumental in the modulation of cardiovascular functions, stress responses and various other physiological processes that are crucial for adaptation and survival mechanisms. Understanding the role of area A5, therefore, not only provides insights into the basic functioning of the sympathetic nervous system but also sheds light on the neuronal basis of a number of autonomic responses. In this review, we look deeper into the specifics of area A5, exploring its anatomical connections, its neurochemical properties and the mechanisms by which it influences sympathetic nervous system activity and cardiorespiratory regulation and, thus, contributes to the overall dynamics of the autonomic function in regulating body homeostasis.
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Affiliation(s)
- Isabel Rocha
- Lisbon School of Medicine and CCUL@Rise, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Marta González-García
- Department of Human Physiology, Faculty of Medicine, University of Malaga, 29590 Malaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Malaga, 29590 Malaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), 29590 Malaga, Spain
| | - Laura Carrillo-Franco
- Department of Human Physiology, Faculty of Medicine, University of Malaga, 29590 Malaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), 29590 Malaga, Spain
| | - Marc Stefan Dawid-Milner
- Department of Human Physiology, Faculty of Medicine, University of Malaga, 29590 Malaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Malaga, 29590 Malaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), 29590 Malaga, Spain
| | - Manuel Victor López-González
- Department of Human Physiology, Faculty of Medicine, University of Malaga, 29590 Malaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Malaga, 29590 Malaga, Spain
- Biomedical Research Institute of Malaga (IBIMA), 29590 Malaga, Spain
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González-García M, Carrillo-Franco L, Morales-Luque C, Dawid-Milner MS, López-González MV. Central Autonomic Mechanisms Involved in the Control of Laryngeal Activity and Vocalization. BIOLOGY 2024; 13:118. [PMID: 38392336 PMCID: PMC10886357 DOI: 10.3390/biology13020118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024]
Abstract
In humans, speech is a complex process that requires the coordinated involvement of various components of the phonatory system, which are monitored by the central nervous system. The larynx in particular plays a crucial role, as it enables the vocal folds to meet and converts the exhaled air from our lungs into audible sounds. Voice production requires precise and sustained exhalation, which generates an air pressure/flow that creates the pressure in the glottis required for voice production. Voluntary vocal production begins in the laryngeal motor cortex (LMC), a structure found in all mammals, although the specific location in the cortex varies in humans. The LMC interfaces with various structures of the central autonomic network associated with cardiorespiratory regulation to allow the perfect coordination between breathing and vocalization. The main subcortical structure involved in this relationship is the mesencephalic periaqueductal grey matter (PAG). The PAG is the perfect link to the autonomic pontomedullary structures such as the parabrachial complex (PBc), the Kölliker-Fuse nucleus (KF), the nucleus tractus solitarius (NTS), and the nucleus retroambiguus (nRA), which modulate cardiovascular autonomic function activity in the vasomotor centers and respiratory activity at the level of the generators of the laryngeal-respiratory motor patterns that are essential for vocalization. These cores of autonomic structures are not only involved in the generation and modulation of cardiorespiratory responses to various stressors but also help to shape the cardiorespiratory motor patterns that are important for vocal production. Clinical studies show increased activity in the central circuits responsible for vocalization in certain speech disorders, such as spasmodic dysphonia because of laryngeal dystonia.
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Affiliation(s)
- Marta González-García
- Department of Human Physiology, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Málaga, 29010 Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA Plataforma BIONAND), 29010 Málaga, Spain
| | - Laura Carrillo-Franco
- Department of Human Physiology, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Málaga, 29010 Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA Plataforma BIONAND), 29010 Málaga, Spain
| | - Carmen Morales-Luque
- Department of Human Physiology, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
| | - Marc Stefan Dawid-Milner
- Department of Human Physiology, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Málaga, 29010 Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA Plataforma BIONAND), 29010 Málaga, Spain
| | - Manuel Víctor López-González
- Department of Human Physiology, Faculty of Medicine, University of Málaga, 29010 Málaga, Spain
- Unit of Neurophysiology of the Autonomic Nervous System (CIMES), University of Málaga, 29010 Málaga, Spain
- Biomedical Research Institute of Málaga (IBIMA Plataforma BIONAND), 29010 Málaga, Spain
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Braun J, Patel M, Kameneva T, Keatch C, Lambert G, Lambert E. Central stress pathways in the development of cardiovascular disease. Clin Auton Res 2024; 34:99-116. [PMID: 38104300 DOI: 10.1007/s10286-023-01008-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention. METHODS Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology. RESULTS Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure. CONCLUSIONS There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.
