title: Functional role of Barrington's nucleus in the micturition reflex: relevance in the surgical treatment of Parkinson's disease.
abstract: The pontine micturition center or Barrington's nucleus (BN) - besides regulating micturition - co-regulates the activity of other pelvic viscera such as the colon and genitals. At present, this issue is gaining particular importance due to: (i) recent findings of α-synuclein in BN, (ii) known urinary dysfunction in parkinsonian patients (part of the so-called non-motor symptoms), other patients with dementia and as in very old individuals; and (iii) its proximity to the pedunculopontine nucleus, a surgical target in deep brain stimulation for Parkinson's disease (PD). The structural and functional organization of the micturition reflex comprises a coordinating action of somatic motor activity with both divisions of the autonomic nervous system, modulated by trunk encephalic and cortical centers that involve the BN as locus coeruleus and periaqueductal gray matter, among other trunk encephalic structures. The involvement of dopaminergic activity (physiologic inhibition of the micturition reflex mediated by dopaminergic D1 activity) that diminishes in Parkinsonism and leads to overactivity of the micturition reflex is also well known. In this review, the integrating role of the BN in the context of vesical and gastrointestinal behavior is revisited, and the principal morpho-functional findings that associate dysfunction with the urinary disorders that appear during the pre-motor stages of PD are summarized.
authors.affiliation: Clinical and Experimental Neuroscience, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), School of Medicine, University of Murcia, Campus de Espinardo, 30071 Murcia, Spain; International Center of Neurological Restoration, Department of Experimental Neurophysiology, Avenue 25 #15805, 11300 Havana, Cuba.
authors.forename: L
authors.initials: L
authors.lastname: Blanco
authors.affiliation: Clinical and Experimental Neuroscience, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), School of Medicine, University of Murcia, Campus de Espinardo, 30071 Murcia, Spain; Department of Medicine, School of Health Sciences, University Jaime I, Campus del Riu Sec, 12071 Castellón de la Plana, Spain.
authors.forename: C M
authors.initials: CM
authors.lastname: Ros
authors.affiliation: Department of Medicine, School of Health Sciences, University Jaime I, Campus del Riu Sec, 12071 Castellón de la Plana, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Tarragón
authors.affiliation: Clinical and Experimental Neuroscience, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), School of Medicine, University of Murcia, Campus de Espinardo, 30071 Murcia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Fernández-Villalba
authors.affiliation: Clinical and Experimental Neuroscience, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), School of Medicine, University of Murcia, Campus de Espinardo, 30071 Murcia, Spain; Department of Medicine, School of Health Sciences, University Jaime I, Campus del Riu Sec, 12071 Castellón de la Plana, Spain. Electronic address: ezquerro@uji.es.
authors.forename: M T
authors.initials: MT
authors.lastname: Herrero
mesh_terms: D000818:Animals; D065835:Barrington's Nucleus / Q000503:physiopathology*; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology*; D014554:Urination / Q000502:physiology*
keywords: Barrington nucleus; Parkinson’s disease; locus coeruleus; micturition reflex; α-synuclein