Afferent projections to the pontine micturition center in the cat

Kuipers, Rutger; Mouton, Leonora J.; Holstege, Gert

doi:10.1002/cne.20775

Cited by 57 publications

(44 citation statements)

References 113 publications

(105 reference statements)

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“…Plausibly, in response to urgency, it may exert similar motor regulation of bladder behavior via brainstem nuclei. The pathway must be indirect since the ACG has no monosynaptic connection to the PMC (Kuipers et al, 2006). ACG activation seems to be a response to threatened loss of bladder control; therefore one might expect that its action on the PMC should be inhibitory.…”

Section: Motor Controlmentioning

confidence: 99%

Cerebral control of the bladder in normal and urge-incontinent women

et al. 2007

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Aim: To identify age-related changes in the normal brain/bladder control system, and differences between urge incontinence in younger and older women, as shown by brain responses to bladder filling; and to use age, bladder volume, urge incontinence and detrusor overactivity (DO) as probes to reveal control-system function. Functional MRI was used to examine regional brain responses to bladder infusion in 21 females (26 -85 years): 11 "cases" with urge incontinence and DO (proven previously) and 10 normal "controls". Responses and their age dependence were determined at small and large bladder volumes, in whole brain and in regions of interest representing right insula and anterior cingulate (ACG). In "controls", increasing bladder volume/sensation led to increasing insular responses; with increasing age, insular responses became weaker. In younger "cases", ACG responded abnormally strongly at large bladder volumes/strong sensation. Elderly "cases" showed strong ACG responses even at small bladder volume, but more moderate responses at larger volumes; if DO occurred, pontine micturition center (PMC) activation did not increase. Conclusion:Among normal "controls", increasing age leads to decreased responses in brain regions involved in bladder control, including right insula, consistent with its role in mapping normal bladder sensations. Strong ACG activation occurs in urge-incontinent "cases" and may be a sign of urgency, indicating recruitment of alternative pathways when loss of bladder control is feared. Easier ACG provocation in older "cases" reflects lack of physiological reserve or different etiology. ACG responses seem associated with PMC inhibition: reduced ACG activity accompanies failure of inhibition (DO).

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Section: Motor Controlmentioning

confidence: 99%

Cerebral control of the bladder in normal and urge-incontinent women

et al. 2007

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“…A very important question, therefore, is what controls the PMC. As shown by Holstege and coworkers, the PMC does not receive direct projections from the sacral spinal cord but is the target of very strong projections from the PAG (Blok et al, 1994(Blok et al, , 1995Kuipers et al, 2005). Indeed, the PAG plays a crucial part in the micturition reflex, even in humans, as shown by Yaguchi et al (2004), who reported that a small lesion in the right PAG in a 31-year-old man caused acute urinary retention.…”

Section: The Function Of the Pag In Micturitionmentioning

confidence: 84%

“…A recent study by Kuipers et al (2005) shows that direct afferents to the PMC other than from the PAG are relatively scarce. Such afferents originate in the preoptic region (see also Holstege, 1987) and the caudal hypothalamus.…”

Section: Other Afferents To the Pmcmentioning

confidence: 98%

Micturition and the soul

Holstege

2005

J of Comparative Neurology

Self Cite

121

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There is a close connection between micturition and emotion. Several species use micturition to signal important messages as territorial demarcation and sexual attraction. For this reason, micturition is coordinated not in the spinal cord but in the brainstem, where it is closely connected with the limbic system. In cat, bladder afferents terminate in a cell group in the lateral dorsal horn and lateral part of the intermediate zone. Neurons in this cell group project to supraspinal levels, not to the thalamus but to the central periaqueductal gray (PAG). Neurons in the lateral PAG, not receiving direct sacral cord afferents, project to the pontine micturition center (PMC). The PMC projects directly to the parasympathetic bladder motoneurons and to sacral GABA-ergic and glycinergic premotor interneurons that inhibit motoneurons in Onuf's nucleus innervating the external striated bladder sphincter. Thus, PMC stimulation causes bladder contraction and bladder sphincter relaxation, i.e., complete micturition. Other than the PAG, only the preoptic area and a cell group in the caudal hypothalamus project directly to the PMC. The ventromedial upper medullary tegmentum also sends projections to the PMC, but they are diffuse and also involve structures that adjoin the PMC. Neuroimaging studies in humans suggest that the systems controlling micturition in cat and human are very similar. It seems that the many structures in the brain that are known to influence micturition use the PAG as relay to the PMC. This basic organization has to be kept in mind in the fight against overactive bladder (OAB) and urge-incontinence.

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“…Most of the observed neurogenic factors in the literature are limited to suprapontine or spinal pathologies. To our knowledge, there are only a few studies evaluating brainstem structures in OAB [1,2,3]. …”

Section: Introductionmentioning

confidence: 99%

Overactive Bladder and Pontine Reticular Formation

Zorba

Kırbaş²,

Uzun³

et al. 2013

Urol Int

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Background: The etiology of overactive bladder (OAB) remains unclear. Observed neurogenic factors in the literature are limited to suprapontine or spinal pathologies. The blink reflex is a useful tool in the evaluation of brainstem functions. Blink reflex latency times were evaluated in order to reveal pathology in the brainstem. Methods: A total of 60 women, 30 patients with idiopathic OAB and 30 healthy controls, were enrolled in the study. Blink reflex latency times were analyzed by electrical stimulation of the supraorbital nerve. Two responses in the orbicularis oculi muscle, early ipsilateral response (R1) and late bilateral response (R2) latency times, were recorded. Results: Mean ages of the patients and controls were 51.9 ± 5.3 and 49.2 ± 6.2 years, respectively. R2 latency times were significantly higher in patients than in controls. However, R1 latency times were similar between the two groups. Conclusions: The results of the study suggest a significant relation between late blink latency times and OAB. An oligosynaptic path via the trigeminal nuclei is responsible for R1; however, R2 response is relayed through the reticular formation. Stimulation of pontine reticular formation inhibits micturition contraction. In some patients, idiopathic OAB may result from reticular formation-originated pathology. Additional studies on other reticular formation-mediated reflexes are needed to reveal possible dysfunction of reticular formation.

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Afferent projections to the pontine micturition center in the cat

Cited by 57 publications

References 113 publications

Cerebral control of the bladder in normal and urge-incontinent women

Cerebral control of the bladder in normal and urge-incontinent women

Micturition and the soul

Overactive Bladder and Pontine Reticular Formation

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