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Affiliation(s)
- Joe Braun
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia.
| | - Mariya Patel
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
| | - Tatiana Kameneva
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Charlotte Keatch
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia
| | - Gavin Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
| | - Elisabeth Lambert
- School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia
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Moreno-Gutiérrez JÁ, de Rojas Leal C, López-González MV, Chao-Écija A, Dawid-Milner MS. Impact of music performance anxiety on cardiovascular blood pressure responses, autonomic tone and baroreceptor sensitivity to a western classical music piano-concert. Front Neurosci 2023; 17:1213117. [PMID: 37539390 PMCID: PMC10394300 DOI: 10.3389/fnins.2023.1213117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/23/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Music Performance Anxiety (MPA) is a prevalent condition among musicians that can manifest both psychologically and physiologically, leading to impaired musical performance. Physiologically, MPA is characterized by excessive muscular and/or autonomic tone. This study focuses on the cardiovascular blood pressure responses, autonomic tone and baroreceptor sensitivity changes that occur during musical performance due to MPA. Methods Six professional pianists perform a piece for piano written only for the left hand by Alexander Scriabin. The following parameters have been studied during the performance: ECG, non-invasive beat to beat continuous arterial blood pressure and skin conductance. Sympathetic and parasympathetic autonomic flow was studied with Wigner-Ville analysis (W-V) from R-R ECG variability, and baroreceptor sensitivity with the Continuous Wavelet Transform (CWT). Results During the concert a significant increase of heart rate, systolic, mean and diastolic arterial pressure were observed. No significant differences were found in skin conductance. The W-V analysis, which studies frequency changes in the time domain, shows a significant increase of sympathetic flow and a decrease of parasympathetic flow during the concert which is associated with a significant decrease in sympathetic and vagal baroreceptor sensitivity. Discussion The study of cardiac variability using the Wigner-Ville analysis may be a suitable method to assess the autonomic response in the context of MPA, and could be used as biofeedback in personalized multimodal treatments.
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Affiliation(s)
| | - Carmen de Rojas Leal
- School of Medicine, Autonomic Nervous System Unit, CIMES, University of Málaga, Malaga, Spain
- Department of Neurology, Hospital Universitario Virgen de La Victoria, Malaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Manuel Víctor López-González
- School of Medicine, Autonomic Nervous System Unit, CIMES, University of Málaga, Malaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Alvaro Chao-Écija
- School of Medicine, Autonomic Nervous System Unit, CIMES, University of Málaga, Malaga, Spain
| | - Marc Stefan Dawid-Milner
- School of Medicine, Autonomic Nervous System Unit, CIMES, University of Málaga, Malaga, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
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Central control of cardiac activity as assessed by intra-cerebral recordings and stimulations. Neurophysiol Clin 2023; 53:102849. [PMID: 36867969 DOI: 10.1016/j.neucli.2023.102849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 03/05/2023] Open
Abstract
Some of the most important integrative control centers for the autonomic nervous system are located in the brainstem and the hypothalamus. However, growing recent neuroimaging evidence support that a set of cortical regions, named the central autonomic network (CAN), is involved in autonomic control and seems to play a major role in continuous autonomic cardiac adjustments to high-level emotional, cognitive or sensorimotor cortical activities. Intracranial explorations during stereo-electroencephalography (SEEG) offer a unique opportunity to address the question of the brain regions involved in heart-brain interaction, by studying: (i) direct cardiac effects produced by the electrical stimulation of specific brain areas; (ii) epileptic seizures inducing cardiac modifications; (iii) cortical regions involved in cardiac interoception and source of cardiac evoked potentials. In this review, we detail the available data assessing cardiac central autonomic regulation using SEEG, address the strengths and also the limitations of this technique in this context, and discuss perspectives. The main cortical regions that emerge from SEEG studies as being involved in cardiac autonomic control are the insula and regions belonging to the limbic system: the amygdala, the hippocampus, and the anterior and mid-cingulate. Although many questions remain, SEEG studies have already demonstrated afferent and efferent interactions between the CAN and the heart. Future studies in SEEG should integrate these afferent and efferent dimensions as well as their interaction with other cortical networks to better understand the functional heart-brain interaction.
