The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 5: 892 - 898

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.05.022

Reviews

Research progress of paraventricular nucleus of thalamus in the mechanism of general anesthesia

  • Yali LU ,
  • Wenjia CHEN ,
  • Zhidan KE ,
  • Liang ZHOU
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  • 1.School of Anesthesiology，Zunyi Medical University，Zunyi 563000，Guizhou，China
    2.Guizhou Key Laboratory of Anesthesia and Organ Protection，Zunyi Medical University，Zunyi 563000，Guizhou，China

Received date: 2025-07-18

  Online published: 2026-03-09

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Abstract

General anesthesia is widely used in clinical practice； however， the mechanism through which general anesthetics induce reversible loss of consciousness remains elusive. In recent years， with the rapid development of neurobiology， researchers have identified the thalamus as a key hub， not only for transmitting sensory information to the cortex and facilitating cortex-cortex communication， but also as an important site of the ascending arousal system， making it a long-standing focus in theoretical investigations into the neural basis of consciousness. A large number of studies have confirmed that the paraventricular thalamic nucleus serves as a key arousal nucleus within the thalamus， featuring extensive connections with brain regions involved in arousal regulation. This article systematically reviews the research progress on the neural mechanisms of the paraventricular thalamic nucleus in sleep-wake regulation and general anesthesia-induced loss of consciousness， aiming to provide a theoretical foundation for clarifying how general anesthetics regulate changes in consciousness.

Key words： paraventricular thalamic nucleus; general anesthesia; arousal

Cite this article

Yali LU , Wenjia CHEN , Zhidan KE , Liang ZHOU . Research progress of paraventricular nucleus of thalamus in the mechanism of general anesthesia[J]. The Journal of Practical Medicine, 2026 , 42(5) : 892 -898 . DOI: 10.3969/j.issn.1006-5725.2026.05.022

