Ultrastructural Evidence For A Paucity Of Projections From The Lumbosacral Cord To The Pontine Micturition Center Or M-region In The Cat : A New Concept For The Organization Of The Micturition Reflex With The Periaqueductal Gray As Central Relay

Information concerning the rate of bladder filling is determined by receptors in the bladder wall and conveyed via afferent fibers in the pelvic nerve to sensory neurons in the lumbosacral cord. It was assumed that this information is relayed from the lumbosacral cord to a medial cell group in the dorsolateral pontine tegmentum, called the M-region, the pontine micturition center, or Barrington's nucleus. The M-region, in turn, projects via long descending pathways to the sacral parasympathetic motoneurons. In the present electron microscopic study, it was investigated in cats whether monosynaptic projections from lumbosacral neurons to the M-region indeed exist. Wheat-germ agglutinin-horseradish peroxidase injections were made into the lumbosacral cord.
Many retrogradely labeled dendrites and somata were found in the M-region, but no labeled terminals were found on retrogradely labeled dendrites or somata.
Only a small number of anterogradely labeled terminals, which were filled with mainly round vesicles, contacted unlabeled dendrites in the M-region. In contrast, many more anterogradely labeled terminals, which were filled with mainly round and, to a limited extent, dense core vesicles and with asymmetrical synapses, were found on dendrites in the lateral part of the periaqueductal gray (PAG). Previously (Blok and Holstege [I9941 Neurosci. Lett. 166:93-96), it was demonstrated that the lateral part of the PAG contains neurons projecting to the M-region.
A concept for the central organization of the micturition reflex is presented in which
ascending projections from the lumbosacral cord convey information on bladder filling to the PAG. When the bladder contains so much urine that voiding is necessary, the PAG, in turn, triggers the M-region. The M-region, however, also receives afferents from the preoptic area, which might be involved in the final decision to start micturition.

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