Central control of autonomic function

In this review, current understanding of the control of autonomic function is outlined and its development over the last 50 years highlighted. Using the control of the cardiovascular system as the primary tool, the importance of the patterning of autonomic outflows is shown to be crucial in both homeostasis and behaviour. Technical advances have made it possible to obtain a clearer idea of how the central nervous system evolves patterns of autonomic discharge that optimise autonomic changes to support motor and behavioural responses. The specific roles of sympathetic and parasympathetic preganglionic neurones and premotor neurones are surveyed and the importance of their roles in integrating afferent inputs that result from peripheral sensory inputs and drive from multiple levels of the neuraxis is outlined. The autonomic control of the viscera, including the urinogenital organs and other organs is discussed briefly. The current ability to use animal models to monitor and modulate autonomic neural discharge and simultaneously co-relate this with end-organ activity is shown to have translational potential. There is every prospect that these studies will lead to the identification of new therapies for pathophysiological conditions.