title: Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea.
abstract: While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects' ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anti-correlated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target.
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Roberta
authors.initials: R
authors.lastname: Sclocco
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
authors.forename: Jieun
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA Medical School, Universidad de Santander (UDES), Bucaramanga, Colombia.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Garcia
authors.affiliation: Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Sheehan
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
authors.forename: Florian
authors.initials: F
authors.lastname: Beissner
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Bianchi
authors.affiliation: Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Cerutti
authors.affiliation: Gastroenterology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Braden
authors.initials: B
authors.lastname: Kuo
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Barbieri
authors.affiliation: Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA Department of Biomedical Engineering, Kyunghee University, Yongin, Korea.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Napadow
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001341:Autonomic Nervous System / Q000503:physiopathology*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D015331:Cohort Studies; D005260:Female; D005712:Galvanic Skin Response; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009325:Nausea / Q000473:pathology* / Q000503:physiopathology*; D009434:Neural Pathways / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: brain–gut interactions; motion sickness; neuroimaging; parasympathetic; sympathetic