Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions.
The pathophysiology and pharmacological targets of disorders of the bladder and colon have focused predominantly on the periphery. However, these viscera are regulated by the CNS, which, in turn, must integrate their functions with compatible behaviours. This review focuses on the role of the pontine micturition centre, Barrington's nucleus, as a key to this integration. Through its efferent network this pontine centre links parasympathetic preganglionic neurones with forebrain-projecting nuclei, providing an anatomical substrate for coregulation of pelvic visceral and forebrain activity. Disorders characterized by multiple pelvic visceral symptoms and comorbidity with psychiatric disorders (for example functional bowel disorders) might have their roots in dysfunctions of this circuit, which could provide a novel target for pharmacological treatment.
Valentino
R J
RJ
Department of Psychiatry, Medical College of Pennsylvania and Hahnemann University, Broad and Vine Sts, Philadelphia, PA 19102, USA.
Miselis
R R
RR
Pavcovich
L A
LA
D000818:Animals; D003106:Colon / Q000187:drug effects / Q000294:innervation* / Q000503:physiopathology; D018691:Excitatory Amino Acid Antagonists / Q000494:pharmacology; D018756:GABA Antagonists / Q000494:pharmacology; D006801:Humans; D011149:Pons / Q000187:drug effects / Q000502:physiology*; D001743:Urinary Bladder / Q000187:drug effects / Q000294:innervation* / Q000503:physiopathology
D018691:Excitatory Amino Acid Antagonists; D018756:GABA Antagonists