Role of the Cerebral Cortex in Autonomic Function

Abstract

As early as 1869, the British neurologist John Hughlings Jackson (cited in Hoff et al., 1963), noting the autonomic responses that accompanied motor seizures in epileptic patients, proposed that within the convolutions of the cerebrum were represented not only the voluntary movements of the whole body but also the involuntary movements of the blood vessels and viscera. Jackson's interpretation was prescient in more ways than one: in addition to being the first modern neuroscientist to suggest a cortical visceral representation, his observations underscored the difficulties in distinguishing direct autonomic responses from reflex changes that accompany somatic motor activity, pain, and generalized epileptic discharge. These issues have been inordinately difficult to resolve and remain a problem to this day. In this chapter, we will first examine the methods that have been used to explore the cerebral cortex for areas involved in autonomic function. Then we will review in detail the anatomical and physiological data on three cortical regions for which such a role has been proposed.