Добавил:
kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4693_Библиотеки_им_академика_М_И_Перельмана

.pdf
Скачиваний:
0
Добавлен:
10.10.2026
Размер:
8 Мб
Скачать
☆
enters the cranium, diverges from the facial nerve, and enters the solitary tract in the medulla. A
somatosensory branch innervating the pinna joins the facial nerve in the canal. The GLN runs just
underneaththepharyngealepitheliumtoinnervatefoliateorcircumvallatepapillae.TheGLNformsthe
petrosalganglion,andtheVNformsthenodosalganglion.Thelattertwoenterthecraniumtothesolitary
tract.In humans, all three taste nerves enter thesolitary tract before terminating in the NTS, while in
monkeystheIMNandGLNdonot.
25
Fig.13.4Courseofperipheraltaste nerves.FN,facial nerve; Ggl,geniculateganglion; Ndgl,nodosalganglion;Pgl,petrosalganglion;SGP,
superficial greater petrosal nerve;tm, tympanicmembrane;Slgl, semilunar ganglion;SLN,superiorlaryngeal nerve;GLN, glossopharyngeal
nerve;CT,chordatympani.
TheIMN,GLN,andsupralaryngealnervescontainlargeandsmallsomatosensoryfibers.TheIMNand
GLNalso containautonomic nerve fibersinnervatingsalivaryglands. The conductionvelocity of taste
fibersissimilartothatofmyelinatedorunmyelinatedfibers.
26
ResponseProfileofTasteNerveFibers:NeuralTasteInformation
Singletastefibersareresponsivetoasingleorafewbasictastantsdependingonthespeciesofanimal.In
monkeysandmice,singletastefibersgenerallyrespondtoasinglebasictaste,butinratsandcatsthey
respondtomultiplebasictastes.Theresponsivenessoftastefiberstovarioustastantsisoftenexpressed
intermsofthetastantthat produces thelargestresponseof thefouror fivebasictastes(best-stimulus
category).
27
Whentastantsarearrangedintheorderofsweet,salt,sour,andbitteralongtheabscissa,and
responsemagnitudes areplottedontheordinate, theresponseprofileofsingle tastefibershasasingle
peakineachbest-stimuluscategoryintheCTNandGLN.
27
Inmonkeys,single CTNfibers aremostresponsivetosweet,salty,or soursubstances,butrarelyto
bitter or umami substances, whereas single GLN fibers best respond to sweet, bitter, and umami
substances (Fig. 13.5).
28–30
 In rats, umami mixtures evoke synergistic effects in the CTN (the
sweetresponsive fibers inparticular
31
) butnot intheGLN.In rodents, thewholeSGP bundle is more
responsive to sweet substances than theCTN.
32
 However, single-fiber analysis does not confirmthis
finding.Mostsinglefibersinthesupralaryngealnerveareresponsivetowaterinrabbitsorrats,andthis
responseisinhibitedbyadditionofions.
33
TheCTNofprimatesalsoyieldsresponsestowater.
34
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Each of the taste nerves innervates different regions of the oral cavity, conveying various
characteristicsoftastesignals.Theytaketheirowncoursestothecentralnervoussystemwherethey
maybedamagedduringsurgicalprocedures,e.g.,surgeryofthemiddleear.
CentralPathways:TasteRelayNucleusandRelatedStructures
NucleusoftheSolitaryTract
Anatomy
The NTS is located at the dorsal medulla. The anterior portion lies ventral to the dorsal vestibular
nucleus and the posterior portion fuses with the contralateral counterpart to make the nucleus
communicans near the obex, the posterior end of the rhomboid fossa. In monkeys, the NTS is
histologically subdivided into the lateral and medial subnucleus.
25
 The anterior portion, made of the
lateralsubnucleus,isthefirstrelayofthecentralgustatorypathway.TheIMNenterstheNTSposteriorto
the entryofthefacialnerve, followedbythe GLN, andtheVNmostposteriorly.
25
TheIMNandGLN
terminateatthelateralsubnucleus,whilethe VN terminatesatbothsubnuclei.
25
Thelateralsubnucleus
probably contains taste neurons. The human NTS is subdivided into ten subnuclei, among which the
interstitial subnucleuscorrespondstothelateral subnucleusinmonkey.
25
Somatosensorycomponentsof
tastenerves,includingthefacialnerveinnervatingthepinna,terminateatthenucleusofthespinaltractof
thetrigeminus.
