The dorsal column–medial lemniscus pathway (DCML) (also known as the posterior column-medial lemniscus pathway, PCML) is a sensory pathway of the

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...

that conveys sensations of

fine touch In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch (haptic perception), as well as temperature (thermoception), body position (proprioception), and pain. It i ...

vibration Vibration is a mechanical phenomenon whereby oscillations occur about an equilibrium point. The word comes from Latin ''vibrationem'' ("shaking, brandishing"). The oscillations may be periodic function, periodic, such as the motion of a pendulum ...

two-point discrimination Two-point discrimination (2PD) is the ability to discern that two nearby objects touching the skin are truly two distinct points, not one. It is often tested with two sharp points during a neurological examination and is assumed to reflect how fi ...

, and

proprioception Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense". Proprioception is mediated by proprioceptors, mechanosensory neurons ...

(position) from the skin and joints. It transmits information from the body to the

primary somatosensory cortex In neuroanatomy, the primary somatosensory cortex is located in the postcentral gyrus of the brain's parietal lobe, and is part of the somatosensory system. It was initially defined from surface stimulation studies of Wilder Penfield, and paralle ...

in the

postcentral gyrus In neuroanatomy, the postcentral gyrus is a prominent gyrus in the lateral parietal lobe of the human brain. It is the location of the primary somatosensory cortex, the main sensory receptive area for the somatosensory system, sense of touch. Lik ...

of the

parietal lobe The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus. The parietal lobe integrates sensory informa ...

of the brain.O'Sullivan, S. B., & Schmitz, T. J. (2007). Physical Rehabilitation (5th Edition ed.). Philadelphia: F.A. Davis Company. The pathway receives information from sensory receptors throughout the body, and carries this in

nerve tract A nerve tract is a bundle of nerve fibers (axons) connecting nuclei of the central nervous system. In the peripheral nervous system this is known as a nerve, and has associated connective tissue. The main nerve tracts in the central nervous syste ...

s in the

white matter White matter refers to areas of the central nervous system (CNS) that are mainly made up of myelinated axons, also called tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distribution ...

of the dorsal column of the

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...

to the

medulla Medulla or Medullary may refer to: Science * Medulla oblongata, a part of the brain stem * Renal medulla, a part of the kidney * Adrenal medulla, a part of the adrenal gland * Medulla of ovary, a stroma in the center of the ovary * Medulla of t ...

, where it is continued in the

medial lemniscus In neuroanatomy, the medial lemniscus, also known as Reil's band or Reil's ribbon (for German anatomist Johann Christian Reil), is a large ascending bundle of heavily myelinated axons that decussate (cross) in the brainstem, specifically in the m ...

, on to the

thalamus The thalamus (from Greek θάλαμος, "chamber") is a large mass of gray matter located in the dorsal part of the diencephalon (a division of the forebrain). Nerve fibers project out of the thalamus to the cerebral cortex in all directions, ...

and relayed from there through the

internal capsule The internal capsule is a white matter structure situated in the inferomedial part of each cerebral hemisphere of the brain. It carries information past the basal ganglia, separating the caudate nucleus and the thalamus from the putamen and the g ...

and transmitted to the somatosensory cortex. The name dorsal-column medial lemniscus comes from the two structures that carry the sensory information: the dorsal columns of the

, and the

in the

brainstem The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...

. There are three groupings of neurons that are involved in the pathway: first-order neurons, second-order neurons, and third-order neurons. The first-order neurons are

sensory neuron Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The cell ...

s located in the

dorsal root ganglia A dorsal root ganglion (or spinal ganglion; also known as a posterior root ganglion) is a cluster of neurons (a ganglion) in a dorsal root of a spinal nerve. The cell bodies of sensory neurons known as first-order neurons are located in the do ...

, that send their

afferent fibers Afferent nerve fibers are the axons (nerve fibers) carried by a sensory nerve that relay sensory information from sensory receptors to regions of the brain. Afferent projections ''arrive'' at a particular brain region. Efferent nerve fibers a ...

through the two dorsal columns – the gracile fasciculus, or gracile tract, and the cuneate fasciculus, or cuneate tract. The first-order

axon An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action po ...

s make contact with second-order neurons of the

dorsal column nuclei In neuroanatomy, the dorsal column nuclei are a pair of nuclei in the dorsal columns in the brainstem. The name refers collectively to the cuneate nucleus and gracile nucleus, which are present at the bottom of the medulla oblongata. Both nucl ...

(the

gracile nucleus In neuroanatomy, the dorsal column nuclei are a pair of nuclei in the dorsal columns in the brainstem. The name refers collectively to the cuneate nucleus and gracile nucleus, which are present at the bottom of the medulla oblongata. Both nucl ...

and the

cuneate nucleus In neuroanatomy, the dorsal column nuclei are a pair of nuclei in the dorsal columns in the brainstem. The name refers collectively to the cuneate nucleus and gracile nucleus, which are present at the bottom of the medulla oblongata. Both nu ...

