The omnipresence of autonomic modulation in health and disease

Julia Forstenpointner; Igor Elman; Roy Freeman; David Borsook

doi:10.1016/j.pneurobio.2022.102218

The omnipresence of autonomic modulation in health and disease

Prog Neurobiol. 2022 Mar:210:102218. doi: 10.1016/j.pneurobio.2022.102218. Epub 2022 Jan 13.

Authors

Julia Forstenpointner¹, Igor Elman², Roy Freeman³, David Borsook⁴

Affiliations

¹ Center for Pain and the Brain (Boston Children's Hospital, Massachusetts General Hospital, and McLean Hospital), Harvard Medical School, Boston, MA, USA; Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, SH, Germany. Electronic address: julia.forstenpointner@uksh.de.
² Center for Pain and the Brain (Boston Children's Hospital, Massachusetts General Hospital, and McLean Hospital), Harvard Medical School, Boston, MA, USA; Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.
³ Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁴ Center for Pain and the Brain (Boston Children's Hospital, Massachusetts General Hospital, and McLean Hospital), Harvard Medical School, Boston, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

PMID: 35033599
DOI: 10.1016/j.pneurobio.2022.102218

Abstract

The Autonomic Nervous System (ANS) is a critical part of the homeostatic machinery with both central and peripheral components. However, little is known about the integration of these components and their joint role in the maintenance of health and in allostatic derailments leading to somatic and/or neuropsychiatric (co)morbidity. Based on a comprehensive literature search on the ANS neuroanatomy we dissect the complex integration of the ANS: (1) First we summarize Stress and Homeostatic Equilibrium - elucidating the responsivity of the ANS to stressors; (2) Second we describe the overall process of how the ANS is involved in Adaptation and Maladaptation to Stress; (3) In the third section the ANS is hierarchically partitioned into the peripheral/spinal, brainstem, subcortical and cortical components of the nervous system. We utilize this anatomical basis to define a model of autonomic integration. (4) Finally, we deploy the model to describe human ANS involvement in (a) Hypofunctional and (b) Hyperfunctional states providing examples in the healthy state and in clinical conditions.

Keywords: ANS; Allostatic load; Autonomic nervous system; Neuropsychopathology; Parasympathetic; Sympathetic.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Autonomic Nervous System* / physiology
Homeostasis
Humans

Grants and funding

R01 NS105844/NS/NINDS NIH HHS/United States