Parabrachial nuclear complex Multiple functions and potential clinical implications

The parabrachial (PB) nuclear complex is located in the dorsolateral pons, surrounding the superior cerebellar peduncle. This complex consists of 3 major subdivisions: lateral PB, medial PB, and the Kölliker-Fuse nucleus; each consists of several subnuclei that have different neurochemical markers and connections. The PB nuclear complex provides an interface between medullary reflexes and forebrain mechanisms regulating cardiovascular and respiratory functions. It is also involved in control of food and sodium intake, thermoregulation, and relay of pain and visceral sensations to the thalamus, hypothalamus, and amygdala. Recent evidence indicates that portions of the medial and lateral PB, via projections to the basal forebrain, are a critical component of the brainstem arousal system. The PB nuclear complex is activated by visceral and nociceptive inputs in humans; it is also a relay station of taste pathways in rodents, but its role in taste sensation in humans is uncertain. The PB may participate in compensatory ventilatory and arousal responses in the setting of sleep apnea. Involvement of the PB nuclear complex may underlie impaired arousal in comatose patients with brainstem lesions and may contribute to the manifestations of neurodegenerative disorders. The functional organization of the PB nuclear complex and its role in respiratory and cardiovascular control, food intake, sodium intake, thermoregulation, nociception, and arousal have been the subject of several reviews.


Neurology 2016