Abstract :
Much work has been done in recent years to understand the functional roles of sensory neurons that regulate reflexes and sensations. Information about the response patterns of spinal dorsal horn and brain stem neurons associated with esophageal functions has become available by using electrophysiological techniques. These techniques allow understanding of response characteristics of neurons to various types of stimuli, neurotransmitters involved in excitation or inhibition of neurons, changes in response characteristics of neurons under pathological conditions, and the shape and size of a particular neuron in the central nervous system, as well as its projection to other areas of the brain. Response properties of primary afferent fibers in the vagus and thoracic sympathetic nerves have been studied in intact animal models by using single-fiber or extracellular microelectrode recording techniques. Recently, the single-fiber recording technique has been used in vitro in isolated esophagus-vagus nerve preparations.
Recordings from the brain stem nuclei and thoracic spinal dorsal horn neurons also have examined the response characteristics of second-order neurons receiving afferent input from the esophagus. In the spinal cord, dorsal horn neurons responsive to esophageal distension also receive ipsilateral somatic input (ie, viscero-somatic convergence) from the upper thoracic area. These neurons exhibit sensitization of response after repeated noxious distension of the esophagus or instillation of irritant substances in the esophagus. In the nucleus ambiguus, neurons receiving input from the distal esophagus exhibit excitation to distension of the distal esophagus but undergo inhibition to midthoracic esophageal distension or to swallow. Neurons in the nucleus tractus solitarius receiving input from the distal esophagus exhibit 2 types of responses to proximal and distal esophageal distension. One type of response is a rhythmic firing synchronized with peristaltic contractions of the distal esophagus. This response undergoes inhibition in response to proximal distension. In addition, there is a second, nonrhythmic firing response that occurs both proximal and distal esophageal distension. This observation suggests that swallow-induced inhibition of the distal esophagus is controlled by the preganglionic motor neurons in the brain stem.
Electrophysiological studies allow direct understanding of neuronal activities regulating esophageal functions. In vivo recording has an advantage for studying functional roles of the neurons in regulatory reflexes, whereas in vitro recording is useful for more accurate study of receptor pharmacology. Recordings from the central nervous system allow study of the neurotransmitters involved in neuronal function and the circuitry of different reflex mechanisms.
