The rostral ventrolateral medulla mediates suppression of the circulatory system by the ventromedial nucleus of the hypothalamus

REM-related bradyarrhythmia syndrome

Cardiac arrhythmias during sleep are relatively common and include a diverse etiology, from benign sinus bradycardia to potentially fatal ventricular arrhythmias. Predisposing factors include obstructive sleep apnea and cardiac disease. Rapid eye movement (REM)-related bradyarrhythmia syndrome (including sinus arrest and complete atrioventricular block with ventricular asystole) in the absence of an underlying cardiac or physiologic sleep disorder was first described in the early 1980s. Although uncertain, the underlying pathophysiology likely reflects abnormal autonomic neural-cardiac inputs during REM sleep. The autonomic nervous system (ANS) is a known key modulator of heart rate fluctuations and rhythm during sleep and nocturnal heart rate reflects a balance between the sympathetic-parasympathetic systems. Whether the primary trigger for REM-related bradyarrhythmias reflects abnormal centrally mediated control of the ANS during REM sleep or anomalous baroreflex parasympathetic influences is unknown. This review focuses on the salient features of the REM-related bradyarrhythmia syndrome and explores potential mechanisms with a particular assessment of the relationship between the ANS and nocturnal heart rate fluctuations.

Subthalamic locomotor region is involved in running activity originating in the rat ventromedial hypothalamus

We have previously shown the involvement of the ventromedial nucleus of the hypothalamus (VMH) in inducing running behavior. Stimulation of kainate (KA)-type glutamate receptors in the unilateral VMH of the rat exclusively elicited stereotyped running behavior. However, the neural pathways or functional connections of the VMH neurons involved in the running activity are yet to be elucidated further. In this study we examined whether the subthalamic locomotor region (SLR) is involved in the expression of the running activity originating in the VMH. The multiunit activity (MUA) in the ipsilateral SLR was significantly increased by KA injection into the VMH of urethane-anesthetized animals. Concomitant injection of 6,7-dinitroquioxalline-2,3-dione (DNQX, a KA-type glutamate receptor antagonist) with KA blocked this change in the MUA. Unilateral pre-injection of either kynurenate (non-selective glutamate receptor antagonist), D-2-amino-5-phosphonovalerate (AP5, an NMDA-type glutamate receptor antagonist) or DNQX into the SLR blocked the expression of the running activity induced by KA injection into the ipsilateral VMH. Results from the present study suggest that communication between KA-sensitive efferents from the VMH to glutamatergic pathways acting via NMDA and non-NMDA receptors in the SLR may underlie expression of running behavior originating in the VMH.

Hypothalamic projections to cardiovascular centers of the medulla

The purpose of this project was to identify hypothalamic neurons having projections to two cardiovascular centers of the medulla, the rostral ventrolateral medulla (RVLM; a vasopressor region) and the nucleus of the solitary tract (NTS; a vasodepressor region). To accomplish this, fluorescent tracers (fast blue and diamidino yellow) were injected into NTS and RVLM, after each site had been physiologically identified in rats. In each case, one of the tracers was injected into the RVLM and another was injected into the NTS. Labelled neurons were subsequently observed along the entire rostral-caudal extent of the hypothalamus, where they were found in nuclei having known cardiovascular functions. Although the two groups of hypothalamomedullary neurons were largely overlapped in their distributions, less than 0.1% of the neurons were double labelled. In addition to this overlapping distribution of neurons, there were some areas within the hypothalamus where the two groups of hypothalamomedullary neurons were somewhat segregated. This clustering pattern was observed in the posterolateral hypothalamus (PLH) and, to a much lesser degree, in the paraventricular nucleus (PVN). Within the PLH, lying medial to the subthalamic nucleus, virtually all the labelled neurons projected exclusively to the NTS. Within the PVN, neurons projecting to the NTS were more numerous ventrally, whereas neurons projecting to the RVLM were more evenly dispersed within the PVN. In addition to hypothalamic labeling, clusters of labelled neurons were also observed in the zona incerta and the interstitial nucleus of the stria terminalis. Within the zona incerta, almost all the labelled neurons projected to the RVLM. Within the interstitial nucleus of the stria terminalis, neurons projecting to NTS were much more abundant in the dorsal portion of this nucleus; whereas, neurons projecting to the RVLM were more abundant ventrally. The findings of this study provide additional support to the notion that hypothalamic influences upon cardiovascular functions are in part mediated through hypothalamomedullary projections.

Activity of ventromedial hypothalamic neurons suppressing heart rate is associated with paradoxical sleep in the rat

Cardiovascular change is one of the common features of paradoxical sleep. Our study offers evidence that one of the central areas regulating the circulation during sleep is the ventromedial nucleus of the hypothalamus (VMH). We found a group of neurons in this hypothalamic nucleus of rats whose electrical activity was exclusively increased during paradoxical sleep, and was associated with a reduction in heart rate. The onset of this neural activity usually followed that of paradoxical sleep. The incidence and duration of paradoxical sleep was increased by means of microinjection of carbachol, a cholinergic agonist, into the pontine reticular formation, and the neural activity of the VMH still appeared in synchrony with carbachol-induced paradoxical sleep. These results suggest that the cholinergic paradoxical sleep-inducing mechanism in the pons facilitate the excitability of these neurons. We have previously shown that these VMH neurons suppress blood pressure and heart rate via inhibition of the vasomotor neurons in the medulla oblongata. Taken together, our findings suggest that a group of neurons in the VMH suppresses the circulatory system during paradoxical sleep.