ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 5 of 44
УЖМБС 2022, 7(2): 34–39
Medicine. Reviews

Modern Scientific Views on the Composition and Structure of the Autonomic Nervous System (Literature Review)

Polstianoi A. O.

The purpose of the study was to analyze literary sources to summarize modern scientific views on the structure and possible changes in the existing classification of the autonomic nervous system. Results and discussion. According to classical views, the anatomically and functionally autonomic nervous system is divided into sympathetic and parasympathetic parts, and the last one includes cranial and sacral centers. This classification, in addition to ontogenetic, anatomical and physiological justification, has historical roots and is associated with the research of J. Langley. For more than a century, such a classification of the autonomic nervous system was considered commonplace. However, modern views on this issue emphasize the mechanisms of development and molecular mechanisms of these systems. More attention was paid to such elements as gene expression, features of embryogenesis and development, as well as the general functions of neurons localized in these parts of the autonomic nervous system. In recent years, a group of researchers Espinosa-Medina et al. determined the differential genetic features and relationships of sympathetic and parasympathetic preganglionic and postganglionic neurons. The aim of the study was to compare the relationships and genetic characteristics of lumbar and sacral preganglionic neurons with cranial (parasympathetic) and thoracic (sympathetic) neurons. In general, 15 phenotypic and ontogenetic features are given that distinguish the pre- and postganglionic neurons of the cranial part of the parasympathetic part from the sympathetic neurons of the thoracolumbar region. Each of the features, according to Espinosa-Medina et al., proves that the sacral section must be considered as part of the sympathetic, and not the parasympathetic, section of the autonomic nervous system. This assumption is based on the study on mice at 11.5, 13, 165 days of embryonic development of several transcription factors common to both sacral and thoracolumbar preganglionic neurons, but absent in cranial preganglionic neurons. When revising the existing classification, cranial vegetative nervous structures are proposed to be considered parasympathetic, and spinal – sympathetic. However, a number of researchers were critical of the proposed changes to the existing classification. They consider the interpretation of the findings controversial, point to possibly misleading conclusions due to misinterpretations of the evidence, and suggest that the phenotypes of common thoracic and sacral preganglionic neurons may simply share a common spinal identity. Conclusion. In recent years, thanks to the latest research, there has been a rethinking and possible change in the ideas that have existed for a long time about the composition and structure of the autonomic nervous system. The proposed reclassification of the autonomic nervous system involves the assignment of the sacral region to its sympathetic, not parasympathetic part. Such a simplified two-component structure offers a new concept of neurophysiology, as well as the evolution and development of the autonomic nervous system. At the same time, a number of researchers give their arguments in favor of rejecting the proposed radical changes and saving the existing classification. In this regard, further studies are highly demanded, which could finally shed light on this issue

Keywords: autonomic nervous system, sympathetic nervous system, parasympathetic nervous system

