Reticular formation and spinal cord injury

Compact literature review to provide basic knowledge of the reticular formation (RF) for clinicians.

United Kingdom.

The anatomical findings were collected from very recently published and well-edited books on neuroscience instead of hundreds of articles that contain materials still requiring test of time and difficult for busy clinicians to digest. Other individual references on specific issues such as a micturition centre, source of sildenafil citrate and so on are added. Clinical considerations discuss commonly encountered problems of spinal cord injury service and science. Every clinical condition is discussed in conjunction with the anatomy and physiology of the RF.

This section involves anatomy. (1) The core RF is located in the brain stem. The RF proper is divided into three longitudinal zones: the lateral (sensory), the medial (motor) and the midline (all others) zone. The midline zone is essential for wakefulness and consciousness. (2) Other brain stem structures sharing functions of the RF proper: periaqueductal grey (PAG), red nuclei, inferior olivary nucleus and precerebellar nucleus. PAG is almost related to all functions of the central nervous system, whereas the others are more connected to cerebellar functions of movements. (3) Spinal cord RF is located in the intermediolateral zone. It sends ascending and receives descending signals to coordinate and modulate motor, sensory and other functions.

This section involves clinical consideration. Multisystem damage, muscle contraction, upper urinary tract, sexual behaviour, skin trophic, pain, sleep apnoea, cross-system damages, spinal cord repair and comprehensive management are discussed to enlighten the clinical importance of the RF.