INTRODUCTION TO BRAINSTEM

Professor John Mitrofanis

GENERAL

red
nucleus

sergeant
5 structures within:
sensory cells

medial
lemniscus
reticular
formation

cranials

motor cells

MIDBRAIN

4V

substantia
nigra
cerebral peduncle

pathways

PONS

reticular cells
cranials

cranials

superior reticular
colliculus formation

cuneate
medial
lemniscus

pontine
nuclei
pontine tract

gracile

cranials
reticular
formation

MEDULLA

Modified from Nieuwenhuys R, J Voggd, C van Huijzen (1985)

The Human Central Nervous System : a synopsis and atlas. 3rd
rev. edition. Springer Verlag : Berlin.

medial
lemniscus
pyramid

BRAINSTEM RETICULAR FORMATION

cortex

primitive core
functions: 2 general (related)
(i) Arousal-Mood Setter
- samples somatic/visceral worlds
- sets forebrain activity (arousal/mood)

(ii) Autonomic Policeman

- samples somatic/visceral world
- influences crucial reflexes

thalamus

basal ganglia
midbrain
pons
medulla

BRF
cerebellum

individual nuclei with distinct functions

spinal cord

neurotransmitter systems within BRF

- serotonin, acetylcholine, dopamine, noradrenaline

somatic (eg, pain)

visceral (eg, GIT)

NEUROTRANSMITTERS OF THE BRAINSTEM RETICULAR FORMATION

Serotonin

Acetylcholine

cortex

cortex
basal
ganglia
basal
ganglia

thalamus

thalamus

amygdala
hippocampus
amygdala
hippocampus

midbrain

pons
medulla

pons
cerebellum

medulla
cerebellum

midbrain

hypothalamus

hypothalamus
spinal cord

spinal cord

locale: raphe nuclei

connections: all over
functions:
-

behaviour
mood (depression)
aggression
pain
blood flow control

locale: BRF cholinergic groups

connections: all over
functions:
-

arousal
memory (attention)
ANS control
pain
dreamer

NEUROTRANSMITTERS OF THE BRAINSTEM RETICULAR FORMATION

cortex

basal
ganglia

cortex

basal
ganglia

thalamus

thalamus

amygdala
hippocampus

midbrain
pons

amygdala
hippocampus

cerebellum

medulla

midbrain

Noradrenaline

pons
cerebellum
medulla

hypothalamus

spinal cord

Dopamine
spinal cord

locale: substantia nigra, ventral tegmental area

connections: forebrain
functions:
- behaviour regulation
- focus
- pleasure/motivation

hypothalamus

locale: locus coeruleus

connections: all over
functions:
-

ANS control
pleasure/motivation
blood flow control
neural plasticity
global attention

BRAINSTEM LESIONS
injury = death?
tightly packed: lesion = catastrophe
signs/symptoms depend on level
- know nuclei/pathway
- better detective (single/clusters)
- associated often with other centres
examples (not complete list):
Signs/Symptoms

Structure Involved

coma

brainstem reticular formation (BRF)

cerebellar signs

cerebellar peduncles

balance/posture, vertigo
nausea, nystagmus

vestibular nuclei

speech

nucleus ambiguus (X)

vomit

BRF (vomit centre=area postrema)

motor loss

corticospinal tract

sensory loss

trigeminal nuclei
spinothalamic tract

(cardinal signature)

Modified from Nieuwenhuys R, J

Voggd, C van Huijzen (1985)

ventral view

MEDULLA
trigeminal
nucleus
(V)
BRF

CsT

vestibular nuclei
vomit centre

cerebellar peduncle

spinothalamic tract (StT)

V
StT

BRF
nucleus ambiguus

MEDULLA

corticospinal tract (CsT)

Modified from Nieuwenhuys R, J Voggd, C van Huijzen (1985)

BRAINSTEM LESIONS
Sensory loss
cardinal signature
- spinothalamic tract
- trigeminal nerve/nuclei

spinothalamic
tract

trigeminal
lemniscus

V
brainstem

V
spinal nerve
spinal cord