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Neural Mechanisms of Cardiac Pain
Author Biography
Introduction
Anterolateral System
Somatic vs. Visceral Nociceptive Processing
Angina Pectoris
Sympathetic Sensory Innervation
Referred Pain
Vagal Sensory Innervation
Other Ascending Pathways
Central Sensitization
Currently selected section: Thalamus and Cerebral Cortex
Neurophysiology of Angina Pectorsis
Nausea and Vomiting

Dyspnea
Summary

 

Chapter 25:Neural Mechanisms of Cardiac Pain: Thalamus and Cerebral Cortex
        

Thalamus and Cerebral Cortex

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Figure 12: Structures in Thalamus and Cortex Likely to Receive Cardiac Input from the Spinothalamic Tract: Graphic depiction of structures in thalamus and cortex, described in text

The lateral thalamus that receives cardiac information via the spinothalamic tract includes the ventroposterolateral, ventroposteromedial, and ventroposteroinferior nuclei. Axons from cells of the lateral thalamus relay information to the primary somatosensory cortex and possibly to the secondary somatic cortex. This evidence suggests that visceral information projects to the somatosensory cortex (Bruggemann and Apkarian, 1997; Follett and Dirks, 1994). Information processed in this cortical area contributes to sensory discrimination (Melzack and Wall, 1982; Price and Dubner, 1977).

Cardiac and somatic information also project via the spinothalamic and spinoreticular tracts to the intralaminar thalamic nuclei, primarily to the centralis lateralis and centrum medianum-parafascicularis nuclei (Boivie, 1979; Mehler, 1960; Craig and Dostrovsky, 1997). The information generated in these nuclei is relayed to the association cortex including the insular cortex, amygdala and cingulate gyrus (Bentivoglio et al., 1981; Berendse and Groenewegen, 1991; Sadikot et al., 1990). These nuclei may contribute to the emotional components of pain including autonomic adaptations (Melzack and Wall, 1982; Albe-Fessard and Besson, 1973; Casey and Jones, 1978; Melzack and Casey, 1968).

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