Second section of the paper contains description of hypothalamic centres involved in regulation of circadian rhythms. Connections between these neurons and activating reticular system are described. Transition from arousal to sleep, promoted by substances called somnogens, is discussed. Lastly, function of suprachiasmatic nucleus as circadian oscillator is presented.Key words: consciousness, awareness, sleep, arousal, reticular system, thalamus, hypothalamus Anaesthesiology Intensive Therapy 2015, vol. 47, no 2, 168-174
HYPOTHALAMUS AND REGULATION OF CIRCADIAN RHYTHMThe hypothalamus is uniformly perceived as the main structure responsible for the regulation of sleep-wakefulness states [1]. Mention of hypothalamic significance in circadian rhythm dates back to the 1930s. An Austrian scientist, Constantin von Economo, performed autopsies on brains from patients who died during viral encephalitis (encephalitis lethargica) epidemics and noted that the occurrence of coma in those patients was related to injury of the posterior hypothalamus and anterior midbrain. In some patients, disease-related damage could be found in the anterior hypothalamus, and those subjects presented quite a different symptomatology, as they remained in a state of constant wakefulness. Von Economo suggested that the anterior hypothalamus contains neurons responsible for falling asleep, while the posterior part of the organ contains neurons generating a state of wakefulness. Von Economo published his observations and conclusions in 1931 [2].In the 1950s Moruzzi and Mogoun presented the notion of an activating reticular system of the brainstem, and in the 1960s the role of the hypothalamus and basal part of the forebrain in the generation of awareness was acknowledged [3]. Further milestones in the neurophysiology of awareness included the theory of the thalamic system of modulating sensory information, the discovery of reciprocal relationships between different neuronal systems in the state of dynamic equilibrium as well as the discovery of the stabiliser, which regulates oscillations of neuronal networks having opposing effects on the state of awareness.The main centres involved in the generation and regulation of sleep and wakefulness include: -basal forebrain (BF), -reticular formation (RF) of the pons and midbrain, -pedunculopontine tegmental nuclei (PPT) and laterodorsal tegmental nuclei (LDT) of the pons, -ventrolateral preoptic nucleus (VLPO) of the hypothalamus, -median preoptic area (MNPO), -tubero-mammillary nucleus (TMN) of the hypothalamus, -dorsal and median raphe nuclei (DR) of the brainstem, -locus coeruleus (LC) of the pons and midbrain, -orexinergic lateral part of hypothalamus (ORXN), -suprachiasmatic nucleus (SCN) (Fig. 1).Synaptic mediators involved in the generation of sleep and wakefulness states include noradrenaline, serotonin, acetylcholine, histamine, melanin-concentrating hormone (MCH), dopamine, γ-aminobutyric acid (GABA), glutamine, glycine and orexins.Homeostatic regulation of this system depends on th...