Regulation Of Arousal Systems

Arousal systems are regulated not only by external stimuli and other arousal systems but also by control systems of the brain. For example, the frontal cortex, particularly the orbitofrontal area, regulates the thalamic reticular nucleus and the cholinergic, basal forebrain structures. Patients with lesions in this area show deficits in arousal. Cortical control is probably not limited to cholinergic modulation. Recent work in the noradrenergic system suggests that the frontal cortex regulates impulse activity in LC neurons as well. The frontal cortex also exerts an influence on the limbic system, which regulates emotional arousal. In the condition known as akinetic mutism, patients may be immobile for hours but when aroused are capable of a wide range of behaviors. This condition is a result of lesions in the mediodorsal frontal cortex and damaged connections with the limbic system. The anterior cingulate region is also important in the self-regulation of arousal through its connections with the cholinergic basal forebrain. In summary, the frontal cortex acts as an executive to regulate the brain stem influences on cortical excitability.

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