查看Ch14 The Autonomic Nervous System的源代码

=== 前脑可以调节自主神经输出，反过来，整合在脑干中的本能感觉输入可以影响甚至压倒前脑 ===
<b style=color:#0ae>The forebrain can modulate autonomic output, and reciprocally, visceral sensory input integrated in the brainstem can influence or even overwhelm the forebrain</b>

Only a subset of the nervous system is necessary to maintain autonomic body homeostasis under most conditions. The necessary structures include (1) the brainstem nuclei discussed in the preceding section, (2) the brainstem nuclei that contain the parasympathetic preganglionic neurons, (3) the spinal cord, and (4) the peripheral ANS. These components are capable of acting autonomously, even without input from higher (i.e., rostral) forebrain regions. However, forebrain regions do play a role in coordinating and modulating activity in the lower centers. Many rostral CNS centers influence autonomic output; these centers include the hypothalamus, amygdala, prefrontal cortex, entorhinal cortex, insula, and other forebrain nuclei.

在大多数情况下，维持自主体稳态只需要神经系统的一个子集。必要的结构包括 （1） 上一节中讨论的脑干核，（2） 包含副交感神经节前神经元的脑干核，（3） 脊髓，以及 （4） 外周 ANS。这些组件能够自主行动，即使没有来自高级（即嘴部）前脑区域的输入。然而，前脑区域确实在协调和调节下部中心的活动中发挥作用。许多喙部 CNS 中心影响自主神经输出;这些中枢包括下丘脑、杏仁核、前额叶皮层、内嗅皮层、岛叶和其他前脑核。


The hypothalamus, especially the paraventricular nucleus, is the most important brain region for coordination of autonomic output. The hypothalamus projects to the parabrachial nucleus, medullary raphé, NTS, central gray matter, locus coeruleus, dorsal motor nucleus of the vagus, nucleus ambiguus, and intermediolateral cell column of the spinal cord. Thus, the hypothalamus can initiate and coordinate an integrated response to the body’s needs, including modulation of autonomic output as well as control of neuroendocrine function by the pituitary gland (see p. 978). The hypothalamus coordinates autonomic function with feeding, thermoregulation, circadian rhythms, water balance, emotions, sexual drive, reproduction, motivation, and other brain functions and thus plays a dominant role in the integration of higher cortical and limbic systems with autonomic control. The hypothalamus can also initiate the fight-orflight response[N14-7].

下丘脑，尤其是脑室旁核，是协调自主神经输出的最重要大脑区域。下丘脑投射到臂旁核、髓质、NTS、中央灰质、蓝斑、迷走神经背运动核、模糊核和脊髓中间外侧细胞柱。因此，下丘脑可以启动和协调对身体需求的综合反应，包括自主神经输出的调节以及垂体对神经内分泌功能的控制（见第 978 页）。下丘脑将自主神经功能与进食、体温调节、昼夜节律、水平衡、情绪、性驱动、生殖、动机和其他大脑功能协调起来，因此在高级皮质和边缘系统与自主神经控制的整合中起主导作用。下丘脑也可以启动战斗或逃跑反应[N14-7]。


The hypothalamus often mediates interactions between the forebrain and the brainstem. However, a number of forebrain regions also have direct connections to brainstem nuclei involved in autonomic control. Most of these forebrain regions are part of the limbic system rather than the neocortex. The paucity of direct neocortical connections probably explains why individuals trained to control autonomic output by biofeedback can generally produce only relatively minor effects on overall autonomic activity rather than regulate output to specific organs. Most individuals are incapable of even limited cortical control over the ANS. However, even though we may have only minimal conscious control of autonomic output, cortical processes can strongly modulate the ANS. Emotions, mood, anxiety, stress, and fear can all alter autonomic output (Table 14-5, top section). The pathways for these effects are unknown, but they could be mediated by direct connections or through the hypothalamus.

下丘脑通常介导前脑和脑干之间的相互作用。然而，许多前脑区域也与参与自主神经控制的脑干核有直接联系。这些前脑区域中的大多数是边缘系统的一部分，而不是新皮层的一部分。缺乏直接的新皮层连接可能解释了为什么受过生物反馈控制自主神经输出训练的个体通常只能对整体自主神经活动产生相对较小的影响，而不是调节对特定器官的输出。大多数人甚至无法对 ANS 进行有限的皮层控制。然而，即使我们对自主神经输出的意识控制可能很小，皮层过程也可以强烈调节 ANS。情绪、情绪、焦虑、压力和恐惧都会改变自主神经输出（表 14-5，顶部）。这些影响的途径尚不清楚，但它们可能通过直接连接或通过下丘脑介导。


Not only does forebrain function influence the ANS, visceral activity also influences forebrain function. Visceral afferents reach the neocortex. However, because these afferents are not represented viscerotopically, they cannot be well localized. Nevertheless, visceral afferents can have profound effects on cortical function. Visceral input can modulate the excitability of cortical neurons (Box 14-2) and, in some cases, can result in such overpowering sensory stimuli that it is not possible to focus cortical activity on anything else (see Table 14-5, bottom section).

不仅前脑功能会影响 ANS，内脏活动也会影响前脑功能。内脏传入神经到达新皮层。然而，由于这些传入神经没有在内脏位上表示，因此无法很好地定位。然而，内脏传入神经会对皮质功能产生深远的影响。本能输入可以调节皮层神经元的兴奋性（框 14-2），并且在某些情况下，会导致如此强大的感觉刺激，以至于不可能将皮层活动集中在其他任何东西上（见表 14-5，下半部分）。

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