EfferentConnections
In monkeys, neuronsintheanterior NTSsendaxons ipsilaterallythrough the central tegmental tractto
terminatedirectlyinthethalamictasterelay, a parvicellularpartoftheventromedial posteriornucleus
(VPMpc)(Fig.13.6).
25
No projection is seen to the parabrachial nucleus from the lateral subnucleus, but from the medial
subnucleus receiving visceral afferents.
25
 Thus, in subhuman primates, the parabrachial nucleus is
probablynotinvolvedintastesensation.Inrats,therostralportionoftheNTSprojectstothereticular
formationinthemedulla,whichisinvolvedintheingestionreflexandmastication.
35
Noreporthasbeen
publishedonpathwaystothethalamusthroughthereticularformation.
PhysiologicalFeatures
Tasteneurons have been recorded from theNTSinmacaque monkeys.
36
 However,detailed studyhas
been limited to rats, in which taste neurons are found among neurons responding to tactile or high-
thresholdmechanical stimulation. Tasteneuronsrespondbesttosweet,salty,orsourtastants,asinthe
CTN,butrarelytobittertastants,withsomeresponsivetomechanicalstimulation.
37
Tasteneuronsfrom
the anterior tonguerespondbest tosalt,butthose from both thetongue andthenasoincisorduct inthe
Fig.13.5a–dResponsesofsinglechordatympanifibers.NaCl, sodiumchloride;HCl, hydrochloricacid.(Reproducedwith kindpermission
fromSatoetal28fora,bandd;andSatoetal29forc.)
aSucrose-bestfiber.
bQuinine-bestfiber.
cResponseprofileoftotal50fibers.
dResponseprofilesofafewsinglefibersineachbest-stimuluscategory.
palaterespondbesttosweettastants.
25,38
Tasteneuronswithareceptivefield(RF)attherostralpartof
theoralcavitytendtobelocatedinthemorerostralportionofthenucleus.Tasteneuronsrespondingto
saltyorsourtastantsoftenhaveRFsintheanteriortongue,andthosetosweettastantshaveRFsinboth
theanteriortongueandthenasoincisorduct,inwhichmanytastebudsarefoundinrodents.
38
Sometaste
neuronshaveRFsintheposteriortongueorsoftpalate.
38
Sometasteneuronsrespondtoseveralolfactorystimuli
39
inrats,probablybywayoftrigeminalnerve
innervationofthenasalcavity.
TheVentralPosteromedialNucleusoftheThalamus,aParvicellularPart
Anatomy
The VPMpcliesbetweentheVPMproperandthemedial lemniscusattheventralposteriorpartofthe
thalamus,andispackedwithsmall-sizedcells.Thegustatorypartis themedial half,
25
comprisingthe
secondrelayofthegustatorypathwayinprimates.
AfferentConnections
Inmonkeys,theVPMpcreceivesafferentsipsilaterallyfromthelateralsubnucleusoftheNTS,andalso
ipsilaterallyfromtheparabrachialnucleus.
25
Fig.13.6Gustatorypathwayfromthesolitarytractnucleus(NTS)toa parvocellularpartofthe ventromedial posteriornucleus (VPMpc).
Thecentral gustatory pathwaystartsfromthelateral subnucleusoftheNTSandgoesupthroughthecentraltegmentalpathtotheVPMpc,
which iscontrastto the visceralpathwaythatgoesupfromthemedial subnucleusofthe NTStothe parabrachial nucleus(PBN). AbdN,
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
abducence nucleus; bc, brachium conjunctivum; CG, central gray; cp, cerebral peduncle; FN, facial nerve; IO, inferior olive; LC, locus
coeruleus; LGB,lateralgeniculatebody; lNTS, lateralsubnucleusoftheNTS;MGB, medialgeniculatebody; ml,mediallemniscus;mNTS,
medialsubnucleusoftheNTS;PUL,pulvinarnucleus;PV,principalnucleusofthetrigeminus;py,pyramidaltract;SC,superiorcolliculus;SN,
substantia nigra;sptV, spinaltractofthetrigeminus;VPL,ventralposterolateralthalamic nucleus;VPMpc, parvocellular partoftheventral
posteromedialthalamicnucleus;VesN,vestibularnucleus.
TheVPMpcisreciprocallyconnectedwiththereticularformationofthalamusinrats,
40
andisfound in
specificnucleiinthethalamusinotheranimals.Thegustatorypartofthethalamicreticularformationis
ventraltothecaudalendofthesomatosensorypart,rostraltoboththevisualandauditoryparts.
