[Central oculomotor circuits].

Abstract

Recent data and hypotheses concerning the central oculomotor pathways are reviewed. Lateral and vertical eye movements are discussed successively, beginning in each case with the final common pathway and then progressing step by step along the main supranuclear tracts selectively involved in the 3 types of eye movements: vestibular movements, saccades and smooth pursuit. It is now established that the final common pathway of lateral eye movements in frontal-eyed species is the abducens nucleus, which controls not only the ipsilateral lateral rectus, but also, through the internuclear neurons, almost all the conjugate lateral activity of the opposite medial rectus. The ascending tract of Deiters, providing direct excitatory vestibular signals to the medial rectus motoneurons, could either have totally regressed in man or would play only a minor functional role. Likewise, a direct inhibition of the medial rectus motoneurons now seems unlikely or ineffective, the relaxation of this muscle resulting essentially from the disfacilitation mediated by the abducens internuclear neurons. This particular mechanism could be explained by the fact that the medial rectus motoneurons also receive messages of convergence, a slow disjunctive movement independent of lateral eye movements. Convergence is performed by excitatory reticular neurons near the oculomotor nucleus and by inhibitory pathways projecting onto the abducens motoneurons, perhaps passing through the internuclear neurons of the oculomotor nucleus. The premotor relay of horizontal reflex eye movements is the medial vestibular nucleus (M.V.N.) which contains excitatory and inhibitory neurons projecting onto the contralateral and ipsilateral abducens nuclei respectively. Afferences of the M.V.N. arise from: the labyrinth, through the vestibular nerve (vestibulo-ocular reflex); the neck, through the dorsal part of the medullary tegmentum (cervico-ocular reflex); the peripheral retina and the visual pathways (for the vestibular contribution of optokinetic nystagmus), perhaps via the pretectum, the nucleus reticularis tegmenti pontis (N.R.T.P.) and/or the nucleus prepositus hypoglossi (N.P.H.) (visuo-ocular reflex). The premotor relay for all ipsilateral saccades is the paramedian pontine reticular formation (P.R.F.) which excites the ipsilateral abducens nucleus and inhibits the contralateral abducens nucleus, via the burst inhibitory neurons located ventrally to the ipsilateral abducens nucleus.(ABSTRACT TRUNCATED AT 400 WORDS)