Role of the ventral surface of the brain stem in the hypotensive action of clonidine

The imidazoline receptors and ligands in pain modulation

Pain is an unpleasant experience and effects daily routine negatively. Although there are various drugs, many of them are not entirely successful in relieving pain, since pain modulation is a complex process involving numerous mediators and receptors. Therefore, it is a rational approach to identify the factors involved in the complex process and develop new agents that act on these pain producing mechanisms. In this respect, the involvement of the imidazoline receptors in pain modulation has drawn attention in recent years. In this review, it is aimed to focus on the imidazoline receptors and their ligands which contribute to the pain modulation. It is demonstrated that imidazoline-2 (I2) receptors are steady new drug targets for analgesics. Even if the mechanism of I2 receptor is not well known in the modulation of pain, it is known that it plays a role in tonic and chronic pain but not in acute phasic pain. Moreover, the I2 receptor ligands increase the analgesic effects of opioids in both acute and chronic pain and prevent the development of opioid tolerance. So, they are valuable for the chronic pain treatment and also therapeutic coadjuvants in the management of chronic pain with opiate drugs due to the attenuation of opioid tolerance and addiction. Thus, the use of the ligands which bind to the imidazoline receptors is an effective strategy for relieving pain. This educational forum exhibits the role of imidazoline receptors and ligands in pain process by utilizing experimental studies.

Site and mode of action of clonidine in the central nervous system

In urethane-anaesthetized rats clonidine was administered intravenously (i.v.), intracerebroventricularly (i.c.v.) or onto the surface of the area postrema which protrudes into the fourth cerebral ventricle. In each instance clonidine induced a dose-dependent lowering of the blood pressure. The region of the area postrema appears to be the most sensitive site for the action of clonidine so far studied. In order to obtain similar blood pressure effects, approximately 8 times higher amounts were needed i.c.v., and about 80 times higher amounts i.v., than onto the surface of the area postrema. A pretreatment of the rats with the specific histamine H2-receptor blocking drug, metiamide (4.5 micronmoles/rat i.c.v.) shifted the dose-response curve of clonidine (i.c.v.) to the right. The results suggest that clonidine exerts its hypotensive effect in the rat via a stimulation of histamine H2-receptors in, or in the vicinity of, the area postrema.

Mechanism of the hypotensive action of Rhazya stricta leaf extract in rats

The hypotensive action of Rhazya stricta lyophilized leaf extract was found to be partly caused by the electrolyte content of the extract, and partly caused by a strongly basic alkaloidal fraction (AF). AF (0.05-1.6 mg animal(-1)) caused a dose-dependent reduction in mean arterial blood pressure (MAP) of urethane-anaesthetized rat preparations. In naiuml;ve pithed rats, AF administration (0.5-2.0 mg animal(-1)) significantly increased MAP. In pithed or spinalized rats made normotensive by noradrenaline infusion, AF (0.25 mg animal(-1)) did not cause any significant changes. Direct intracerebroventricular injection of AF (0.1-0.4 mg) markedly and significantly reduced MAP. It is suggested that the hypotensive action of AF to be mediated by a central mechanism.

Synergistic centrally mediated cardiovascular effects of a kappa opioid agonist and an alpha2-adrenoceptor agonist

In this study, we determined possible additive and synergistic centrally mediated hypotensive and bradycardic effects of U-62,066E, a nonpeptide kappa opioid agonist acting on the hippocampal formation (HF), and guanabenz, an alpha2-adrenoceptor agonist acting on the rostral ventrolateral medulla (RVLM), the nucleus tractus solitarius (NTS), or the locus coeruleus (LC). The drugs were microinjected at various doses into these areas of alpha-chloralose-anesthetized Sprague-Dawley rats. There were synergistic hypotensive and bradycardic effects between low, noneffective doses of U-62,066E acting on the HF and guanabenz acting simultaneously on the RVLM. Higher doses of each agent, which themselves caused hypotension and bradycardia acting on each brain area alone, did not lead to synergistic effects when the drugs were injected simultaneously into those areas. There were no synergistic effects between U-62,066E acting on the HF and guanabenz acting on the NTS or the LC.