40
Inrats,thegustatorycortexandVPMpcarethoughttoformthethalamocorticalreverberatingcircuits
involvingthereticularformationandcontaininginhibitoryneurons.
41
EfferentConnections
NeuronsinthegustatorypartoftheVPMpcprojecttotwogustatorycortices,attheexposedpartofthe
frontaloperculumandattherostralendoftheSylviansulcusinmonkeys.
25
PhysiologicalFeatures
In humans and monkeys, taste responses are recorded from the VPMpc.
25
 Detailed studies have been
carried out in rats.
25,36,42
 Thalamic neurons are spontaneously active, but yield a small response to
tastants.TheirRFsarelargerthanthoseofNTSneurons,coveringthewholetongueoranteriortongue.
42
ThecentraltastepathwayfromtheNTS,thefirstrelay,totheVPMpcrunsdirectlyandipsilaterally
through the central tegmental path. Then the VPMpc sends axons to the two primary gustatory
cortices:thefrontalextentofArea3,andAreaGwithintheSylviansulcus.
GustatoryCorticesinSubhumanPrimates
PrimaryCortex
AnatomyandAfferentConnections
Theprimarygustatorycorticesinmonkeyshavebeenidentifiedbytheevokedpotentialmethod
43,44
and
bytracermethods.
25,44
Twoprimarygustatorycorticesarerecognized:(1)TheprecentralextensionofArea3(precentral
Area3)towhichtheCTN,LN,andGLNprojectbilaterallywithipsilateralpredominance;
43,44
and
(2)AreaG
45
attherostralendintheinsideoftheSylviansulcustowhichtheCTNandGLN,butnot
theLN,projectipsilaterally.
AreaGliesatthe transitionbetween Areas1 and2atthe frontaloperculumand granularinsula(Fig.
13.7),
44,45
 andis the granular area, characterized with well-developed outer and inner granular layers
(layersIIandIV)andwithGennaristriaatlayerIV.
44,45
CytochromeoxidaseactivitydistinguishesArea
Gfromthesurroundingareas.
44
StudiesusingtracershowtheprojectionsoftheVPMpctobothAreaG
andprecentralArea3.
25
TheaxonsofVPMpcneuronsmaybebifurcatedtoprojecttobothareas.
43
Areas
1and2mayalsobeincludedintheprimarygustatoryareas,asthedepositionofalargeconcentrationof
tracers in the VPMpc has identified terminals in Areas 1 and 2 (Pritchard, personal communication,
September1994).
EfferentConnections
The precentralArea3projectstothe precentraloperculum(PrCO)andArea12,thelateralpartofthe
orbitofrontal cortex,
46,48
 whereas Area G projects to Area 12 and the orbitofrontal operculum(OFO)
(Fig. 13.7).
47,48
 In rats, the gustatory cortex is connected to the contralateral counterpart through the
corpuscallosum.
49
PhysiologicalFeatures
AreasGand3contain manymechanoreceptiveneurons,suchaschewingmovement–relatedneuronsor
tactile neurons with RFs in the mouth.
50
 Among these mechanoreceptive neurons, taste neurons are
found.
36,44,50
 Areas G and3 contain neurons withdifferent taste response characteristics
51
: neurons in
AreaGtendtoresponddifferentiallytohedonicallypositive(sweetorsalty)ornegative(sourorbitter)
tastants,butthoseinArea3donot.Ineachbestcategory,sometasteneuronsdisplayresponseprofiles
with two modes at the best stimulus and another one, by producing the largest responses to the two
tastants and a difference in response between the two (Fig. 13.8). For example, some sucrose-best
neuronsshowlargerresponsestoquininebutsmalleronestoNaClorHCl.Thesefindingssuggestthatthe
primary cortex is concernedwith taste contrast,as inrats.
52
 Neurons mostresponsive tomonosodium
glutamatearealsofoundinAreas3andG(Fig.13.8),
36
probablyrepresentingumami.
Studyingthegustatorycorticesinbehavingmonkeysrevealedthatalmostalloftheneuronsinboth
Area3andAreaGrespondtothesamechemicalcueswithconsistentresponsepatternsirrespective
ofchangesinbehavioralresponses,suchasleverpressingtogainareward
53
;thisindicatesthatthe
neuronsintheprimarycorticesarerealtasteneurons.
HigherOrderCortexandOtherAreas
Anatomy
The PrCO,Area 12, andprobably the OFO,receivingafferents from theprimaryareas,
46,47
arehigher
order gustatoryareas. They are dysgranularneocortex. Tasteneuronsare also foundinArea 13 inthe
medialpartoftheorbitofrontalcortex,thelimbiccortex.
