Trigger zone

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In neuroscience and neurology, a trigger zone is an area in the body, or of a cell, in which a specific type of stimulation triggers a specific type of response.

The term was first used in this context around 1914 by Hugh T. Patrick, who was writing about trigeminal neuralgia, a condition in which pain fibers in the trigeminal nerve become hypersensitive. [1] In people with trigeminal neuralgia, even a light touch to some part of the body—often a tooth or a part of the face—can give rise to an extended period of excruciating pain. Patrick referred to the sensitive part of the body as the "dolorogenic zone", and used the term "trigger zone" as a simpler equivalent. [2] Through the 1920s and 1930s the term came into steadily wider use, but almost always in the context of neuralgia. [3]

Starting in the late 1930s, other types of stimulation and other types of responses were characterized as having the properties of a trigger zone. In 1940, for example, Morison and Dempsey observed that a small area of the cerebral cortex could be triggered when electrical stimulation would evoke widespread activity in other parts of the cerebral cortex. [4] In 1944 Paul Wilcox described triggering of epileptic seizure by electrical stimulation of another area of the cerebral cortex. [5]

The chemoreceptor trigger zone is within the area postrema of the medulla oblongata in which many types of chemical stimulation can provoke nausea and vomiting. This area was first identified and named in 1951 by Herbert L. Borison and Kenneth R. Brizzee. [6]

Parts of cells, rather than parts of the body, can also behave as trigger zones. The axon hillock of a neuron possesses the highest density of voltage-gated Na+ channels, and is therefore the region where it is easiest for the action potential threshold to be reached. [7]

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<span class="mw-page-title-main">Medulla oblongata</span> Structure of the brain stem

The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involuntary) functions, ranging from vomiting to sneezing. The medulla contains the cardiac, respiratory, vomiting and vasomotor centers, and therefore deals with the autonomic functions of breathing, heart rate and blood pressure as well as the sleep–wake cycle.

<span class="mw-page-title-main">Brainstem</span> Posterior part of the brain, adjoining and structurally continuous

The brainstem is the stalk-like part of the brain that interconnects the cerebrum and diencephalon with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is continuous with the thalamus of the diencephalon through the tentorial notch.

<span class="mw-page-title-main">Trigeminal nerve</span> Cranial nerve responsible for the faces senses and motor functions

In neuroanatomy, the trigeminal nerve (lit. triplet nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewing; it is the most complex of the cranial nerves. Its name (trigeminal, from Latin tri- 'three', and -geminus 'twin') derives from each of the two nerves (one on each side of the pons) having three major branches: the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). The ophthalmic and maxillary nerves are purely sensory, whereas the mandibular nerve supplies motor as well as sensory (or "cutaneous") functions. Adding to the complexity of this nerve is that autonomic nerve fibers as well as special sensory fibers (taste) are contained within it.

<span class="mw-page-title-main">Glossopharyngeal nerve</span> Cranial nerve IX, for the tongue and pharynx

The glossopharyngeal nerve, also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper medulla, just anterior to the vagus nerve. Being a mixed nerve (sensorimotor), it carries afferent sensory and efferent motor information. The motor division of the glossopharyngeal nerve is derived from the basal plate of the embryonic medulla oblongata, whereas the sensory division originates from the cranial neural crest.

<span class="mw-page-title-main">Trigeminal neuralgia</span> Neurological pain disorder

Trigeminal neuralgia, also called Fothergill disease, tic douloureux, or trifacial neuralgia is a long-term pain disorder that affects the trigeminal nerve, the nerve responsible for sensation in the face and motor functions such as biting and chewing. It is a form of neuropathic pain. There are two main types: typical and atypical trigeminal neuralgia. The typical form results in episodes of severe, sudden, shock-like pain in one side of the face that lasts for seconds to a few minutes. Groups of these episodes can occur over a few hours. The atypical form results in a constant burning pain that is less severe. Episodes may be triggered by any touch to the face. Both forms may occur in the same person. It is regarded as one of the most painful disorders known to medicine, and often results in depression.