References

[1] REN S， WANG Y， YUE F， et al. The paraventricular thalamus is a critical thalamic area for wakefulness［J］. Science， 2018， 362（6413）： 429-434. doi：10.1126/science.aat2512 .
[2] CUI G， YUAN Y， WANG Q， et al. Transcranial ultrasound stimulation modulates neural activity of paraventricular thalamus and prefrontal cortex in the propofol-anesthetized mice［J］. J Neural Eng， 2025， 22（3）. doi：10.1088/1741-2552/ade28f .
[3] WANG Y L， WANG L， XU W， et al. Paraventricular thalamus controls consciousness transitions during propofol anaesthesia in mice［J］. Br J Anaesth， 2023， 130（6）： 698-708. doi：10.1016/j.bja.2023.01.016 .
[4] ZHAO Y， OU M， LIU J， et al. Astrocytes modulate a specific paraventricular Thalamus→Prefrontal cortex projection to enhance consciousness recovery from anesthesia［J］. J Neurosci， 2024， 44（34）： e1808232024. doi：10.1523/JNEUROSCI.1808-23.2024 .
[5] WU Y， ZHANG D， LIU J， et al. Activity of the sodium leak channel maintains the excitability of paraventricular thalamus glutamatergic neurons to resist anesthetic effects of sevoflurane in mice［J］. Anesthesiology， 2024， 141（1）： 56-74. doi：10.1097/ALN.0000000000005015 .
[6] WANG X， XING K， HE M， et al. Time-restricted feeding is an intervention against excessive dark-phase sleepiness induced by obesogenic diet［J］. Natl Sci Rev， 2022， 10（1）： nwac222. doi：10.1093/nsr/nwac222 .
[7] ZHAO J， LIU C， ZHANG F， et al. A paraventricular thalamus to central amygdala neural circuit modulates acute stress-induced heightened wakefulness［J］. Cell Rep， 2022， 41（11）： 111824. doi：10.1016/j.celrep.2022.111824 .
[8] MUNN B R， MüLLER E J， ARU J， et al. A thalamocortical substrate for integrated information via critical synchronous bursting［J］. Proc Natl Acad Sci USA， 2023， 120（46）： e2308670120. doi：10.1073/pnas.2308670120 .
[9] ADAMANTIDIS A R， DE LECEA L. Sleep and the hypothalamus［J］. Science， 2023， 382（6669）： 405-412. doi：10.1126/science.adh8285 .
[10] KARK S M， BIRNIE M T， BARAM T Z， et al. Functional Connectivity of the Human Paraventricular Thalamic Nucleus： Insights From High Field Functional MRI［J］. Front Integr Neurosci， 2021，15： 662293. doi： 10.3389/fnint.2021.724071 .
[11] PENZO M A， GAO C. The paraventricular nucleus of the thalamus： An integrative node underlying homeostatic behavior［J］. Trends Neurosci， 2021， 44（7）： 538-549. doi：10.1016/j.tins. 2021.03.001 .
[12] VIENA T D， RASCH G E， ALLEN T A. Dual medial prefrontal cortex and hippocampus projecting neurons in the paraventricular nucleus of the thalamus［J］. Brain Struct Funct， 2022， 227（5）： 1857-1869. doi：10.1007/s00429-022-02478-x .
[13] HORIE K， INOUE K， NISHIMORI K， et al. Investigation of oxtr-expressing neurons projecting to nucleus accumbens using oxtr-ires-cre knock-in prairie voles （Microtus ochrogaster）［J］. Neuroscience， 2020， 448： 312-324. doi：10.1016/j.neuroscience.2020.08.023 .
[14] YE Q， NUNEZ J， ZHANG X. Oxytocin receptor-expressing neurons in the paraventricular thalamus regulate feeding motivation through excitatory projections to the nucleus accumbens core［J］. J Neurosci， 2022， 42（19）： 3949-3964. doi：10.1523/JNEUROSCI.2042-21.2022 .
[15] WILLIFORD K M， TAYLOR A， MELCHIOR J R， et al. BNST PKCδ neurons are activated by specific aversive conditions to promote anxiety-like behavior［J］. Neuropsychopharmacology， 2023， 48（7）： 1031-1041. doi：10.1038/s41386-023-01569-5 .
[16] GAO C， GOHEL C A， LENG Y， et al. Molecular and spatial profiling of the paraventricular nucleus of the thalamus［J］. eLife， 2023， 12： e81818. doi：10.7554/eLife.81818 .
[17] CURTIS G R， OAKES K， BARSON J R. Expression and distribution of neuropeptide-expressing cells throughout the rodent paraventricular nucleus of the thalamus［J］. Front Behav Neurosci， 2021， 14： 634163. doi：10.3389/fnbeh.2020.634163 .
[18] MCGINTY J F， OTIS J M. Heterogeneity in the paraventricular thalamus： The traffic light of motivated behaviors［J］. Front Behav Neurosci， 2020， 14： 590528. doi：10.3389/fnbeh. 2020. 590528 .
[19] BARSON J R， MACK N R， GAO W J. The paraventricular nucleus of the thalamus is an important node in the emotional processing network［J］. Front Behav Neurosci， 2020， 14： 598469. doi：10.3389/fnbeh.2020.598469 .
[20] BHATNAGAR S， DALLMAN M F. The paraventricular nucleus of the thalamus alters rhythms in core temperature and energy balance in a state-dependent manner［J］. Brain Res， 1999， 851（1/2）： 66-75. doi：10.1016/s0006-8993（99）02108-3 .
