Thayer Julian F, Brosschot Jos F
NIA/GRC/LPC, 5600 Nathan Shock Drive, Baltimore, MD 21224, USA.
Psychoneuroendocrinology. 2005 Nov;30(10):1050-8. doi: 10.1016/j.psyneuen.2005.04.014.
The autonomic nervous system (ANS) plays a role in a wide range of somatic and mental diseases. Using a model of neurovisceral integration, this article describes how autonomic imbalance and decreased parasympathetic tone in particular may be the final common pathway linking negative affective states and conditions to ill health. The central nervous system (CNS) network that regulates autonomic balance (central autonomic network, CAN) is closely related and partially overlaps with networks serving executive, social, affective, attentional, and motivated behavior (anterior executive region, AER; and Damasio's [Damasio, A.R., 1998. Emotion in the perspective of an integrated nervous system. Brain Res. Rev. 26, 83-86.] 'emotion circuit'). A common reciprocal inhibitory cortico-subcortical neural circuit serves to regulate defensive behavior, including autonomic, emotional and cognitive features. This inhibitory cortico-subcortical circuit may structurally, as well as functionally, link psychological processes with health-related physiology. When the prefrontal cortex is taken 'offline' for whatever reason, parasympathetic inhibitory action is withdrawn and a relative sympathetic dominance associated with disinhibited defensive circuits is released, which can be pathogenic when sustained for long periods. This state is indicated by low heart rate variability (HRV), which is a marker for low parasympathetic activation and prefrontal hypoactivity. Consistent with this, HRV is associated with a range of psychological and somatic pathological conditions, including immune dysfunction. Finally, we discuss supportive evidence from recent studies of the reflexive startle blink, attention and working memory, which shows that low HRV predicts hypervigilance and inefficient allocation of attentional and cognitive resources.
自主神经系统（ANS）在多种躯体和精神疾病中发挥作用。本文利用神经内脏整合模型，描述了自主神经失衡，尤其是副交感神经张力降低，如何可能是将负面情绪状态和状况与健康问题联系起来的最终共同途径。调节自主神经平衡的中枢神经系统（CNS）网络（中枢自主网络，CAN）与服务于执行、社交、情感、注意力和动机行为的网络（前执行区域，AER；以及达马西奥[达马西奥，A.R.，1998年。从整合神经系统的角度看情绪。《脑研究回顾》26，83 - 86]的“情绪回路”）密切相关且部分重叠。一个常见的相互抑制性皮质 - 皮质下神经回路用于调节防御行为，包括自主神经、情感和认知特征。这种抑制性皮质 - 皮质下回路可能在结构和功能上，将心理过程与健康相关的生理联系起来。当由于任何原因前额叶皮质“离线”时，副交感神经抑制作用被撤销，与解除抑制的防御回路相关的相对交感神经优势被释放，长期持续时可能致病。这种状态以低心率变异性（HRV）为指标，HRV是副交感神经激活降低和前额叶活动减退的标志。与此一致的是，HRV与一系列心理和躯体病理状况相关，包括免疫功能障碍。最后，我们讨论了来自近期关于反射性惊跳眨眼、注意力和工作记忆研究的支持性证据，这些证据表明低HRV预示着过度警觉以及注意力和认知资源的低效分配。