Exhalation is the flow of the breath out of an organism. In animals, it is the movement of air from the lungs out of the airways, to the external environment during breathing. This happens due to elastic properties of the lungs, as well as the internal intercostal muscles which lower the rib cage and decrease thoracic volume. As the thoracic diaphragm relaxes during exhalation it causes the tissue it has depressed to rise superiorly and put pressure on the lungs to expel the air. During forced exhalation, as when blowing out a candle, expiratory muscles including the abdominal muscles and internal intercostal muscles generate abdominal and thoracic pressure, which forces air out of the lungs.

<span class="mw-page-title-main">Neocortex</span> Mammalian structure involved in higher-order brain functions

The neocortex, also called the neopallium, isocortex, or the six-layered cortex, is a set of layers of the mammalian cerebral cortex involved in higher-order brain functions such as sensory perception, cognition, generation of motor commands, spatial reasoning and language. The neocortex is further subdivided into the true isocortex and the proisocortex.

A chemoreceptor, also known as chemosensor, is a specialized sensory receptor which transduces a chemical substance to generate a biological signal. This signal may be in the form of an action potential, if the chemoreceptor is a neuron, or in the form of a neurotransmitter that can activate a nerve fiber if the chemoreceptor is a specialized cell, such as taste receptors, or an internal peripheral chemoreceptor, such as the carotid bodies. In physiology, a chemoreceptor detects changes in the normal environment, such as an increase in blood levels of carbon dioxide (hypercapnia) or a decrease in blood levels of oxygen (hypoxia), and transmits that information to the central nervous system which engages body responses to restore homeostasis.

The control of ventilation is the physiological mechanisms involved in the control of breathing, which is the movement of air into and out of the lungs. Ventilation facilitates respiration. Respiration refers to the utilization of oxygen and balancing of carbon dioxide by the body as a whole, or by individual cells in cellular respiration.

<span class="mw-page-title-main">Carotid body</span>

The carotid body is a small cluster of chemoreceptor cells and supporting sustentacular cells situated at bifurcation of each common carotid artery in its adventitia.

<span class="mw-page-title-main">Pyramidal tracts</span> Include both the corticobulbar tract and the corticospinal tract

The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (corticobulbar) or spinal cord (corticospinal) and are involved in the control of motor functions of the body.

The cardiovascular centre is a part of the human brain which regulates heart rate through the nervous and endocrine systems. It is considered one of the vital centres of the medulla oblongata.

The chemoreceptor trigger zone (CTZ) is an area of the medulla oblongata that receives inputs from blood-borne drugs or hormones, and communicates with other structures in the vomiting center to initiate vomiting. The CTZ is located within the area postrema, which is on the floor of the fourth ventricle and is outside of the blood–brain barrier. It is also part of the vomiting center itself. The neurotransmitters implicated in the control of nausea and vomiting include acetylcholine, dopamine, histamine, substance P, and serotonin. There are also opioid receptors present, which may be involved in the mechanism by which opiates cause nausea and vomiting. The blood–brain barrier is not as developed here; therefore, drugs such as dopamine which cannot normally enter the CNS may still stimulate the CTZ.

<span class="mw-page-title-main">Reticular formation</span> Spinal trigeminal nucleus

The reticular formation is a set of interconnected nuclei that are located throughout the brainstem. It is not anatomically well defined, because it includes neurons located in different parts of the brain. The neurons of the reticular formation make up a complex set of networks in the core of the brainstem that extend from the upper part of the midbrain to the lower part of the medulla oblongata. The reticular formation includes ascending pathways to the cortex in the ascending reticular activating system (ARAS) and descending pathways to the spinal cord via the reticulospinal tracts.

Neuralgia is pain in the distribution of one or more nerves, as in intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal neuralgia.

