Translational Neuromodeling Unit, University of Zürich and ETH Zürich, Zürich, Switzerland; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Boston Scientific, Valencia, USA.
Neurosci Biobehav Rev. 2019 Mar;98:135-144. doi: 10.1016/j.neubiorev.2018.12.020. Epub 2019 Jan 3.
The periaqueductal gray (PAG) plays a critical role in autonomic function and behavioural responses to threatening stimuli. Recent evidence has revealed the PAG's potential involvement in the perception of breathlessness, a highly threatening respiratory symptom. In this review, we outline the current evidence in animals and humans on the role of the PAG in respiratory control and in the perception of breathlessness. While recent work has unveiled dissociable brain activity within the lateral PAG during perception of breathlessness and ventrolateral PAG during conditioned anticipation in healthy humans, this is yet to be translated into diseases dominated by breathlessness symptomology, such as chronic obstructive pulmonary disease. Understanding how the sub-structures of the PAG differentially interact with interoceptive brain networks involved in the perception of breathlessness will help towards understanding discordant symptomology, and may reveal treatment targets for those debilitated by chronic and pervasive breathlessness.
导水管周围灰质（periaqueductal gray，PAG）在自主功能和对威胁性刺激的行为反应中起着关键作用。最近的证据表明，PAG 可能参与了呼吸困难的感知，这是一种极具威胁性的呼吸症状。在这篇综述中，我们概述了目前关于 PAG 在呼吸控制和呼吸困难感知中的作用的动物和人类研究证据。虽然最近的研究揭示了健康人类在感知呼吸困难时，外侧 PAG 存在可分离的大脑活动，而在条件性预期时，腹外侧 PAG 存在大脑活动，但这尚未转化为以呼吸困难症状为主的疾病，如慢性阻塞性肺疾病。了解 PAG 的亚结构如何与参与呼吸困难感知的内脏感觉脑网络差异相互作用，将有助于理解不同的症状学，并可能为那些深受慢性和普遍呼吸困难困扰的人揭示治疗靶点。
