NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France; Neurology Department, University Hospital, Saint-Etienne, France.
NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France.
Neurophysiol Clin. 2023 Apr;53(2):102849. doi: 10.1016/j.neucli.2023.102849. Epub 2023 Mar 1.
Some of the most important integrative control centers for the autonomic nervous system are located in the brainstem and the hypothalamus. However, growing recent neuroimaging evidence support that a set of cortical regions, named the central autonomic network (CAN), is involved in autonomic control and seems to play a major role in continuous autonomic cardiac adjustments to high-level emotional, cognitive or sensorimotor cortical activities. Intracranial explorations during stereo-electroencephalography (SEEG) offer a unique opportunity to address the question of the brain regions involved in heart-brain interaction, by studying: (i) direct cardiac effects produced by the electrical stimulation of specific brain areas; (ii) epileptic seizures inducing cardiac modifications; (iii) cortical regions involved in cardiac interoception and source of cardiac evoked potentials. In this review, we detail the available data assessing cardiac central autonomic regulation using SEEG, address the strengths and also the limitations of this technique in this context, and discuss perspectives. The main cortical regions that emerge from SEEG studies as being involved in cardiac autonomic control are the insula and regions belonging to the limbic system: the amygdala, the hippocampus, and the anterior and mid-cingulate. Although many questions remain, SEEG studies have already demonstrated afferent and efferent interactions between the CAN and the heart. Future studies in SEEG should integrate these afferent and efferent dimensions as well as their interaction with other cortical networks to better understand the functional heart-brain interaction.
一些最重要的自主神经系统整合控制中心位于脑干和下丘脑。然而，越来越多的新兴神经影像学证据支持一组被称为中枢自主神经网络（CAN）的皮质区域参与自主控制，并似乎在高级情绪、认知或感觉运动皮质活动的连续自主心脏调节中发挥主要作用。立体脑电图（SEEG）的颅内探索通过研究以下方面提供了一个独特的机会来解决涉及心脏-大脑相互作用的脑区问题：（i）通过对特定脑区的电刺激产生的直接心脏效应；（ii）引起心脏改变的癫痫发作；（iii）涉及心脏内感受和心脏诱发电位源的皮质区域。在这篇综述中，我们详细介绍了使用 SEEG 评估心脏中枢自主调节的现有数据，讨论了该技术在这方面的优势和局限性，并探讨了未来的研究方向。SEEG 研究中出现的涉及心脏自主控制的主要皮质区域是岛叶和属于边缘系统的区域：杏仁核、海马体、前扣带回和中扣带回。尽管仍有许多问题有待解决，但 SEEG 研究已经证明了 CAN 与心脏之间的传入和传出相互作用。未来的 SEEG 研究应整合这些传入和传出维度及其与其他皮质网络的相互作用，以更好地理解功能性心脏-大脑相互作用。