<span class="mw-page-title-main">Pontine tegmentum</span>

The pontine tegmentum, or dorsal pons, is located within the brainstem, and is one of two parts of the pons, the other being the ventral pons or basilar part of the pons. The pontine tegmentum can be defined in contrast to the basilar pons: basilar pons contains the corticospinal tract running craniocaudally and can be considered the rostral extension of the ventral medulla oblongata; however, basilar pons is distinguished from ventral medulla oblongata in that it contains additional transverse pontine fibres that continue laterally to become the middle cerebellar peduncle. The pontine tegmentum is all the material dorsal from the basilar pons to the fourth ventricle. Along with the dorsal surface of the medulla, it forms part of the rhomboid fossa – the floor of the fourth ventricle.

The pedunculopontine nucleus (PPN) or pedunculopontine tegmental nucleus is a collection of neurons located in the upper pons in the brainstem. It lies caudal to the substantia nigra and adjacent to the superior cerebellar peduncle. It has two divisions of subnuclei; the pars compacta containing mainly cholinergic neurons, and the pars dissipata containing mainly glutamatergic neurons and some non-cholinergic neurons. The pedunculopontine nucleus is one of the main components of the reticular activating system. It was first described in 1909 by Louis Jacobsohn-Lask, a German neuroanatomist.

<span class="mw-page-title-main">Area postrema</span> Medullary structure in the brain that controls vomiting

The area postrema, a paired structure in the medulla oblongata of the brainstem, is a circumventricular organ having permeable capillaries and sensory neurons that enable its dual role to detect circulating chemical messengers in the blood and transduce them into neural signals and networks. Its position adjacent to the bilateral nuclei of the solitary tract and role as a sensory transducer allow it to integrate blood-to-brain autonomic functions. Such roles of the area postrema include its detection of circulating hormones involved in vomiting, thirst, hunger, and blood pressure control.

<span class="mw-page-title-main">Respiratory center</span> Brain region controlling respiration

The respiratory center is located in the medulla oblongata and pons, in the brainstem. The respiratory center is made up of three major respiratory groups of neurons, two in the medulla and one in the pons. In the medulla they are the dorsal respiratory group, and the ventral respiratory group. In the pons, the pontine respiratory group includes two areas known as the pneumotaxic center and the apneustic center.

References

  1. ↑ E. H. Beckman (1916). "Observations on the diagnosis and treatment of trifacial neuralgia". Annals of Surgery. 64 (2): 242–247. doi:10.1097/00000658-191608000-00008. PMC   1426385 . PMID   17863586.
  2. ↑ H. T. Patrick (1915). "The symptomatology of trifacial neuralgia". Transactions of the American Neurological Association: Annual Meeting, Volume 1914. Springer. pp. 362–379.
  3. ↑ Source: Google Scholar search for "trigger zone" in the year range 1920-1940.
  4. ↑ R. S. Morison; E. W. Dempsey; B. R. Morison (1940). "On the propagation of certain cortical potentials". American Journal of Physiology. Legacy Content. 131 (3): 744–751. doi:10.1152/ajplegacy.1940.131.3.744.
  5. ↑ P. H. Wilcox (1944). "The electroshock convulsion syndrome". American Journal of Psychiatry. 100 (5): 668–673. doi:10.1176/ajp.100.5.668.
  6. ↑ H. L. Borison; K. R. Brizzee (1951). "Morphology of emetic chemoreceptor trigger zone in cat medulla oblongata". Proceedings of the Society for Experimental Biology and Medicine. 77 (1): 38–42. doi:10.3181/00379727-77-18670. PMID   14844387. S2CID   41022535.
  7. ↑ R. Adachi; R. Yamada; H. Kuba (2015). "Plasticity of the axonal trigger zone". The Neuroscientist. 21 (3): 255–265. doi:10.1177/1073858414535986. PMID   24847046. S2CID   20853066.
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