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Shafei M, Hosseiniravesh M, Hojati V, Mohebbati R, Khajavirad A, Shajiee H. Effect of the non-N-Methyl-D-aspartate receptor of the glutamatergic system of the pedunculopontine tegmental nucleus on cardiovascular responses in normotensive and hydralazine-induced hypotensive rats. Adv Biomed Res 2022; 11:78. [DOI: 10.4103/abr.abr_14_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/08/2021] [Accepted: 06/02/2021] [Indexed: 11/04/2022] Open
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López-González MV, González-García M, Peinado-Aragonés CA, Barbancho MÁ, Díaz-Casares A, Dawid-Milner MS. Pontine A5 region modulation of the cardiorespiratory response evoked from the midbrain dorsolateral periaqueductal grey. J Physiol Biochem 2020; 76:561-572. [PMID: 32812210 DOI: 10.1007/s13105-020-00761-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/09/2020] [Indexed: 12/19/2022]
Abstract
Connections between the midbrain dorsolateral periaqueductal grey (dlPAG) and the pontine A5 region have been shown. The stimulation of both regions evokes similar cardiovascular responses: tachycardia and hypertension. Accordingly, we have studied the interactions between dlPAG and A5 region in spontaneously breathing anesthetized rats. dlPAG was electrically stimulated (20-30 μA 1-ms pulses were given for 5 s at 100 Hz). Changes in the evoked cardiorespiratoy response were analysed before and after ipsilateral microinjections of muscimol (GABAergic agonist, 50 nl, 0.25 nmol, 5 s) within the A5 region. Electrical stimulation of the dlPAG produces, in the rat, a response characterized by tachypnoea (p < 0.001), hypertension (p < 0.001) and tachycardia (p < 0.001). The increase in respiratory rate was due to a decrease in expiratory time (p < 0.01). Pharmacological inhibition of the A5 region with muscimol produced a marked reduction of the tachycardia (p < 0.001) and the tachypnoea (p < 0.01) evoked from the dlPAG. Finally, to assess functional interactions between A5 and dlPAG, extracellular activity of putative A5 neurones were recorded during dlPAG electrical stimulation. Forty A5 cells were recorded, 16 of which were affected by dlPAG stimulation (40%). 4 cells showed activation, 5 cells excitation and 7 cells decreased spontaneous activity to dlPAG stimulation (p < 0.001). These results confirm a link between the A5 region and dlPAG. The potential role of these connections in the modulation of dlPAG evoked cardiorespiratory responses and their possible clinical implications are discussed.
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Affiliation(s)
- Manuel Víctor López-González
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain. .,Unidad de Neurofisiología del Sistema Nervioso Autónomo (CIMES), Universidad de Málaga, Málaga, Spain.
| | - Marta González-García
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.,Unidad de Neurofisiología del Sistema Nervioso Autónomo (CIMES), Universidad de Málaga, Málaga, Spain
| | - Carlos Antonio Peinado-Aragonés
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Miguel Ángel Barbancho
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Amelia Díaz-Casares
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.,Unidad de Neurofisiología del Sistema Nervioso Autónomo (CIMES), Universidad de Málaga, Málaga, Spain
| | - Marc Stefan Dawid-Milner
- Departamento de Fisiología Humana, Histología Humana, Anatomía Patológica y Educación Física y Deportiva, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.,Unidad de Neurofisiología del Sistema Nervioso Autónomo (CIMES), Universidad de Málaga, Málaga, Spain
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