Binding of [3H]2-(2-benzofuranyl)-2-imidazoline (BFI) to human brain: potentiation by tranylcypromine

Recently, a new imidazoline (I2) ligand, [3H]2-(2-benzofuranyl)-2-imidazoline (BFI) was shown to be more selective for I2 vs alpha 2 binding in rodent brain. We characterized [3H]BFI binding in human brain cortex and lateral reticular nucleus (NRL). Membranes were incubated with [3H]BFI at 22 degrees C in 50 mM Tris, 1.5 mM EDTA at pH 7.5. Saturation experiments with [3H]BFI (0.5-80 nM) were analyzed using non-linear curve fitting. The NRL had 4X more binding sites than cortex with similar affinity (Bmax = 2085 +/- 732 and 471 +/- 41 fmol/mg protein; KD = 9.3 +/- 3.5 and 11.9 +/- 2.7 nM, respectively). In competition studies, cortical [3H]BFI binding was displaced in order of decreasing potency by clorgyline > BFI > or = cirazoline > idazoxan > or = guanabenz > clonidine > RX821002. The monoamine oxidase (MAO) inhibitor tranylcypromine (TCP) (1 nM-10 microM), markedly enhanced [3H]BFI binding in both NRL and cortex. Enhanced binding was maximal at 300 nM (12 X control) and returned to baseline at 30 microM. Potentiation was not seen with pargyline or clorgyline. TCP did not effect [3H]BFI binding in rat cortex, or [3H]idazoxan binding in human cortex and NRL. In human cortex, inhibition of MAO by preincubation with pargyline (10 micro M) abolished the TCP effect. Upon preincubation with TCP, the stimulation of [3H]BFI binding was dose-dependently related to a simultaneous inhibition of MAO. Thus, [3H]BFI labels a site in human NRL and cortex that appears similar to the previously described I2 site labeled by [3H]idazoxan. However, [3H]BFI binding is dramatically stimulated by TCP in human brain via a mechanism dependent on endogenous MAO activity.

The I1-imidazoline receptor: from binding site to therapeutic target in cardiovascular disease

OBJECTIVE

To review previous work and present additional evidence characterizing the I1-imidazoline receptor and its role in cellular signaling, central cardiovascular control, and the treatment of metabolic syndromes. Second-generation centrally-acting antihypertensives inhibit sympathetic activity mainly via imidazoline receptors, whereas first-generation agents act via alpha2-adrenergic receptors. The I1 subtype of imidazoline receptor resides in the plasma membrane and binds central antihypertensives with high affinity.

METHODS AND RESULTS

Radioligand binding assays have characterized I1-imidazoline sites in the brainstem site of action for these agents in the rostral ventrolateral medulla. Binding affinity at I1-imidazoline sites, but not at other classes of imidazoline binding sites, correlates closely with the potency of central antihypertensive agents in animals and in human clinical trials. The antihypertensive action of systemic moxonidine is eliminated by the I1/alpha2-antagonist efaroxan, but not by selective blockade of alpha2-adrenergic receptors. Until now, the cell signaling pathway coupled to I1-imidazoline receptors was unknown. Using a model system lacking alpha2-adrenergic receptors (PC12 pheochromocytoma cells) we have found that moxonidine acts as an agonist at the cell level and I1-imidazoline receptor activation leads to the production of the second messenger diacylglycerol, most likely through direct activation of phosphatidylcholine-selective phospholipase C. The obese spontaneously hypertensive rat (SHR; SHROB strain) shows many of the abnormalities that cluster in human syndrome X, including elevations in blood pressure, serum lipids and insulin. SHROB and their lean SHR littermates were treated with moxonidine at 8 mg/kg per day. SHROB and SHR treated with moxonidine showed not only lowered blood pressure but also improved glucose tolerance and facilitated insulin secretion in response to a glucose load. Because alpha2-adrenergic agonists impair glucose tolerance, I1-imidazoline receptors may contribute to the multiple beneficial effects of moxonidine treatment.

CONCLUSION

The I1-imidazoline receptor is a specific high-affinity binding site corresponding to a functional cell-surface receptor mediating the antihypertensive actions of moxonidine and other second-generation centrally-acting agents, and may play a role in countering insulin resistance in an animal model of metabolic syndrome X.

