Cardiovascular effects of human insular cortex stimulation

Oppenheimer, Stephen; Gelb, Adrian W.; Girvin, John P.; Hachinski, Vladimir

doi:10.1212/wnl.42.9.1727

Cited by 1,146 publications

(869 citation statements)

References 20 publications

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“…The authors concluded that autonomic dysfunction in migraine exhibits laterality with parasympathetic hyperfunction in left-sided migraineurs. This concept of asymmetric cerebral function has been suggested previously in studies on the autonomic control of the heart, where the left hemisphere was found to predominantly affect parasympathetic function while the right hemisphere affects sympathetic function (60)(61)(62)(63). Collectively, these data suggest that ANS plays an important role in migraine pathogenesis, where the SPG in particular may mediate parasympathetic hyperactivity considering the efferent fibers, neurotransmitter, and innervation organs of the ganglion (14)(15)(16)(18)(19)(20).…”

Section: Migraine and The Parasympathetic Nervous Systemsupporting

confidence: 67%

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

2013

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Objective: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation. Background: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation has gained increasing interest within recent years, as current treatment strategies often fail to provide adequate relief from this debilitating headache.Common migraine symptoms include lacrimation, nasal congestion, and conjunctival injection, all parasympathetic manifestations. In addition, studies have suggested that parasympathetic activity may also contribute to the pain of migraineurs.The SPG is the largest extracranial parasympathetic ganglion of the head, innervating the meninges, lacrimal gland, nasal mucosa, and conjunctiva, all structures involved in migraine with cephalic autonomic symptoms. Conclusion: We propose two possible mechanisms of action: 1) interrupting the post-ganglionic parasympathetic outflow to inhibit the pain and cephalic autonomic symptoms, and 2) modulating the sensory processing in the trigeminal nucleus caudalis. To further explore SPG stimulation in migraineurs as regards therapeutic potential and mode of action, randomized clinical trials are warranted.

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Section: Migraine and The Parasympathetic Nervous Systemsupporting

confidence: 67%

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

2013

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“…It is likely that regions associated with higher processing functions of the brain appear to be specifically and preferentially affected by propofol (Masamoto et al, 2007). Beside, frontal lobe is implicated in the modulation of emotional behavior and in the control of autonomic responses linked to generalized arousal reactions (Oppenheimer et al, 1992). We speculate that the changes of BOLD signals in frontal cortex during propofol anesthesia might be related to a modification of autonomic outflow that contributes to a decrease in arterial blood pressure.…”

Section: Discussionmentioning

confidence: 85%

The Action Sites of Propofol in the Normal Human Brain Revealed by Functional Magnetic Resonance Imaging

Zhang¹,

Wang²,

Zhao³

et al. 2010

The Anatomical Record

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Propofol has been used for many years but its functional target in the intact brain remains unclear. In the present study, we used functional magnetic resonance imaging to demonstrate blood oxygen level dependence signal changes in the normal human brain during propofol anesthesia and explored the possible action targets of propofol. Ten healthy subjects were enrolled in two experimental sessions. In session 1, the Observer's Assessment of Alertness/Sedation Scale was performed to evaluate asleep to awake/alert status. In session 2, images with blood oxygen level dependence contrast were obtained with echo-planar imaging on a 1.5-T Philips Gyroscan Magnetic Resonance System and analyzed. In both sessions, subjects were intravenously administered with saline (for 3 min) and then propofol (for 1.5 min) and saline again (for 10.5 min) with a constant speed infusion pump. Observer's Assessment of Alertness/Sedation Scale scoring showed that the subjects experienced conscious-sedative-unconscious-analepsia, which correlated well with the signal decreases in the anesthesia states. Propofol induced significant signal decreases in hypothalamus (18.2% AE 3.6%), frontal lobe (68.5% AE 11.2%), and temporal lobe (34.7% AE 6.1%). Additionally, the signals at these three sites were fulminant and changed synchronously. While in the thalamus, the signal decrease was observed in 5 of 10 of the subjects and the magnitude of decrease was 3.9% AE 1.6%. These results suggest that there is most significant inhibition in hypothalamus, frontal lobe, and temporal in propofol anesthesia and moderate inhibition in thalamus. These brain regions might be the targets of propofol anesthesia in human brain. Anat Rec, 293:1985Rec, 293: -1990

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“…However, interpreting the significance of a structural change within the brain is challenging. The posterior insula has also been implicated in cardiorespiratory regulation (Oppenheimer, Gelb, Girvin, & Hachinski 1992). Lacking insight into to the function of the specific posterior insula cluster identified in this investigation, any conclusions about the functional significance of the increased cortical thickness remain highly speculative.…”

Section: Cortical Thickness Changes In the Posterior Insulamentioning

confidence: 83%

An Integrated Assessment of Changes in Brain Structure and Function of the Insula Resulting from an Intensive Mindfulness-Based Intervention

Mooneyham

Mrazek

et al. 2017

J Cogn Enhanc

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Mindfulness training is thought to alter both brain function and structure, yet these effects are almost always investigated and reported independently. In the present study, we combine these two approaches to provide a more complete description of the effects of a 6-week mindfulness-based health and wellness intervention. Region-of-interest analysis of brain structure revealed a significant increase in cortical thickness within the left-hemisphere posterior insula, a region that plays a role in auditory perception and interoception. We then examined changes in the resting-state functional connectivity (rs-FC) of this insula cluster and found two regions with which it displayed increased functional connectivity: one in the right-hemisphere ventrolateral prefrontal cortex (vlPFC) and another spanning parts of the left-hemisphere middle and superior temporal gyri (MTG/STG). Individuals with the greatest improvements in dispositional mindfulness showed the greatest increases in insular thickness as well as greater increases in rs-FC of the posterior insula with vlPFC and MTG/STG. The insula, vlPFC, and MTG/STG comprise a structurally connected network involved in, respectively, early auditory perception, the allocation of attention to changes in sounds, and the detailed analysis of fluctuations in sounds. Accordingly, these findings suggest a mechanistic account of the alterations in brain structure and function that underlie changes in auditory processing following a mindfulnessbased intervention.

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Cardiovascular effects of human insular cortex stimulation

Cited by 1,146 publications

References 20 publications

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

The Action Sites of Propofol in the Normal Human Brain Revealed by Functional Magnetic Resonance Imaging

An Integrated Assessment of Changes in Brain Structure and Function of the Insula Resulting from an Intensive Mindfulness-Based Intervention

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