[21] GARGIULO A T， BADVE P S， CURTIS G R， et al. Inactivation of the thalamic paraventricular nucleus promotes place preference and sucrose seeking in male rats［J］. Psychopharmacology， 2022， 239（8）： 2659-2671. doi：10.1007/s00213-022-06160-2 .
[22] MINèRE M， WILHELMS H， KUZMANOVIC B， et al. Thalamic opioids from POMC satiety neurons switch on sugar appetite［J］. Science， 2025， 387（6735）： 750-758. doi：10.1126/science.adp1510 .
[23] MEFFRE J， SICRE M， DIARRA M， et al. Orexin in the posterior paraventricular thalamus mediates hunger-related signals in the nucleus accumbens core［J］. Curr Biol， 2019， 29（19）： 3298-3306.e4. doi：10.1016/j.cub.2019.07.069 .
[24] LI S， DONG X， KIROUAC G J. Extensive divergence of projections to the forebrain from neurons in the paraventricular nucleus of the thalamus［J］. Brain Struct Funct， 2021， 226（6）： 1779-1802. doi：10.1007/s00429-021-02289-6 .
[25] VERTES R P， LINLEY S B， ROJAS A K P. Structural and functional organization of the midline and intralaminar nuclei of the thalamus［J］. Front Behav Neurosci， 2022， 16： 964644. doi：10.3389/fnbeh.2022.964644 .
[26] LI R， INOUE R， MORI H， et al. Functional roles of gastrin-releasing peptide-producing neurons in the suprachiasmatic nucleus： Insights into photic entrainment and circadian regulation［J］. J Neurosci， 2025， 45（25）： e0065252025. doi：10.1523/JNEUROSCI.0065-25.2025 .
[27] MáTYáS F， KOMLóSI G， BABICZKY á， et al. A highly collateralized thalamic cell type with arousal-predicting activity serves as a key hub for graded state transitions in the forebrain［J］. Nat Neurosci， 2018， 21（11）： 1551-1562. doi：10.1038/s41593-018-0251-9 .
[28] HUA R， WANG X， CHEN X， et al. Calretinin neurons in the midline thalamus modulate starvation-induced arousal［J］. Curr Biol， 2018， 28（24）： 3948-3959.e4. doi：10.1016/j.cub. 2018. 11.020 .
[29] GAO C， LENG Y， MA J， et al. Two genetically， anatomically and functionally distinct cell types segregate across anteroposterior axis of paraventricular thalamus［J］. Nat Neurosci， 2020， 23（2）： 217-228. doi：10.1038/s41593-019-0572-3 .
[30] COLAVITO V， TESORIERO C， WIRTU A T， et al. Limbic thalamus and state-dependent behavior： The paraventricular nucleus of the thalamic midline as a node in circadian timing and sleep/wake-regulatory networks［J］. Neurosci Biobehav Rev， 2015， 54： 3-17. doi：10.1016/j.neubiorev.2014.11.021 .
[31] LU Q， KIM J Y. Mammalian circadian networks mediated by the suprachiasmatic nucleus［J］. FEBS J， 2022， 289（21）： 6589-6604. doi：10.1111/febs.16233 .
[32] MOGA M M， WEIS R P， MOORE R Y. Efferent projections of the paraventricular thalamic nucleus in the rat［J］. J Comp Neurol， 1995， 359（2）： 221-238. doi：10.1002/cne.903590204 .
[33] ONO D， MUKAI Y， HUNG C J， et al. The mammalian circadian pacemaker regulates wakefulness via CRF neurons in the paraventricular nucleus of the hypothalamus［J］. Sci Adv， 2020， 6（45）： eabd0384. doi：10.1126/sciadv.abd0384 .
[34] KORF H W， VON GALL C. Mouse models in circadian rhythm and melatonin research［J］. J Pineal Res， 2024， 76（5）： e12986. doi：10.1111/jpi.12986 .
[35] WANG Y， SONG Z， HAN Q， et al. Melatonin targets the paraventricular thalamus to promote non-rapid eye movement sleep in C3H/HeJ mice［J］. Curr Biol， 2024， 34（16）： 3792-3803.e5. doi：10.1016/j.cub.2024.07.033 .
[36] KROEGER D， ABSI G， GAGLIARDI C， et al. Galanin neurons in the ventrolateral preoptic area promote sleep and heat loss in mice［J］. Nat Commun， 2018， 9（1）： 4129. doi：10.1038/s41467-018-06590-7 .
[37] KELZ M B， SUN Y， CHEN J， et al. An essential role for orexins in emergence from general anesthesia［J］. Proc Natl Acad Sci USA， 2008， 105（4）： 1309-1314. doi：10.1073/pnas. 0707146105 .
[38] ZHOU Y， HUANG S， ZHANG T， et al. Deciphering consciousness： The role of corticothalamocortical interactions in general anesthesia［J］. Pharmacol Res， 2025， 212： 107593. doi：10.1016/j.phrs.2025.107593 .
[39] LI J Y， GAO S J， LI R R， et al. A neural circuit from the paraventricular thalamus to the bed nucleus of the stria Terminalis for the regulation of states of consciousness during sevoflurane anesthesia in mice［J］. Anesthesiology， 2022， 136（5）： 709-731. doi：10.1097/ALN.0000000000004195 .