25
Area12anddysgranularinsulaprojecttothe
amygdala.
36,44,54
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Fig.13.7GustatorypathwayfromVPMpctotheprimarygustatorycortexandtohigherordergustatorycortex.G,areaG;IA,agranularpart
of the insula; OFO,orbitofrontal operculum; PrCO,precentral operculum; ai, arcuate sulcus, inferior branch; as, arcuate sulcus, superior
branch;ipc,inferiorprecentralsulcus;p,principalsulcus;ss,Sylviansulcus;1–2,area1–2;3,area3.Otherabbreviations,seethelegendfor
Fig.13.6.(FromOgawaetal.
48
)
Fig.13.8ResponseprofilesoftasteneuronsinAreas3andG.Responses(numberofimpulsespersecond)areplottedagainsttastestimuli.
AArea3;BAreaG;asucrosebest;bNaClbest;cHClbest;dquininebest;eglutamatebest;0,spontaneousdischargerate;G,glutamate;
H,hydrochloricacid;N,sodiumchloride;Q,quinine;S,sucrose.
ResponseFeatures
NeuronsinArea12respondtotastestimuliandothermodalitiessuchassomatosensory,visual,and
olfactory stimuli.
36,44
 Pleasant stimuli are effective. Neurons in Area 12 show sensory-specific
satiety,withtasteresponsesfacilitatedbyhungertoacertainstimulusbutsuppressedbysatietytoit.
HypothalamicsignalsmaygatetasteinputstoArea12.
36
Inbehavingmonkeys,almostalloftheneuronsinArea12andhalftheneuronsinthePrCOrespondtothe
samechemicalcues,withtheresponsepatternreversedafterchangesinbehavioralresponse(Fig.13.9).
These areas do notrepresent taste, but rather behavioral context,or whatthe monkey wants to do in
responsetocues.
53
Neuronsinthe amygdala tendto respondto aversivestimuli. Neuronsinthe amygdala ortemporal
poledifferentiallyrespondtofoodornon-food.
55
Theamygdalaisalsoinvolvedinlearnedtasteaversion
inrats.
56
 Ablation of the lower part of the parietal cortex and the temporal pole in monkeys yields
hyperorality,orKluever–Bucysyndrome.
54
Fig.13.9a,bResponsesofcorticalneuronstocues inmonkeyengagedina delayedversionoftheNaCl–water discriminationGO/NOGO
task.Thetaskwasreversedbeforeandafterthearrow.(FromIfukuetal.
53
)
aNeuronconsistentlyrespondingtoNaClorwaterirrespectiveoftaskreversal,representingchemicalnatureofcues(AreaG).
bNeuronchangingresponsetocuesaccordingtothetask,representingthebehavioralcontext(Area12).
Taste neurons in the two primary areas show invariant taste responsiveness irrespective of
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
behavioralcontext,whilethoseinhigher-orderArea12,showchangesinresponsivenessdepending
onbehavioralcontext.Thelatteralsoshowssensory-specificsatiety.
GustatoryCorticesinHumans
PrimaryCortex
Thelocationoftheprimarygustatorycortex(PGA)inthehumancerebralcortexhasbeenarguedformany
decades. Börnsteinstudied patients withageusia after bullet wounds involving the parietal lobe, and
locatedagustatorycorticalareainArea43ortheRolandoperculum.
57
PenfieldandJasper,
58
ontheother
hand,suggestedtasterepresentationinthecircuminsular cortex superior tothe circular sulcusnear the
footofthecentralsulcusandextendingtotheinsularcortex,eventhoughtherelationtosecondarysensory
areasisnotcertain.Bothreportssuggestthatthegustatorycortexliesatthefootofthecentralsulcus,but
differastowhetheritisatthelateralsurfaceorburiedinthecerebralcortex.Asdescribedonp.158,
twoprimarygustatorycorticesarerecognizedinsquirrelandmacaquemonkeys.
