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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(02): 121-123
DOI: 10.1590/0004-282X20190118
HISTORICAL NOTE

A concise historical perspective of the area postrema structure and function

Uma perspectiva histórica concisa da estrutura e função da área postrema
Thiago Ferreira Simões DE SOUZA 
1   Hospital da Cruz Vermelha Brasileira, Curitiba-PR, Brasil.
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ABSTRACT

First described by Retzius at the end of the 19th century, the structure in the posterior medulla oblongata, then named area postrema, underwent an intense investigation into its function in the decades that followed. Findings, mainly in animal studies, have partially elucidated its role as an emetic center in the central nervous system. In the second half of the 20th century, this function was associated with reports of syndromes characterized by uncontrollable nausea and vomiting related to structural damage in the area postrema, mainly in the context of demyelinating diseases. At the beginning of the 21st century, the so-called area postrema syndrome has been consolidated as a diagnostic factor in diseases related to the spectrum of neuromyelitis optica, more than 100 years after its first description.

RESUMO

Descrita pela primeira vez por Retzius no final do século XIX, a estrutura na medula oblonga posterior, então nomeada de área postrema, passou por intensa investigação quanto à sua função nas décadas seguintes. Achados sobretudo em estudos com animais elucidaram parcialmente sua função como centro emético no sistema nervoso central. Na segunda metade do século XX, tal função foi associada a relatos de síndromes caracterizadas por náuseas e vômitos incoercíveis relacionadas a lesões estruturais na área postrema, principalmente no contexto das doenças desmielinizantes. Já no início do século XXI, a então chamada síndrome da área postrema se consolida como fator diagnóstico nas doenças relacionadas ao espectro da neuromielite óptica, mais de 100 anos sua primeira descrição.

Keywords:

Area postrema - nausea - vomiting - history of medicine - neuromyelitis optica

Palavras-chave:

Área postrema - náusea - vômito - história da medicina - neuromielite óptica


Publication History

Received: 14 March 2019

Accepted: 05 May 2019

Article published online:
13 June 2023

© 2019. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Giannuzzi G. Untersuchungen über die Organe welche an dem Brechact theilnehmen und über die physiologische Wirkung des Tartarus stibiatus. Zentr Med Wiis.1865;3:1.
  • 2 Thumas LJ. Ueber das Brechcentrum und über die Wirkung einiger pharmakologischer Mittel auf dasselbe. Arch F Path Anat U Physiol. 1891;123(1):44-69. https://doi.org/10.1007/BF01881928
  • 3 Sarikcioglu L, Yildirim FB. Area postrema: one of the terms described by Magnus Gustaf Retzius. J Hist Neurosci. 2008;17(1):109-10. https://doi.org/10.1080/09647040701236578
  • 4 Grant G. [The histologist and anatomist Gustaf Retzius. He never received the Nobel Prize in spite of his twelve nominations]. Lakartidningen. 2000 Jan;97(1-2):64-70. Swedish.
  • 5 Wilson JT. On the anatomy on the calamus region in the human bulb; with an account of a hitherto undescribed "nucleus postremus.": part II. J Anat Physiol. 1906 Jul;40(Pt 4):357-86.
  • 6 Wislocki GB, Putnam TJ. Further observations on the anatomy and physiology of the areae postremae. Anat Rec. 1924;27(3):151-6. https://doi.org/10.1002/ar.1090270302
  • 7 Cammermeyer J. Is the human area postrema a neuro-vegetative nucleus? Acta Anat (Basel). 1946-1947;2(3-4):294-320. https://doi.org/10.1159/000140216
  • 8 Borison HL, Brizzee KR. Morphology of emetic chemoreceptor trigger zone in cat medulla oblongata. Proc Soc Exp Biol Med. 1951 May;77(1):38-42. https://doi.org/10.3181/00379727-77-18670
  • 9 Borison HL. Area postrema: chemoreceptor trigger zone for vomiting: is that all? Life Sci. 1974 May;14(10):1807-17. https://doi.org/10.1016/0024-3205(74)90399-3
  • 10 Leslie RA. Comparative aspects of the area postrema: fine-structural considerations help to determine its function. Cell Mol Neurobiol. 1986 Jun;6(2):95-120. https://doi.org/10.1007/BF00711065
  • 11 Clarke JM. Tubercle of medulla oblongata. Bristol Med Chir J (1883). 1889; 7(25):194-197.
  • 12 Dow RS, Berglund G. Vascular pattern of lesions of multiple sclerosis. Arch NeurPsych. 1942;47(1):1-18. https://doi.org/10.1001/archneurpsyc.1942.02290010011001
  • 13 McFarling DA, Susac JO. Hoquet diabolique: intractable hiccups as a manifestation of multiple sclerosis. Neurology. 1979 Jun;29(6):797-801. https://doi.org/10.1212/WNL.29.6.797
  • 14 Borison HL. History and status of the area postrema. Fed Proc. 1984 Dec;43(15):2937-40.
  • 15 Misu T, Fujihara K, Nakashima I, Miyazawa I, Okita N, Takase S, et al. Pure optic-spinal form of multiple sclerosis in Japan. Brain. 2002 Nov;125(Pt 11):2460-8. https://doi.org/10.1093/brain/awf260
  • 16 Misu T, Fujihara K, Nakashima I, Sato S, Itoyama Y. Intractable hiccup and nausea with periaqueductal lesions in neuromyelitis optica. Neurology. 2005 Nov;65(9):1479-82. https://doi.org/10.1212/01.wnl.0000183151.19351.82
  • 17 Popescu BF, Lennon VA, Parisi JE, Howe CL, Weigand SD, Cabrera-Gómez JA, et al. Neuromyelitis optica unique area postrema lesions: nausea, vomiting, and pathogenic implications. Neurology. 2011 Apr;76(14):1229-37. https://doi.org/10.1212/WNL.0b013e318214332c
  • 18 Iorio R, Lucchinetti CF, Lennon VA, Farrugia G, Pasricha PJ, Weinshenker BG, et al. Intractable nausea and vomiting from autoantibodies against a brain water channel. Clin Gastroenterol Hepatol. 2013 Mar;11(3):240-5. https://doi.org/10.1016/j.cgh.2012.11.021
  • 19 Wingerchuk DM, Banwell B, Bennett JL, Cabre P, Carroll W, Chitnis T, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2015 Jul;85(2):177-89. https://doi.org/10.1212/WNL.20190118201901181729