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In the field of the autonomic nervous system, the most exciting future research developments are likely to be, on the one hand, in the subcellular world and, on the other hand, in the world of the brain’s control of the body’s multicellular machines by way of individual neural programs into a unity of somatomotor, autonomic and neuroendocrine behavior. Today we would rephrase the title of Cannon’s book The Wisdom of the Body to The Wisdom of the Brain in Regulating the Body. It is now clear that a dichotomous concept of the autonomic nervous system divided into sympathetic and parasympathetic and being antagonistically organized, could never explain how the brain controls the body’s organs and tissues.
Axons of postganglionic neurons branch many times close to their effector cells and have hundreds to thousands of varicosities, which contain transmitter(s) packed in vesicles. Excitation of the postganglionic neurons spreads over all its branches and invades all varicosities. Signal transmission from postganglionic neurons to most effector cells occurs through specific neuroeffector synapses. In the heart, acetylcholine released by parasympathetic cardiomotor axons reacts with junctional muscarinic receptors that are coupled via a intracellular second-messenger pathway to the cellular effectors. Arterioles and small arteries are influenced by neural release of noradrenaline and ATP from the varicosities of the vasoconstrictor axons. The ATP reacts with junctional purinoceptors and opens ligand-gated cation channels, which cause activation of voltage-sensitive calcium channels and resultant action potentials. Noradrenaline released from the postganglionic vasoconstrictor terminals reacts with junctionally and extrajunctionally located a-adrenoceptors leading to slow depolarization in some blood vessels. The influence exerted by autonomic neurons on their effector tissues may be modulated by local and remote non-neural signals. The mechanisms of neuroeffector transmission in different autonomic targets are diverse. As no exceptions have yet been found, it is not far-fetched to assume that neuroeffector transmission is specific for all target cells innervated by postganglionic neurons.
Almost all bodily functions are dependent on activity of the autonomic nervous system – from the cardiovascular system, the gastrointestinal tract, the evacuative and sexual organs, to the regulation of temperature, metabolism and tissue defence. Balanced functioning of each aspect of this system is an important basis of our life and well-being. In this long-awaited second edition, the author, a leading figure in this field, provides an up-to-date and detailed description of the cellular and integrative organization of the autonomic nervous system, covering both peripheral and central aspects. The book exposes modern neurobiological concepts that allow us to understand why this system normally runs so smoothly and why its deterioration has such disastrous consequences. This broad overview will appeal to researchers and advanced undergraduate students of the various biological and medical sciences studying how the autonomic nervous system works and to clinicians and physical therapists whose practice involves systems dependent on autonomic functions.