Recentdevelopmentsinimagingtechniqueshaveyieldedvariousnoninvasivemethods(e.g.,functional
magneticresonanceimaging[fMRI],positronemissiontomography[PET],andmagnetoencephalography
[MEG]) that allow us to measure the brain activity in healthy living human subjects. fMRI measures
changesinblood flow bydetecting thecontrastinmagnetic susceptibility betweenoxyhemoglobinand
deoxyhemoglobin. PET measures the density of oxygen-15-water (H
2
15
O) in blood, by detection of
gamma rays caused by electron–positron annihilation. Both methods mainly measure changes in
metabolism associated with neural activity, which provides better spatial resolution than detecting
activatedregions.MEGorelectroencephalography(EEG),however,measurechangesinmagneticfields
orelectricpotential,respectively,onthesurfaceoftheskull,causedbyelectricalactivationinclustersof
neurons.MEGandEEG,therefore,providebettertemporalresolutionofcorticalactivation.Additionally,
MEG is superior to EEG for localizing cortical activity because of the uniformity of magnetic
permeabilityinaskull,comparedwiththelargedistortionofelectricsignalsforEEG.
AsthePGAisthefirstcorticalareareceivingprojectionsfromthethalamus,MEGisthemostsuitable
method of identifying thePGA.MEG experiments revealed that taste stimuli evoked the first cortical
activationattworegions:First,thelowerendofthecentralsulcus,probablycorrespondingtothefrontal
extension of Area 3 in primates; and, second, the transition area between the parietal or Rolandic
operculumandtheposteriorpartoftheinsula,probablycorrespondingtoAreaGneartheanteriorendof
thelateralsulcusinprimates(humanAreaG),asshowninFig.13.10.Activationoftheformerwasfound
tocontinuetoArea43inanfMRIstudy.Theformer,includingArea43andthefootofthecentralsulcus,
probablycorrespondstoBörnstein'sgustatoryarea,andthehumanAreaG(insidethelateralsulcus)to
that of Penfield and Jasper. The onset latency was ~150 milliseconds for sodium chloride and 250
millisecondsforsaccharin(artificialsweetsubstance)inthelatterarea;theselatenciesintheformerarea
are much shorter(90 milliseconds for sodium chloride).
59
 Compared with the location of thePGA in
primates,
43,44
thatofhumanbeingsmovesposteriorly,traversingthecentralsulcustotheparietalcortex.
Suchmovementofsensoryareasonthecerebralcortexwithphylogeneticevolutionisalsoknowninother
areas, such as the visual cortex. Factor analysis of correspondences suggested that gustatory stimuli
activatedtheinsularregion,andsomatogustatorystimuliactivatedtheRolandicopercula,includingapart
ofthesensoryhomunculusdedicatedtothetactilerepresentationoforalstructures.
60
Fig.13.10a,bLocationoftheprimarygustatorycortex(PGA)inhumans.
aCoronalsectionshowsthatoneofthePGAs(humanAreaG)locatesatatransitionareabetweentheinsularcortexandparietalorRolandic
operculum.
bIllustratesthePGAwhentheinsularcortexisexposedbyclamps.
Some reports
61,62
 insist that the frontal operculum and anterior insula are PGA in humans on the
groundsthatthePGAofprimatesislocatedinthesecorticalareas.AsfMRIorPETmeasuremetabolic
changesinthebrainandhavepoor temporal resolution,itisdifficult toestablish whether the PGA is
locatedinparietalareaswithfMRIorPETstudyalone.MEGstudy
59
revealedthatthefrontaloperculum
andanteriorinsulawereactivatedafterAreaGwithlongerlatency(286milliseconds).Itisreasonable,
therefore,toassumethatthesefrontalareasarehigherareasrelatedtotasteperceptionratherthanPGA.
The PGAisinvolved intasteconcentration coding. Theamplitude ofactivity inthe PGAhadgood
linearityaccording tothe logarithm offoursodiumchloride concentrations, asshowninFig. 13.11a.
63
The latency,however,did notchangewithchangesinconcentrations.Fig. 13.11bshows,however,that
psychological perceived intensity has a partial discrepancy from cortical activation in PGA at high
concentration.Theinterpretationforthisphenomenonwillbedescribedinthenextsection.
Inaddition,thePGA ischaracterizedbysensitivitytothe repetition oftastestimulation,asfoundin
otherprimarysensorycortices,suchastheprimaryvisualcortexinwhichchangesinregionalcerebral
bloodflow(rCBF)areobservedbyrepetitivestimuliorchecker-boardreversal.
64
Althoughmanystudies
have reported weakor rare activation of the PGA by long-lasting taste stimuli, significantchangesof
rCBFatthePGAwerealsoobservedbyfrequenttastestimuli,
65
asshowninFig.13.12a,andthelocation
revealedbyfMRIisconsistentwithMEGresults(Fig.13.12b).
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/