The insular cortex, autonomic asymmetry and cardiovascular control: looking at the right side of stroke.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Clinical Autonomic Research Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI:10.1007/s10286-024-01066-9

Marco Antônio Peliky Fontes, Liliane Ramos Dos Santos Machado, Ana Clara Rocha Viana, Matheus Henrique Cruz, Ícaro Santos Nogueira, Marcela Gondim Lima Oliveira, Christiane Braga Neves, Ana Caroline Ventris Godoy, Luke A Henderson, Vaughan G Macefield

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Abstract

Purpose: Evidence from animal and human studies demonstrates that cortical regions play a key role in autonomic modulation with a differential role for some brain regions located in the left and right brain hemispheres. Known as autonomic asymmetry, this phenomenon has been demonstrated by clinical observations, by experimental models, and currently by combined neuroimaging and direct recordings of sympathetic nerve activity. Previous studies report peculiar autonomic-mediated cardiovascular alterations following unilateral damage to the left or right insula, a multifunctional key cortical region involved in emotional processing linked to autonomic cardiovascular control and featuring asymmetric characteristics.

Methods: Based on clinical studies reporting specific damage to the insular cortex, this review aims to provide an overview of the prognostic significance of unilateral (left or right hemisphere) post-insular stroke cardiac alterations. In addition, we review experimental data aiming to unravel the central mechanisms involved in post-insular stroke cardiovascular complications.

Results and conclusion: Current clinical and experimental data suggest that stroke of the right insula can present a worse cardiovascular prognosis.

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岛叶皮层、自律神经不对称和心血管控制：观察中风的右侧。

目的：来自动物和人体研究的证据表明，大脑皮层区域在自律神经调节中起着关键作用，而位于左右脑半球的某些大脑区域则起着不同的作用。这种现象被称为自律神经不对称性，已通过临床观察、实验模型以及目前的神经影像学和交感神经活动直接记录相结合的方法得到证实。左侧或右侧岛叶是大脑皮层的一个多功能关键区域，参与情绪处理，与心血管自主神经控制有关，具有不对称特征：本综述以报道岛叶皮质特定损伤的临床研究为基础，旨在概述单侧（左半球或右半球）岛叶卒中后心脏改变的预后意义。此外，我们还回顾了实验数据，旨在揭示岛叶卒中后心血管并发症的中心机制：目前的临床和实验数据表明，右侧脑岛卒中的心血管预后较差。

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来源期刊

Clinical Autonomic Research 医学-临床神经学

CiteScore

7.40

自引率

6.90%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.