Stereoselective effects of central α2-adrenergic agonist medetomidine on in vivo catechol activity in the rat rostral ventrolateral medulla (RVLM)

The stereoselective central effects of a novel, highly potent and selective alpha 2-agonist medetomidine on adrenergic neuronal activity, reflected by changes in catechol oxidation current, in the rostral ventrolateral medulla of the halothane-anesthetized rat were examined using in vivo differential normal pulse voltammetry. Dexmedetomidine, the active isomer, significantly decreased catechol oxidation current to 33.4 +/- 4.5% of baseline when given centrally (1 microgram, i.c.v.) and to 10.3 +/- 3.9% of baseline when given systemically (50 micrograms/kg, i.v.). Dexmedetomidine also significantly reduced mean arterial blood pressure by 19.9% following central administration but significantly increased mean arterial blood pressure by 59.9% following systemic administration. Levomedetomidine, the inactive isomer, had no effect on catechol oxidation current or blood pressure. The depressant effects of dexmedetomidine on catechol oxidation current were reversed by the selective alpha 2-adrenoceptor antagonist atipamezole (2 micrograms, i.c.v. or 200 micrograms/kg, i.v.). The results of the present study demonstrate, to our knowledge, for the first time the central stereoselective effects of medetomidine and antagonism by atipamezole on rostral ventrolateral medulla activity in the anesthetized rat.

Contribution of alpha 2-adrenoceptors to the central cardiovascular effects of clonidine and S 8350 in anaesthetized rats

1. The alpha 2-adrenoceptor agonist clonidine elicits centrally mediated effects through an interaction with both alpha 2-adrenoceptors and imidazoline binding sites. 2. We selected a new oxazoline derivative, S 8350, which competes with [3H]-yohimbine for binding to cerebral alpha 2-adrenoceptors (IC50, 67 +/= 17 nmol/L) and displays a higher affinity (35-fold) for alpha 2- than for alpha 1-adrenoceptors. 3. As observed for clonidine, intravenous (i.v.) administration of S 8350 resulted in a brief pressor effect followed by a prolonged hypotension. When S 8350 was administered i.v. to spinally pithed rats, only a rise in blood pressure was observed. 4. In order to discriminate the cardiovascular effects related to the central imidazoline receptor or alpha 2-adrenoceptor activation, the effects of intracisternal (i.c.) administration of clonidine and S 8350 were investigated in the rat. 5. In the anaesthetized rat, both clonidine and S 8350 displayed a profound central (i.c. route) hypotensive effect associated with a bradycardia. 6. The cardiovascular effects of S 8350 were abolished by the central administration of the selective alpha 2-adrenoceptor antagonist rauwolscine. Conversely, rauwolscine completely prevented bradycardia but it induced only a partial reversion of the hypotension elicited by clonidine. 7. These results suggest that central alpha 2-adrenoceptors are responsible for hypotension and bradycardia while imidazoline binding sites do not apparently contribute to heart rate control.

The blood pressure effects of alpha-adrenoceptor antagonists injected in the medullary site of action of clonidine: the nucleus reticularis lateralis

We administered a series of alpha-blocking drugs to the nucleus reticularis lateralis (NRL) of the medulla oblongata, the main site for the hypotensive action of clonidine. These experiments were performed on pentobarbital anaesthetized cats. Drugs were injected through a needle which was stereotaxically inserted. Prazosin (6 nmol) was hypertensive (MBP = +25 +/- 8%), corynanthine had no effect and AR-C239 (7 nmol), another alpha 1-blocker, was hypotensive (MBP = -16 +/- 3.5%). The alpha 2-blockers, yohimbine and idaxozan, were hypotensive. The blood pressure effects of alpha-blocking drugs directly microinjected in the nucleus reticularis lateralis cannot be simply related to their selectivity for a particular subtype of alpha-receptors.

Function of the ventrolateral medulla in the control of the circulation

The CNS control of the cardiovascular system involves the coordination of a series of complex neural mechanisms which integrate afferent information from a variety of peripheral receptors and produce control signals to effector organs for appropriate physiological responses. Although it is generally thought that these control signals are generated by a network of neural circuits that are widely distributed in the CNS, over the last two decades a considerable body of experimental evidence has accumulated suggesting that several of these circuits involve neurons found on or near the ventral surface of the medulla oblongata. Neurons in the VLM have been shown to be involved in the maintenance of vasomotor tone, in baroreceptor and chemoreceptor (central and peripheral) reflex mechanisms, in mediating the CIR and somatosympathetic reflexes and in the control of the secretion of vasopressin. These physiological functions of VLM neurons have been supported by neuroanatomical and electrophysiological studies demonstrating direct connections with a number of central structures previously implicated in the control of the circulation, including the IML, the site of origin of sympathetic preganglionic axons, and the SON and PVH, the site of origin of neurohypophyseal projecting axons containing AVP. Considerable suggestive evidence has also been obtained regarding the chemical messengers involved in transmitting information from VLM neurons to other central structures. There have been developments suggesting a role for monoamines and neuropeptides in mediating the neural and humoral control of SAP by neurons in the VLM. This review presents a synthesis of the literature suggesting a main role for VLM neurons in the control of the circulation.