[40] DUAN W Y， PENG K， QIN H M， et al. Esketamine accelerates emergence from isoflurane general anaesthesia by activating the paraventricular thalamus glutamatergic neurones in mice［J］. Br J Anaesth， 2024， 132（2）： 334-342. doi：10.1016/j.bja. 2023. 10.038 .
[41] AO Y， YANG B， ZHANG C， et al. Application of quinpirole in the paraventricular thalamus facilitates emergence from isoflurane anesthesia in mice［J］. Brain Behav， 2021， 11（1）： e01903. doi：10.1002/brb3.1903 .
[42] JIANG S， CHEN L， QU W M， et al. Hypothalamic corticotropin-releasing hormone neurons modulate sevoflurane anesthesia and the post-anesthesia stress responses［J］. eLife， 2024， 12： RP90191. doi：10.7554/eLife.90191 .
[43] RAMADASAN-NAIR R， HUI J， ITSARA L S， et al. Mitochondrial function in astrocytes is essential for normal emergence from anesthesia in mice［J］. Anesthesiology， 2019， 130（3）： 423-434. doi：10.1097/ALN.0000000000002528 .
[44] CAO K， QIU L， LU X， et al. Microglia modulate general anesthesia through P2Y（12） receptor［J］. Curr Biol， 2023， 33（11）： 2187-2200.e6. doi：10.1016/j.cub.2023.04.047 .
[45] CHANG J， LI Z， YUAN H， et al. Protective role of aconitate decarboxylase 1 in neuroinflammation-induced dysfunctions of the paraventricular thalamus and sleepiness［J］. Commun Biol， 2024， 7（1）： 1484. doi：10.1038/s42003-024-07215-0 .
[46] ZHAO S， WANG S， LI H， et al. Activation of orexinergic neurons inhibits the anesthetic effect of desflurane on consciousness state via paraventricular thalamic nucleus in rats［J］. Anesth Analg， 2021， 133（3）： 781-793. doi：10.1213/ANE. 0000000000005651 .
[47] WANG Y， XU L， LIU M Z， et al. Norepinephrine modulates wakefulness via α1 adrenoceptors in paraventricular thalamic nucleus［J］. iScience， 2021， 24（9）： 103015. doi：10.1016/j.isci.2021.103015 .
[48] AO Y， YANG B， ZHANG C， et al. Locus coeruleus to paraventricular thalamus projections facilitate emergence from isoflurane anesthesia in mice［J］. Front Pharmacol， 2021， 12： 643172. doi：10.3389/fphar.2021.643172 .
[49] ZHU Y， NACHTRAB G， KEYES P C， et al. Dynamic salience processing in paraventricular thalamus gates associative learning［J］. Science， 2018， 362（6413）： 423-429. doi：10.1126/science.aat0481 .
[50] WANG T， YAN R， ZHANG X， et al. Paraventricular thalamus dynamically modulates aversive memory via tuning prefrontal inhibitory circuitry［J］. J Neurosci， 2023， 43（20）： 3630-3646. doi：10.1523/JNEUROSCI.1028-22.2023 .
[51] OTIS J M， ZHU M， NAMBOODIRI V M K， et al. Paraventricular thalamus projection neurons integrate cortical and hypothalamic signals for cue-reward processing［J］. Neuron， 2019， 103（3）： 423-431.e4. doi：10.1016/j.neuron.2019.05.018 .
[52] ZHANG G， CUI M， JI R， et al. Neural and molecular investigation into the paraventricular thalamic-nucleus accumbens circuit for pain sensation and non-opioid analgesia［J］. Pharmacol Res， 2023， 191： 106776. doi：10.1016/j.phrs.2023.106776 .
[53] LIANG S H， ZHAO W J， YIN J B， et al. A neural circuit from thalamic paraventricular nucleus to central amygdala for the facilitation of neuropathic pain［J］. J Neurosci， 2020， 40（41）： 7837-7854. doi：10.1523/JNEUROSCI.2487-19.2020 .
[54] CECELI A O， BRADBERRY C W， GOLDSTEIN R Z. The neurobiology of drug addiction： Cross-species insights into the dysfunction and recovery of the prefrontal cortex［J］. Neuropsychopharmacology， 2022， 47（1）： 276-291. doi：10.1038/s41386-021-01153-9 .
[55] ZHOU K， ZHU Y. The paraventricular thalamic nucleus： A key hub of neural circuits underlying drug addiction［J］. Pharmacol Res， 2019， 142： 70-76. doi：10.1016/j.phrs.2019.02.014 .
[56] HE Y， REN Y， CHEN X， et al. Neural and molecular investigation into the paraventricular thalamus for chronic restraint stress induced depressive-like behaviors［J］. J Adv Res， 2025， 75： 521-537. doi：10.1016/j.jare.2024.10.025 .
[57] CUI M， JI R， SONG L， et al. Neuronal and molecular mechanisms underlying chronic pain and depression comorbidity in the paraventricular thalamus［J］. J Neurosci， 2024， 44（13）： e1752232024. doi：10.1523/JNEUROSCI.1752-23.2024 .
[58] CHERON J， BECCARI L， HAGUé P， et al. USP7/Maged1-mediated H2A monoubiquitination in the paraventricular thalamus： An epigenetic mechanism involved in cocaine use disorder［J］. Nat Commun， 2023， 14（1）： 8481. doi：10.1038/s41467-023-44120-2 .
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