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Hypothalamic-Pituitary Axis

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The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.

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Vagus Nerve Stimulation as a Tool to Induce Plasticity in Pathways Relevant for Extinction Learning

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What is the Vagal-Adrenal Axis?

Pedro Trevizan-Baú^1,2,3, Robin M McAllen¹

¹The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

The Journal of Comparative Neurology

|July 9, 2024

Summary

The vagal-adrenal axis in inflammation control is likely mediated by vagal afferents, not efferents. Direct vagal innervation of adrenal glands is weak, suggesting indirect neural pathways are key for anti-inflammatory responses.

Keywords:

acupuncture adrenal cortex adrenal medulla electroacupuncture hypothalamic–pituitary–adrenal axis nodose ganglion somatosensory afferent sympathetic vagal afferent

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Area of Science:

Neuroscience
Immunology
Physiology

Background:

Recent studies propose a "vagal-adrenal axis" for electroacupuncture's anti-inflammatory effects.
This axis suggests direct vagal efferent innervation of adrenal glands influencing catecholamine release.

Purpose of the Study:

To evaluate the evidence for direct and indirect neural connections between the vagus nerve and adrenal glands.
To clarify the role of these connections in the neural regulation of inflammation.

Main Methods:

Review of existing anatomical and functional evidence.
Analysis of studies investigating vagal innervation of the adrenal gland.
Assessment of pathways involved in neural control of inflammation.

Main Results:

Evidence for direct vagal parasympathetic efferent innervation of adrenal glands is weak and likely artifactual.
Strong evidence supports direct innervation of the adrenal gland by vagal afferent fibers, though function is unclear.
Significant evidence indicates indirect pathways where vagal afferents signal through the central nervous system to modulate adrenal responses.

Conclusions:

Vagal afferent fibers, not efferent fibers, are the primary mediators of vagal-adrenal interactions in inflammation.
Indirect neural pathways involving the central nervous system are crucial for vagal control of adrenal-dependent anti-inflammatory responses.