brain stem · caudal medulla to the rostral midbrain and continuous with the zona incerta of the...
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Brain stemBrain stem
Reticular formationReticular formation
DefinitionDefinition
�� MMass of neurons and nerve fibers extending from the ass of neurons and nerve fibers extending from the
caudal medulla to the rostral midbrain and continuous caudal medulla to the rostral midbrain and continuous
with the zona incerta of the subthalamus and midline, with the zona incerta of the subthalamus and midline,
intralaminar and reticular nuclei of the thalamusintralaminar and reticular nuclei of the thalamus
�� OOrganized into definite nuclear groups with known rganized into definite nuclear groups with known
afferent and efferent connections afferent and efferent connections
�� As a whole, the reticular formation comprises a neural As a whole, the reticular formation comprises a neural
system with multiple inputs and multisynaptic system of system with multiple inputs and multisynaptic system of
impulse conductionimpulse conduction
Organization of Organization of reticular formation reticular formation
�� Median rapheMedian raphe nuclear groupnuclear group
�� Paramedian reticularParamedian reticular nuclear groupnuclear group
�� Medial reticularMedial reticular nuclear groupnuclear group
�� Lateral reticularLateral reticular nuclear groupnuclear group
Each nuclear group is represented at the level of Each nuclear group is represented at the level of
midbrainmidbrain
ponspons
medullamedulla
Reticular Reticular nnucleiuclei
(MCP)
Reticular Reticular nnuclei uclei
Cuneiform
Subcuneifor
m
Dorsal Raphe
(nucleus
supratrochlearis)
Superior central
(Bekhterew)
Midbrain
Parabrachial
Pedunculop
ontine
Reticulotegm
entalRostral pons–
caudal
midbrain
Reticularis
parvocellular
is
Reticularis pontis
caudalis
Reticularis
pontis oralis
Raphe pontisPons
Paramedian
reticular
Raphe magnusRostral medulla
caudal pons
Reticularis
parvocellular
is
Reticularis
lateralis
Reticularis giganto
cellularis
Raphe obscurus
Raphe pallidusMedulla
LateralMedialParamedianMedian Raphe
Reticular formation Reticular formation –– summary of functionssummary of functions
Purves, et al, Neuroscience, 3rd ed.
Median raphe nuclei
rostral raphe nuclei →
reticular activating
system (wakefulness,
alertness, and sleep)
caudal raphe nuclei →
pain mechanisms
Pain control
pathways &
reticular formation
Ascending pain pathways
Descending systems modulate the transmission of
ascending pain signals
Kandel, Schwartz, Jessell; Principles of
Neural Science, 4th ed. Purves, et al, Neuroscience, 3rd ed.
Descending analgesic pathways activate enkephalin-
containing local circuit neurons
Purves, et al, Neuroscience, 3rd ed.
SER, NA
Glu, NP
morphine
acts here
Medial reticular
nuclei
Gigantocellular nucleus
cuneiform & subcuneiform nuclei
ascending projections
→ consciousness and
alertness
descending projections →
motor control
Premotor cortex regulates posture via the Premotor cortex regulates posture via the
reticular formationreticular formation
Purves, et al, Neuroscience, 3rd ed.
Integration of direct and indirect Integration of direct and indirect
neocortical pathways to spinal cordneocortical pathways to spinal cord
Cortex
Brainstem
Spinal cord
Limb fine
movementsPostural
adjustments
to movements
Paramedian reticular (precerebellar) nuclei
Cortex
Cerebellum
Spinal cord/vestibular nuclei
control of
movements
Paramedian
reticular nuclei
Lateral reticular nuclei
�� Pedunculopontine Pedunculopontine –– connections with connections with
cortex & substantia nigra cortex & substantia nigra →→ locomotor locomotor
centercenter
�� PParabrachial nucleus arabrachial nucleus –– connections withconnections with
amygdala, nucleus solitariusamygdala, nucleus solitarius, ,
hypothalamushypothalamus →→ autonomic functionautonomic function
�� N. N. parvocellularis and lateralis constitute parvocellularis and lateralis constitute
the receptive component of reticular the receptive component of reticular
nuclei nuclei –– receive from ascending sensory receive from ascending sensory
systems, project to cortex & medial systems, project to cortex & medial
reticular groupreticular group
Reticular formation Reticular formation –– summary of functionssummary of functions
Purves, et al, Neuroscience, 3rd ed.
