Fig. 1. Schematic diagrams of the possible localization of descending vasomotor pathways within the spinal cord as previously reported in experimental animals (A) and human investigations (B). These pathways were localized within different regions of the white matter in primates (Kerr and Alexander, 1964) (arrow 1), in cats and rodents (Lebedev et al., 1986; Reis et al., 1988; Ruggiero et al., 1989) (arrow 2), and in humans (Nathan and Smith, 1987) (arrow 3). (B) The boxed areas indicate the two potential localizations of descending vasomotor pathways in man, which we examined in the present investigation: the dorsal aspect of lateral funiculus (Area I), and white matter adjacent to dorsolateral aspects of the intermediolateral cell column (Area II). (From Furlan et al. (2003), with permission from J. Neurotrauma.)
symptoms had the greatest damage in Area I. The remainder of the cases, who had only minor cardiovascular symptoms, or no symptoms at all, had significantly less damage in this area. The degree of damage to Area II did not correlate well with the extent of cardiovascular dysfunction in these individuals.
On the basis of these data it may be concluded that, in humans, the pathways from the lower brainstem to the sympathetic preganglionic neurons run in the dorsal aspect of the lateral fun-iculus of the white matter. Since this is the general region where previous work on experimental animals (rat, cat, dog, others) had localized similar pathways, this study further confirms the relevance to humans of animal model studies of autonomic dysfunctions after spinal cord injury.
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