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Stress and the "extended" autonomic system.

David S Goldstein1

  • 1Autonomic Medicine Section, Clinical Neurosciences Program, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA; Autonomic Medicine Section, CNP/DIR/NINDS/NIH, 9000 Rockville Pike MSC-1620, Building 10 Room 8N260, Bethesda, MD 20892-1620, USA..

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PubMed
Summary

This review updates autonomic neuroscience concepts, proposing an "extended autonomic system" (EAS) integrating neuroendocrine, immune, and central nervous system functions to explain stress and homeostasis. Understanding stress and the EAS aids in managing chronic, multi-system disorders.

Keywords:
AllostasisAutonomicDyshomeostasisHomeostasisStress

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Area of Science:

  • Autonomic Neuroscience
  • Stress Physiology
  • Neuroendocrinology

Background:

  • Revisiting foundational concepts of stress, the autonomic nervous system (ANS), and homeostasis.
  • Highlighting historical definitions by Selye, Cannon, and Langley.
  • Introducing the homeostat and allostasis theories of stress response.

Purpose of the Study:

  • To propose an
  • extended autonomic system
  • (EAS) integrating multiple physiological systems.
  • To update understanding of stress, ANS, and homeostasis in light of recent scientific advances.
  • To explore the clinical and therapeutic implications of these updated concepts.

Main Methods:

  • Literature review and synthesis of key concepts in autonomic neuroscience.
  • Integration of research on neuroendocrine, immune, and central nervous system interactions.
  • Conceptualization of the EAS based on existing and emerging scientific evidence.

Main Results:

  • Proposal of the "extended autonomic system" (EAS) encompassing neuroendocrine and immune system links.
  • Identification of the central autonomic network (CAN) and central stress system.
  • Explanation of allostasis and allostatic load in chronic, stress-related disorders.

Conclusions:

  • The EAS provides a more comprehensive framework for understanding autonomic regulation.
  • Allostatic load explains the development of chronic multi-system disorders.
  • Updated concepts have significant clinical and therapeutic relevance for stress-related conditions.