Reticular formation Reticular formation –– summary of major pathwayssummary of major pathways
Noradrenergic neurons
Reticulospinal tractSerotonergic neurons
CChemically specified systemshemically specified systems of the reticular of the reticular
formationformation�� CholinergicCholinergic ssystemystem (groups Ch1(groups Ch1--Ch6) Ch6) -- AchAch
�� LLocations ocations
�� pontomesencephalic junction pontomesencephalic junction –– e.g. pedunculopontine nucleuse.g. pedunculopontine nucleus
�� basal forebrainbasal forebrain -- nucleus basalis of Meynert nucleus basalis of Meynert
�� Function Function -- cortical arousal cortical arousal -- wakefulness and REM sleep wakefulness and REM sleep
�� MonoaminergicMonoaminergic System System –– NE, E, Ser, DopNE, E, Ser, Dop
�� Serotonergic neurons Serotonergic neurons ((groups B1 to B9groups B1 to B9) ) –– most median raphe nuclei most median raphe nuclei →→destruction of destruction of thesethese neurons leads to insomnianeurons leads to insomnia; mood regulation; mood regulation
�� Noradrenergic neurons Noradrenergic neurons -- attention, sleepattention, sleep--wake state and moodwake state and mood
�� locus ceruleus (group A6locus ceruleus (group A6); ); (Latin, (Latin, ““dark blue placedark blue place””) )
�� lateral tegmental norepinephrine system (groups A1 to A7)lateral tegmental norepinephrine system (groups A1 to A7)
�� Adrenergic neurons Adrenergic neurons (groups C1(groups C1--C2)C2)-- a minor component of the a minor component of the monoaminergic system monoaminergic system
�� Dopaminergic neurons Dopaminergic neurons –– most are in the midbran most are in the midbran (ventral tegmental area(ventral tegmental area))
�� mesostriatal (mesostriatal (== nigrostriatal) pathway nigrostriatal) pathway –– to substantia nigra to substantia nigra →→ PD!!!PD!!!
�� mesolimbic mesolimbic pathway pathway –– to the limbic system to the limbic system →→ ooveractivity veractivity inin schizophrenischizophreniaa
�� mesocortical mesocortical –– to prefrontal cortex to prefrontal cortex →→ cognitive deficits in PDcognitive deficits in PD
DDirect (aminergic) and indirect (cholinergic) irect (aminergic) and indirect (cholinergic)
cortical arousal system cortical arousal system regulate sleepregulate sleep
MonoMonoaminergic nuclei promote wakefulness via facilitation of the aminergic nuclei promote wakefulness via facilitation of the
cerebral cortex and inhibition of sleepcerebral cortex and inhibition of sleep--promoting neurons promoting neurons
(hypothalamus)
ComaComa
�� Damage to the reticular formation at the level of Damage to the reticular formation at the level of
thethe rostral pons and caudal medulla may lead to rostral pons and caudal medulla may lead to
coma orcoma or akinetic mutism (coma vigil). An EEG akinetic mutism (coma vigil). An EEG
similar to thesimilar to the slow phase of the sleep slow phase of the sleep
characterizes this condition,characterizes this condition, with no appreciable with no appreciable
change in the autonomic andchange in the autonomic and somatomotor somatomotor
reflexes or eye movemenreflexes or eye movementt
�� Coma might be reversibleComa might be reversible
Brain death Brain death
�� SState of irreversible brain damage so severe that normal tate of irreversible brain damage so severe that normal respiration and cardiovascular function can no longer respiration and cardiovascular function can no longer be maintainedbe maintained
�� In modern clinical medicine, cessation of life is equated In modern clinical medicine, cessation of life is equated with brain death rather than with cessation of heart beat with brain death rather than with cessation of heart beat
�� CCriteriariteria ((ccomatose patients fulfillomatose patients fulfillinging thethesese criteria are criteria are considered deadconsidered dead))
�� Unresponsiveness to external stimuliUnresponsiveness to external stimuli
�� Absence of spontaneous breathingAbsence of spontaneous breathing
�� Dilated fixed pupilsDilated fixed pupils
�� Absence of brain stem reflexes (corneal, gag, vestibuloocular)Absence of brain stem reflexes (corneal, gag, vestibuloocular)
�� No recognizable reversible cause for the comaNo recognizable reversible cause for the coma
�� Flat electroencephalogram (absence of electrical activity)Flat electroencephalogram (absence of electrical activity)
�� Nonfilling of cerebral vessels in arteriography or radioisotope Nonfilling of cerebral vessels in arteriography or radioisotope imaging imaging
Reticular formation in midbrainReticular formation in midbrain
Reticular formation in ponsReticular formation in pons
Reticular formation in medullaReticular formation in medulla
Development of reticular formationDevelopment of reticular formation
Modified from Bayer SA et al. Neurotoxicology 14:83–144, 1993