CORTICOBULBAR CONNEXIONS TO THE PONS AND LOWER BRAIN-STEM IN MAN - AN ANATOMICAL STUDY
CORTICOBULBAR CONNEXIONS TO THE PONS AND LOWER BRAIN-STEM IN MAN - AN ANATOMICAL STUDY
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DOI：
10.1093/brain/81.3.364
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发表时间：
1958-01-01
期刊：
影响因子：
14.5
通讯作者：
KUYPERS, HGJ
中科院分区：
文献类型：
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作者：
KUYPERS, HGJ
本文观察了4例大脑中动脉闭塞性脑软化或内囊出血所致脑桥和延髓变性纤维的分布。这是在Nauta-Gygax银浸渍技术的帮助下完成的。在这些脑干中，许多变性纤维分布在三叉神经运动核、面神经核、舌下神经核和棘上神经核，而脊髓副核只接受少量变性纤维，外展神经核中没有变性纤维。鉴于其临床意义，变性元素在整个同侧面神经核的分布进行了更详细的研究。此外，在脊髓背侧灰质中存在的退化纤维和终末分支的积累被发现在整个下脑干中继续向吻侧延伸。在楔状核和股薄核的腹侧区和“门”区，以及三叉神经脊束复合体和外侧被盖至峡部水平观察到变性成分。此外，还发现退化纤维分布于同侧脑桥被盖、延髓被盖内侧部以及延髓外侧网状核，主要分布于病变的对侧。在猫的运动皮层损伤或大脑半球切除术后，也发现了类似的退化元素分布。然而，在这只动物中，运动核的退化纤维几乎完全缺乏。鉴于这些以及最近在猴子身上的发现，我们可以认为，外侧被盖的纤维代表了一个在遗传学上更古老的间接皮质核通路中的离皮质连接，该通路被该区域的一个或多个突触所中断，而在人类中，该通路被一个更近代的直接皮质核系统所中断。
The distribution of degenerating fibers was studied in the medulla oblongata and the pons of 4 human brains, in which either an encephalomalacia was present, due to occlusion of the middle cerebral artery, or a hemorrhage in the internal capsule. This was done with the aid of the Nauta-Gygax silver impregnation technique. In these brain-stems, many degenerating fibers were distributed to the trigeminal motor, facial, hypoglossal and supraspinal nuclei, whereas the spinal accessory nuclei received only a few degenerating fibers and none were present in the abducens nuclei. In view of its clinical importance, the distribution of degenerating elements throughout the ipsilateral facial nucleus was studied in more detail. Moreover, the accumulation of degenerating fibers and end-ramifications present in the dorsal gray substance of the spinal cord, was found to continue rostralwards throughout the entire lower brain-stem. Degenerating elements were observed in the region ventral to and in the "hilus" of the nuclei cuneatus and gracilis, as well as in the spinal trigeminal complex and the lateral tegmentum up to the level of the isthmus. In addition, degenerating fibers were found to be distributed to the ipsilateral pontine tegmentum, the medial part of the tegmentum of the medulla oblongata as well as to the lateral reticular nucleus of the medulla, predominantly contralateral to the lesion. A similar distribution of degenerating elements was found earlier in the cat, after either lesions of the motor cortex or hemispherectomy. However, in this animal, the degenerating fibers to the motor nuclei were almost completely, lacking. In view of these and more recent findings in the monkey, it would appear that specifically the fibers to the lateral tegmentum represent the corticifugal link in a phylogenetically older indirect corticonuclear pathway interrupted by one or more synapses in this region, and which in man is paralleled by a more recent direct corticonuclear system.