Immunohistochemical evidence for the interaction between levator ani and pudendal motor neurons in the coordination of pelvic floor and visceral activity in the squirrel monkey.
OBJECTIVE
The purpose of this study was to characterize the spinal distribution of afferent and efferent pathways that innervate the levator ani (LA) muscle in the female squirrel monkey.


METHODS
Cholera toxin B (CTB) was injected unilaterally into the LA muscle of 5 monkeys to identify primary sensory neurons in the dorsal root ganglia (DRG) and motor neurons in the spinal cord that contribute fibers to the LA nerve. Fluoro-Gold (FG) was injected into the external anal sphincter of 2 of these animals to label pudendal motor neurons (1 of these animals underwent unilateral LA neurectomy before CTB injection). Spinal cord and DRG were processed for immunofluorescence 3 to 7 days after injections.


RESULTS
Retrograde transport of CTB from the LA muscle labeled primary afferent neurons in the ipsilateral DRG, their central projections, and motor neurons in the medial portion of the ipsilateral ventral horn of the spinal cord (L7-S2 segments). Injection of FG into the external anal sphincter labeled cells in Onuf's nucleus, primarily in L7. Importantly, CTB-labeled LA motor neurons were virtually absent in Onuf's nucleus, where all pudendal motor neurons are located. CTB-labeled processes were observed within Onuf's nucleus, adjacent to FG-labeled pudendal motor neurons, and appeared to derive from dendrites of LA motor neurons that project into Onuf's nucleus.


CONCLUSIONS
The LA muscle has a distinct innervation with very little or no contribution from the pudendal nerve. The intriguing labeling of LA neural elements within a nucleus that innervates the external urethral and anal sphincters (involved in pelvic visceral control) may represent a neuroanatomic substrate for physiologic integration of spinal and supraspinal inputs for the coordination of pelvic floor and visceral activity.
Pierce
Lisa M
LM
Department of Obstetrics and Gynecology, Scott & White Hospital, Temple, Tex 76508, USA. lpierce@swmail.sw.org
Reyes
Michelle
M
Thor
Karl B
KB
Dolber
Paul C
PC
Bremer
Ronald E
RE
Kuehl
Thomas J
TJ
Coates
Kimberly W
KW
D000344:Afferent Pathways / Q000502:physiology; D000818:Animals; D002772:Cholera Toxin / Q000008:administration & dosage; D004525:Efferent Pathways / Q000502:physiology; D005260:Female; D005456:Fluorescent Dyes / Q000008:administration & dosage; D005836:Genitalia, Female / Q000294:innervation*; D007150:Immunohistochemistry; D007267:Injections; D009046:Motor Neurons / Q000502:physiology*; D009424:Nervous System Physiological Phenomena; D017773:Pelvic Floor / Q000294:innervation* / Q000502:physiology*; D012007:Rectum / Q000294:innervation*; D012453:Saimiri; D013266:Stilbamidines / Q000008:administration & dosage; D009435:Synaptic Transmission; D014781:Viscera / Q000502:physiology*
C049774:2-hydroxy-4,4'-diamidinostilbene, methanesulfonate salt; D005456:Fluorescent Dyes; D013266:Stilbamidines; D002772:Cholera Toxin