臨床神経学

<シンポジウム(3)―7―1>脳画像と自律神経系

心循環機能と脳画像

朝比奈 正人

千葉大学医学研究院神経内科学〔〒260―8670 千葉県千葉市中央区亥鼻1―8―1〕

The cardiovascular system is regulated by cortical modulation such as the anterior cingulate gyrus, insular cortex, amygdala as well as the reticular formation of the brainstem, including ventrolateral medulla (vasopressor center). These structures are called as the central autonomic network (CAN), and its dysfunction causes autonomic dysregulation. For example, ventrolateral medulla compression by tortuous or ectatic vessels has been etiologically linked with essential hypertension. In regard to a relationship of the cerebral cortex and autonomic dysfunction, hypoperfusion of the anterior cingulate gyrus may be seen in patients with chronic autonomic failure such as pure autonomic failure. Meanwhile, patients with chronic hypertension may also show hypoperfusion of the anterior cingulate gyrus. These findings indicate that inadequate internal environment such as hypotension and hypertension in long term can reduce activities of the anterior cingulate gyrus. In regard to the insular cortex, a relationship with cardiac events or sudden death has drawn attention but now it may be time to revaluate this relationship. Amygdala also play an important role in autonomic regulation. Patients with bilateral amygdala damage show s poor autonomic response to mental stress which induces emotional change.
Full Text of this Article in Japanese PDF (195K)

(臨床神経, 52:1276−1278, 2012)
key words:心循環機能,脳画像,自律神経,中枢自律神経網

(受付日:2012年5月25日)