Electrophysiological study of sympathoexcitatory structures of the bulbar ventrolateral surface as related to vasomotor regulation

The responses in T3-4, T10-11 and L2-3 white rami to stimulation of different zones of the bulbar ventrolateral surface were maximal when the region of about 4 mm laterally to the midline was stimulated. A weak surface stimulation of all these zones elicited only a long latency response consisting of three waves. A short latency response appeared when supramaximal stimuli were applied only to the intermediate zone--the region up to 6 mm rostrally to the hypoglossal nerve root level (zone S and caudal part of zone M). The data presented show that long and short latency responses are conducted from the intermediate zone to the spinal cord via dorsolateral funiculus fibres with a conduction velocity of about 5.6 +/- 0.6 m/s. In addition, a special descending sympathoexcitatory pathway oriented to T2 preganglionic neurons with a conduction velocity of about 12.3 +/- 3.2 m/s was demonstrated. Antidromic discharges of the output sympathoexcitatory neurons elicited by dorsolateral funiculus stimulation were found in the intermediate zone only at a depth of about 400-2000 microM. Stimuli applied to different regions of the ipsilateral bulbar ventrolateral surface activate at least two groups of surface fibres (conduction velocities 6.7-8.0 and 2-3.2 m/s) which, in turn, activate the output neurons with a rather constant delay of about 20 ms equal to a difference between the latencies of long and short latency white rami responses. The mechanism of delay formation seems to be concentrated in the intermediate zone and formed probably by a chain of interneurons. A possible scheme of neuronal organization of the bulbar ventrolateral sympathoexcitatory structures is presented and discussed. The descending tonic activation of spinal vasomotor neurons is formed by spontaneous discharges of antidromically identified output neurons with a mean firing rate of about 14.4 imp./s. Some neurons are reflexly activated within the time limits of the late somatosympathetic reflex response. Coagulation of the intermediate zone resulted in a profound fall of blood pressure, disappearance of pressor and late somatosympathetic reflexes, whereas the spinobulbospinal somatosomatic reflex remains unchanged. The baroreceptor inhibition is partly realized through the elements of sympathoexcitatory intermediate zone because the preferable inhibition of the long latency white rami response was demonstrated in the middle of R-R interval and during a sharp increase in the arterial pressure induced by vasoconstrictor drugs. Thus, the structures of the intermediate zone seem to play a key role in supporting of blood pressure level and organization of pressure reflexes.(ABSTRACT TRUNCATED AT 400 WORDS)

Projections from the nucleus tractus solitarii to the rostral ventrolateral medulla

Projections from the nucleus tractus solitarii (NTS) to autonomic control regions of the ventrolateral medulla, particularly the nucleus reticularis rostroventrolateralis (RVL), which serves as a tonic vasomotor center, were analyzed in rat by anterograde, retrograde, and combined axonal transport techniques. Autonomic portions of the NTS, including its commissural, dorsal, intermediate, interstitial, ventral, and ventrolateral subnuclei directly project to RVL as well as to other regions of the ventrolateral medulla. The projections are organized topographically. Rostrally, a small cluster of neurons in the intermediate third of NTS, the subnucleus centralis, and neurons in proximity to the solitary tract selectively innervate neurons in the retrofacial nucleus and nucleus ambiguus. Neurons generally located in more caudal and lateral sites in the NTS innervate the caudal ventrolateral medulla (CVL). The RVL, CVL, and nucleus retroambiguus are interconnected. A combined retrograde and anterograde transport technique was developed so as to prove that projections from the NTS to the ventrolateral medulla specifically innervate the region of RVL containing neurons projecting to the thoracic spinal cord or the region of the nucleus containing vagal preganglionic neurons. When the retrograde tracer, fast blue, was injected into the thoracic spinal cord, and wheat germ agglutinin-conjugate horseradish peroxidase (HRP) was injected into the NTS, anterogradely labeled terminals from the NTS surrounded the retrogradely labeled neurons in the RVL and in the nucleus retroambiguus in the caudal medulla. Among the bulbospinal neurons in the RVL innervated by the NTS were adrenaline-synthesizing neurons of the C1 group. When fast blue was applied to the cervical vagus, and HRP was injected into the NTS, anterogradely labeled terminals from the NTS surrounded retrogradely labeled neurons in the rostral dorsal motor nucleus of the vagus, the region of the nucleus ambiguus, the retrofacial nucleus, and the dorsal portion of the RVL, a region previously shown to contain cardiac vagal preganglionic neurons. This combined anterograde and retrograde transport technique provides a useful method for tracing disynaptic connections in the brain. These data suggest that the RVL is part of a complex of visceral output regions in the ventrolateral medulla, all of which receive afferent projections from autonomic portions of the NTS. Bulbospinal neurons in the RVL, in particular the C1 adrenaline neurons, may provide a portion of the anatomic substrate of the baroreceptor and other visceral reflexes.

