Central Nervous System Control of Fluid Balance: Physiology and Pathology

  • Stafford Lightman
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 47)


The water content of the body is divided between extracellular and intracellular compartments. The 33% of body water in the extracellular fluid is very finely regulated and even following major physiological changes such as exercise, drinking or eating, plasma osmolality remains within a narrow range of about 286–294 mmol/kg. The pre-eminent mechanism controlling body water content is the hormone arginine vasopressin (AVP) which is synthesized in the supraoptic and paraventricular nuclei of the hypothalamus, and acts on the kidney to reduce free water clearance.


Multiple System Atrophy Diabetes Insipidus Hypertonic Saline Plasma Osmolality Vasopressin Secretion 
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  1. Arnauld E, du Pont J (1982) Vasopressin release and firing of supraoptic neurosecretory neurones during drinking in the dehydrated monkey. Pflügers Arch 394: 195–201PubMedCrossRefGoogle Scholar
  2. Clarkson EM, Koutsaimanis KG, Davidman M, Dubois M, Penn WP, de Wardener HE (1974) The effect of brain extracts on urinary sodium excretion of the rat and the intracellular sodium concentration of renal tubule fragments. Clin Sci Mol Med 47: 201–213Google Scholar
  3. Day TA, Ferguson AV, Renaud LP (1984) Facilitatory influence of noradrenergic afferents on the excitability of rat paraventricular nucleus neurosecretory cells. J Physiol 355: 237–249PubMedGoogle Scholar
  4. Dunger DB, Lightman SL, Williams M, Preece MA, Grant DB (1985) Lack of thirst, osmoreceptor dysfunction, early puberty and abnormally aggressive behaviour in two boys. Clin Endocrinol 22: 469–478CrossRefGoogle Scholar
  5. Ikkos D, Luft R, Olivecrona H (1955) Hypophysectomy in man: effect on water excretion during the first two postoperative months. J Clin Endocrinol Metab 15: 553–567PubMedCrossRefGoogle Scholar
  6. Lightman SL, Everitt BJ, Todd K (1984) Ascending noradrenergic projections from the brainstem; evidence for a major role in the regulation of blood pressure and vasopressin secretion. Exp Brain Res 55: 145–151PubMedCrossRefGoogle Scholar
  7. Lightman SL, Everitt BJ, Todd K (1986) Water excretion. In: Lightman SL, Everitt BJ (eds) Neuroendocrinology. Blackwell Scientific Publications, Oxford, pp 197–206Google Scholar
  8. Lipsett MB, Maclean JP, West CD, Li MC, Pearson OH (1956) An analysis of the polyuria induced by hypophysectomy in man. J Clin Endocrinol Metab 16: 183–195PubMedCrossRefGoogle Scholar
  9. Oppenheimer D (1983) Neuropathology of progressive autonomic failure. In: Bannister R (ed) Autonomic failure. Oxford Medical Publications, Oxford, pp 267–283Google Scholar
  10. Poole CJM, Williams TDM, Lightman SL, Frankel HL (1987) Neuroendocrine control of vasopressin secretion and its effect on blood pressure in subjects with spinal cord transection. Brain 110: 727–735PubMedCrossRefGoogle Scholar
  11. Puritz R, Lightman SL, Wilcox CS, Forsling M, Bannister R (1983) Blood pressure and vasopressin in progressive autonomic failure. Brain 106: 503–511PubMedCrossRefGoogle Scholar
  12. Randall RV, Clark EC, Dodge HW, Love JG (1960) Polyuria after operation for tumors in the region of the hypophysis and hypothalamus. J Clin Endocrinol Metab 20: 1614–1621PubMedCrossRefGoogle Scholar
  13. Sawchenko PE, Swanson LW (1982) The organisation of noradrenergic pathways from the brainstem to the paraventricular and supraoptic nuclei in the rat. Brain Res Rev 4: 275–325CrossRefGoogle Scholar
  14. Seckl JR, Dunger DB, Lightman SL (1987) Neurohypophyseal peptide function during early postoperative diabetes insipidus. Brain 110: 737–746PubMedCrossRefGoogle Scholar
  15. Seckl JR, Dunger DB, Lightman SL Williams TDM, Lightman SL (1986) Oral hypertonic saline causes transient fall of vasopressin in humans. Am J Physiol 2511 R 214–217Google Scholar
  16. Sladek CD, Johnson AK (1983) Effects of anteroventral third ventricle lesions on vasopressin release by organ-cultured hypothalamo-neurohypophyseal explants. Neuroendocrinology 37: 7884CrossRefGoogle Scholar
  17. Spokes EG, Bannister R, Oppenheimer DR (1979) Multiple system atrophy with autonomic failure: Clinical, histological and neurochemical observations on four cases. J Neurol Sci 43: 59–82PubMedCrossRefGoogle Scholar
  18. Thrasher TN, Keil LC, Ramsay DJ (1982) Lesions of the organum vasculosum of the lamina terminalis ( OVLT) attenuate osmotically induced drinking and vasopressin secretion in the dog. Endocrinology 100: 1837–1839CrossRefGoogle Scholar
  19. Verbalis JG, Robinson AG, Moses AM (1985) Postoperative and post-traumatic diabetes insipidus. In: Czernichow P, Robinson AG (eds) Diabetes insipidus in man. Frontiers of hormone research, Vol 13. Basel, Karger, pp 242–265Google Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • Stafford Lightman
    • 1
  1. 1.Charing Cross and Westminster Medical SchoolWestminster HospitalLondonUK

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