Role of cortical–brainstem circuitry in physiological responses to stress: perspectives for non‐invasive brain stimulation.

The article focuses on the role of the ventromedial prefrontal cortex (vmPFC) projections to the rostral ventrolateral medulla (RVLM) in regulating physiological stress responses. Using optogenetics and anatomical tracing in male and female rats, the study found that activation of vmPFC terminals in the RVLM reduces stress-induced glucocorticoid release in both sexes and decreases hyperglycaemia in males, primarily by stimulating inhibitory interneurons rather than catecholaminergic neurons. The findings highlight a cortical-brainstem pathway that may suppress sympathetic overactivity during stress and suggest further research into this circuit's role in cardiovascular regulation and its potential relevance to non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS). The article underscores the need for additional studies to clarify how vmPFC-RVLM signaling contributes to stress adaptation and its therapeutic implications.