Conflicts of interest: none.
Article first published online: 18 DEC 2009
Copyright © 2009 Wiley-Liss, Inc.
Neurourology and Urodynamics
Volume 29, Issue 1, pages 42–48, January 2010
How to Cite
Holstege, G. (2010), The emotional motor system and micturition control. Neurourol. Urodyn., 29: 42–48. doi: 10.1002/nau.20789
Christopher Chapple led the review process.
- Issue published online: 18 DEC 2009
- Article first published online: 18 DEC 2009
- Manuscript Accepted: 22 JUN 2009
- Manuscript Received: 8 JAN 2009
- emotional motor system;
- periaqueductal gray, pontine micturition center;
Micturition is, similar to all other movements of the body, the result of activation of the motor system in the central nervous system. This review explains how the brain and brainstem control micturition. The basic reflex system begins with a distinct cell group called Gert's Nucleus (GN) in the sacral cord. GN receives information about bladder contents via A-δ fibers from the bladder and bladder sphincter and relays this information to the central part of the midbrain periaqueductal gray (PAG), but not to the thalamus. The PAG, in turn, in case of substantial bladder filling, excites the pontine micturition center (PMC), which cell group, via its long descending pathways to the sacral cord, induces micturition. Higher brain regions in prefrontal cortex and limbic system, by means of its projections to the PAG are able to interrupt this basic reflex system. It allows the individual to postpone micturition until time and place are appropriate. Lesions in the pathways from prefrontal cortex and limbic system to the PAG probably cause urge-incontinence in the elderly. Neurourol. Urodynam. 29: 42–48, 2010. © 2009 Wiley-Liss, Inc.