Journal
CLINICAL AUTONOMIC RESEARCH
Volume 11, Issue 6, Pages 343-349Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/BF02292765
Keywords
insula; anterior cingulate; spinobulbar; periaqueductal gray
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The nociceptive and the autonomic systems interact a( the level of the periphery, spinal cord, brainstem, and forebrain. Spinal and visceral afferents provide converging information to spinothalamic neurons in the dorsal horn and to neurons of the nucleus tractus solitarius and parabrachial nuclei. These structures project to areas involved in reflex, homeostatic, and behavioral control of autonomic outflow, endocrine function, and nociception. These include monoaminergic cell groups of the medulla and pons, periaqueductal gray, hypothalamus, amygdala, insular cortex, and anterior cingulate gyrus. These interactions should be taken into account to understand the complex pathophysiology of chronic pain disorders.
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