Distribution of alpha 2 agonist binding sites in the rat and human central nervous system: analysis of some functional, anatomic correlates of the pharmacologic effects of clonidine and related adrenergic agents

Using [3H]para-aminoclonidine, alpha 2 adrenergic binding sites have been mapped in the rat and human CNS using in vitro labeling autoradiographic techniques. In both the rat and human thoracic spinal cord, high densities of alpha 2 binding sites were associated with the substantia gelatinosa and the intermediolateral cell column. In the rat medulla, high binding site density was observed in the medial nucleus of the solitary tract, dorsal motor nucleus of the vagus, raphe pallidus and the substantia gelatinosa of the trigeminal nucleus, while lower levels of specific binding were found in the lateral and ventrolateral medulla. In the human, a similar distribution was observed. However, significantly lower levels of specific binding were seen in the medial nts as opposed to the dmv. In the rat, high levels of specific binding were seen at pontine and midbrain levels in the locus coeruleus, parabrachial nucleus and periaqueductal gray. In the forebrain, several hypothalmic and limbic regions, including the paraventricular and arcuate nuclei of the hypothalamus, the central, medial and basal nuclei of the amygdala, lateral septum and bed nucleus of the stria terminalis and pyriform, entorhinal and insular cortex were labeled. Each of these regions are involved in either modulating autonomic functions directly or integrating somatosensory and/or affective function with autonomic mechanisms. Further, these regions are interrelated by reciprocal connections, and neurons that utilize noradrenaline or adrenaline as their neurotransmitter form a vital part of these connections. Thus, these functional, anatomical and neurochemical correlates of the alpha 2 binding site distribution establish a neurological basis for the complex pharmacological effects of centrally acting alpha 2 agonists.

Adrenaline synthesizing neurons in the rostral ventrolateral medulla: a possible role in tonic vasomotor control

Adrenaline-containing neurons of the rostral ventrolateral medulla (the C1 group) project selectively to autonomic spinal neurons in rats. Stimulation of these neurons electrically or chemically elevates arterial pressure, while neuronal blockade by microinjection of tetrodotoxin bilaterally drops arterial pressure to levels comparable to those produced by spinal cord transection. Adrenaline neurons of the ventral medulla appear necessary for maintaining normal levels of blood pressure, and thus may constitute a tonic vasomotor center.

Alpha-Adrenergic and 5-hydroxytryptaminergic receptor stimulants as new antihypertensive drugs, with observations on involvement of opiate receptors

Cardiovascular actions of central alpha-adrenergic and 5-hydroxytryptaminergic stimulants are discussed in terms of overall effects, correlation of various activities, receptor activation and side-effects. The involvement of opiate receptors in their actions is also examined.

The nucleus reticularis lateralis: a region highly sensitive to clonidine

Slow bilateral microinjections of a low dose of clonidine (75 ng/kg) in the cat's nucleus reticularis lateralis (NRL) lead to significant hypotension and bradycardia. This finding confirms the existence of a ventromedullary highly sensitive site of action of clonidine. It is suggested that clonidine inhibits some vasopressive and cardioacceleratory structures within the NRL region.

Effects on blood pressure of noradrenaline and isoprenaline administered into the third ventricle of the brain of anaesthetized and conscious cats