Full text: PDF (Ukr) 254K

  1. Wehrwein EA, Orer SH, Barman SM. Overview of the Anatomy, Physiology, and Pharmacology of the Autonomic Nervous System. Compr Physiol. 2016;6(3):1239-78. PMID: 27347892.
  2. Espinosa-Medina I, Saha О, Boismoreau F, Chettouh Z, Rossi F, Richardson WD, et al. The sacral autonomic outflow is sympathetic. Science. 2016;354(6314):893–7. PMID: 27856909. PMCID: PMC6326350.
  3. Reutov VP, Chertkov VM. Novyye predstavleniya o roli vegetativnoy nervnoy sistemy i sistem generatsii oksida azota v sosudakh mozga [New views on the role of the autonomic nervous system and nitric oxide generation systems in brain vessels]. Pacific Medical Journal. 2016;2(64):10–20. [Russian]
  4. Ackerknecht EH. The history of the discovery of the vegatative (autonomie) nervous system. Med Hist. 1974;18(1):1-8. PMID: 4618581. PMCID: PMC1081519.
  5. Navarro X. Physiology of autonomic nervous system. Rev Neurol. 2002;35(6):553-62. PMID: 12389173
  6. O’Connor WJ. British physiologists 1885-1914. A biographical dictionary. Manchester: Manchester University Press; 1991. 575 p.
  7. Jänig W, Neuhuber W. Reclassification of the Sacral Autonomic Outflow to Pelvic Organs as the Caudal Outpost of the Sympathetic System Is Misleading. J Am Osteopath Assoc. 2017;117(7):416-7. PMID: 28662551.
  8. Kandel ER, Schwartz JH, Jessell TM. Principles of Neural Science. McGraw-Hill Companies; 2012. 1760 p.
  9. Pattyn A, Vallstedt A, Dias JМ, Samad OA, Krumlauf R, Rijli FM, et al. Coordinated temporal and spatial control of motor neuron and serotonergic neuron generation from a common pool of CNS progenitors. Genes Dev. 2003;17:729–37. PMID: 12651891. PMCID: PMC196019.
  10. Pattyn A, Morin X, Cremer H, Goridis C, Brunet JF. The homeobox gene Phox2b is essential for the development of autonomic neural crest derivatives. Nature. 1999;399(6734):366-70. PMID: 10360575.
  11. Briscoe J, Sussel L, Serup P, Hartigan-O'Connor D, Jessell TM, Rubenstein JL, et al. Homeobox gene Nkx2.2 and specification of neuronal identity by graded Sonic hedgehog signaling. Nature. 1999;398(6728):622-7. PMID: 10217145.
  12. Guthrie S. Patterning and axon guidance of cranial motor neurons. Nat Rev Neurosci. 2007;8(11):859-71. PMID: 17948031.
  13. Markham JE, Vaughn J. Migration patterns of sympathetic preganglionic neurons in embryonic rat spinal cord. J Neurobiol. 1991;22(8):811-22. PMID: 1779224.
  14. Alaynick WA, Jessell TM, Pfaff SL. SnapShot: spinal cord development. Cell. 2011;146(1):178. PMID: 21729788. PMCID: PMC3158655.
  15. Prasad A, Hollyday M. Development and migration of avian sympathetic preganglionic neurons. J Comp Neurol. 1991;307(2):237-58. PMID: 1713232.
  16. Keast JR. Plasticity of pelvic autonomic ganglia and urogenital innervation. Int Rev Cytol. 2006;248:141-208. PMID: 16487791.
  17. Horn JP, de Groat WC. E-Letter: functional criteria defne divisions of the autonomic motor system. In: Science. 2017.
  18. Jänig W, Keast J, McLachlan E, Neuhuber W, Southard-Smith M. E-Letter. In :Science. 2016.
  19. Janig W, Keast JR, McLachlan EM, Neuhuber WL, Southard-Smith M. Renaming all spinal autonomic outfows as sympathetic is a mistake. Auton Neurosci. 2017;206:60-62. PMID: 28566236.
  20. Janig W, McLachlan EM, Neuhuber WL. The sacral autonomic outfow: against premature oversimplifcation. Clin Auton Res. 2018;28(1):5-6. PMID: 29299713.
  21. Janig W, Neuhuber W. Reclassifcation of the sacral autonomic outfow to pelvic organs as the caudal outpost of the sympathetic system is misleading. J Am Osteopath Assoc. 2017;117(7):416-7. PMID: 28662551.
  22. Neuhuber W, McLachlan E, Janig W. The sacral autonomic outfow is spinal, but not “Sympathetic”. Anat Rec (Hoboken). 2017;300(8):1369-1370. PMID: 28342217.
  23. Amen CJ. Landmark Article Transforms Traditional View of the Autonomic Nervous System. J Am Osteopath Assoc. 2017;117(2):72. PMID: 28134958.
  24. Horn JP. The sacral autonomic outflow is parasympathetic: Langley got it right. Clin Auton Res. 2018;28(2):181-5. PMID: 29453697. PMCID: PMC5859694.
  25. Dyachuk V, Furlan A, Shahidi MK, Giovenco M, Kaukua N, Konstantinidou C, et al. Neurodevelopment. Parasympathetic neurons originate from nerve- associated peripheral glial progenitors. Science. 2014;345(6192):82-7. PMID: 24925909.
  26. Espinosa-Medina I, Outin E, Picard CA, Chettouh Z, Dymecki S, Consalez GG, et al. Neurodevelopment. Parasympathetic ganglia derive from Schwann cell precursors. Science. 2014;345:87–90. PMID: 24925912.
  27. Espinosa-Medina I, Saha O, Boismoreau F, Brunet JF. The “sacral parasympathetic”: ontogeny and anatomy of a myth. Clin Auton Res. 2018;28:13–21. PMID: 29103139. PMCID: PMC5805809.
  28. Lefcort F. Rethinking the autonomic nervous system: genetics and cell fate. Clin Auton Res. 2018;28(2):165-6. PMID: 29282587. PMCID: PMC5860953.
  29. Tubbs RS, Iwanaga J. Surgical anatomy of the sacral plexus and its branches. Elsevier Health Sciences; 2020. 262 p. p. 88-89.
  30. Gray's Anatomy: The Anatomical Basis of Clinical Practice. Elsevier Health Sciences; 2021. 1606 p.