1 Noradrenaline administered into the third ventricle of the brain (IIIv) of both conscious and anaesthetized cats induced increases in blood pressure accompanied by small and variable heart rate effects. The pressor responses were reduced after autonomic ganglion blockade indicating their likely central origin. 2 Noradrenaline when administered either into a lateral cerebral ventricle (i.c.v.) in conscious and anaesthetized cats or into the cisterna magna (i.c.) in anaesthetized cats induced falls in blood pressure accompanied by bradycardia. 3 Pressor responses to IIIv noradrenaline in conscious cats were partly blocked by either propranolol or thymoxamine indicating a possible involvement in the responses of excitatory adrenoreceptors of both alpha and beta types. 4 Pressor responses induced by IIIv isoprenaline in conscious cats were blocked by propranolol but not by thymoxamine suggesting the effect is mediated solely via excitatory beta-adrenoreceptors. 5 In anaesthetized cats prior i.c. administration of noradrenaline reduced the pressor responses induced by IIIv noradrenaline. 6 In conscious cats i.v. clonidine reduced pressor responses to IIIv noradrenaline without depressing peripheral vascular noradrenaline sensitivity. 7 The results suggest the involvement of excitatory and inhibitory alpha-adrenoreceptors and of excitatory beta-adrenoreceptors in central blood pressure control. It is also concluded that activation of inhibitory alpha-adrenoreceptors in the hind brain region can suppress the cardiovascular effects of stimulating excitatory alpha- and beta-adrenoreceptors located in the region of the third ventricle.

Experimental hypertension and catecholamine distribution in the rat brain

Hypertension was induced in rats (Hebrew University strain) by three different procedures: (1) deoxycorticosterone acetate (DOCA)--salt treatment; (2) unilateral renal artery clip or (3) chronic salt-loading. Noradrenaline (NA) and dopamine (DA) distribution in different brain areas was assayed following induction of hypertension. NA content increased significantly in various areas: the increase of NA in the pons-medulla was common to all procedures inducing hypertension. NA content increased also in the mesencephalon, the hypothalamus and the rest of the forebrain (DOCA--salt hypertension), in the mesencephalon, the hypothalamus and the cortex (in renal clip hypertension). No significant changes in DA content were observed in any region of the brain following induction of hypertension by the three different methods. In two substrains, selected from the Hebrew University strain, for their respective sensitivity (H) or immunity (N) to hypertension induced by DOCA--salt treatment, there were no significant increases in NA or DA in any part of the brain following DOCA--salt treatment. Comparison of NA concentrations in these strains showed that NA was significantly higher in the pons-medulla of the untreated N strain rats than in the medulla of untreated H strain or in untreated rats of the original strain (Hebrew University). A model is presented suggesting that central NA-containing neurons plays a major role in controlling hypertension.

Topography of the respiratory and circulatory responses to acetylcholine and nicotine on the ventral surface of the medulla oblongata

1. Acetylcholine and nicotine were superfused on the ventral medullary surface between the ponto-medullary border and C1 in anaesthetized cats in order to determine the topical distribution of their actions on respiration and circulation. 2. Acetylcholine (10(-4) g . ml-1 = 5.5 . 10(-4) mMol . ml-1) produced an increase in respiration and a lowering of blood pressure. The magnitude and the time course of the responses varied according to the points of superfusion on the surface. 3. Nicotine (10(-4) g . ml-1 = 6.2 . 10(-4) mMol . ml-1) elicited hyperventilation and more often an increase in arterial pressure on unilateral superfusion of the surface. In some cases, however, a drop in blood pressure was also observed. 4. The responsive regions of the surface on which nicotine acted and elicited hyperventilation, bear a close resemblance to the regions responsive to acetylcholine. 5. The topographical distribution of the respiratory effects elicited by the above-mentioned drugs were similar to the distribution of the responses to changes in pH on the ventral medullary surface or to electrical stimulation. 6. Procaine (2 . 10(-2) g . ml-1 = 7.3 . 10(-2) mMol . ml-1) applied bilaterally in the intermediate zone (S) caused profound inhibition of respiration and of arterial pressure. Procaine at this concentration also inhibited respiratory hyperventilation caused by nicotine (10(-4) g . ml-1 = 6.2 . 10(-4) mMol . ml-1) applied to the caudal and rostral areas.

Relationship between the ventromedullary clonidine-sensitive area and the posterior hypothalamus

The connections between the areas 'S' which have been previously described as the ventromedullary sites of the action of clonidine and the posterior hypothalamus have been investigated. Superficial electrocoagulation of the left area 'S' suppresses the pressor response to electrical stimulation of the homolateral part of the posterior hypothalamus. Although such medullary lesions cause a significant reduction of the mean arterial pressure, the contralateral hypothalamic stimulation can still increase blood pressure. Clonidine it self applied topically (8 micrograms/kg) to the ventral face of the brain stem decreases the blood pressure response to liminal hypothalamic stimulation. It is concluded that efferent pathways, which are involved in vasomotor regulation, originate in the posterior hypothalamus and run through the ventrolateral part of the brain stem. The mechanism of the blocking effect of clonidine on these pathways is discussed.