) in the lower

. The second-order neurons send their axons to the

. The third-order neurons are in the

ventral nuclear group The ventral nuclear group is a collection of nuclei on the ventral side of the thalamus. According to MeSH, it consists of the following: * ventral anterior nucleus * ventral lateral nucleus * ventral posterior nucleus – this is made up of two nu ...

in the thalamus and fibres from these ascend to the postcentral gyrus. Sensory information from the upper half of the body is received at the

cervical In anatomy, cervical is an adjective that has two meanings: # of or pertaining to any neck. # of or pertaining to the female cervix: i.e., the ''neck'' of the uterus. *Commonly used medical phrases involving the neck are **cervical collar **cerv ...

level of the spinal cord and carried in the cuneate tract, and information from the lower body is received at the

lumbar In tetrapod anatomy, lumbar is an adjective that means ''of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum.'' The lumbar region is sometimes referred to as the lower spine, or as an area of the back i ...

level and carried in the gracile tract. The gracile tract is medial to the more lateral cuneate tract. The axons of second-order neurons of the gracile and cuneate nuclei are known as the

internal arcuate fibers In neuroanatomy, the internal arcuate fibers or internal arcuate tract are the axons of second-order sensory neurons that compose the gracile and cuneate nuclei of the medulla oblongata. These second-order neurons begin in the gracile and cunea ...

and when they cross over the midline, at the

sensory decussation In neuroanatomy, the sensory decussation or decussation of the lemnisci is a decussation (i.e. crossover) of axons from the gracile nucleus and cuneate nucleus, which are responsible for fine touch, vibration, proprioception and two-point discri ...

in the medulla, they form the medial lemniscus which connects with the thalamus; the axons synapse on neurons in the

which then send axons to the postcentral gyrus in the parietal lobe. All of the axons in the DCML pathway are rapidly conducting, large,

myelin Myelin is a lipid-rich material that surrounds nerve cell axons (the nervous system's "wires") to insulate them and increase the rate at which electrical impulses (called action potentials) are passed along the axon. The myelinated axon can be ...

ated fibers.

Structure

The DCML pathway is made up of the axons of first, second, and third-order

s, beginning in the

. The axons from the first-order neurons form the ascending tracts of the gracile fasciculus, and the cuneate fasciculus which synapse on the second-order neurons in the

and the

known together as the

; axons from these neurons ascend as the

; the fibers cross over at the

and form the

which connects with thalamus; the axons synapse on neurons in the

which then send axons to the

in the

. The gracile fasciculus carries sensory information from the lower half of the body entering the spinal cord at the lumbar level. The cuneate fasciculus carries sensory information from the upper half of the body (upper limbs, trunk, and neck) entering the spinal cord at the cervical level. The gracile fasciculus is wedge-shaped on transverse section and lies next to the posterior median septum. Its base is at the surface of the spinal cord, and its apex directed toward the posterior gray commissure. The gracile fasciculus increases in size from inferior to superior. The cuneate fasciculus is triangular on transverse section, and lies between the gracile fasciculus and the posterior column, its base corresponding with the surface of the spinal cord. Its fibers, larger than those of the gracile fasciculus, are mostly derived from the same source, viz., the posterior nerve roots. Some ascend for only a short distance in the tract, and, entering the gray matter, come into close relationship with the cells of the dorsal nucleus, while others can be traced as far as the medulla oblongata, where they end in the gracile nucleus and cuneate nucleus. The two ascending tracts meet at the level of the sixth thoracic vertebra (T6). Ascending tracts typically have three levels of neurons, namely

first-order In mathematics and other formal sciences, first-order or first order most often means either: * "linear" (a polynomial of degree at most one), as in first-order approximation and other calculus uses, where it is contrasted with "polynomials of high ...

second-order Second-order may refer to: Mathematics * Second order approximation, an approximation that includes quadratic terms * Second-order arithmetic, an axiomatization allowing quantification of sets of numbers * Second-order differential equation, a di ...

, and

third-order neuron In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch ( haptic perception), as well as temperature ( thermoception), body position (proprioception), and pain. It ...

s, that relay information from the physical point of reception to the actual point of interpretation in the brain. 1417 Ascending Pathways of Spinal Cord

First-order neurons

Periphery and spinal cord

When an

action potential An action potential occurs when the membrane potential of a specific cell location rapidly rises and falls. This depolarization then causes adjacent locations to similarly depolarize. Action potentials occur in several types of animal cells, ...

is generated by a

mechanoreceptor A mechanoreceptor, also called mechanoceptor, is a sensory receptor that responds to mechanical pressure or distortion. Mechanoreceptors are innervated by sensory neurons that convert mechanical pressure into electrical signals that, in animals, ...

in the tissue, the action potential will travel along the peripheral axon of the first-order neuron. The first-order neuron is

pseudounipolar A pseudounipolar neuron is a type of neuron which has one extension from its cell body. This type of neuron contains an axon that has split into two branches. A single process arises from the cell body and then divides into an axon and a dendrite. ...

in shape with its

body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anima ...

in the

dorsal root ganglion A dorsal root ganglion (or spinal ganglion; also known as a posterior root ganglion) is a cluster of neurons (a ganglion) in a dorsal root of a spinal nerve. The cell bodies of sensory neurons known as first-order neurons are located in the dorsa ...

. The action signal will continue along the central axon of the neuron through the

posterior root The dorsal root of spinal nerve (or posterior root of spinal nerve or sensory root) is one of two "roots" which emerge from the spinal cord. It emerges directly from the spinal cord, and travels to the dorsal root ganglion. Nerve fibres with the Ve ...

, into the posterior horn, and up the

posterior column Posterior may refer to: * Posterior (anatomy), the end of an organism opposite to its head ** Buttocks, as a euphemism * Posterior horn (disambiguation) * Posterior probability, the conditional probability that is assigned when the relevant evidenc ...

of the

. Axons from the lower body enter the posterior column below the level of T6 and travel in the midline section of the column called the gracile fasciculus. Axons from the upper body enter at or above T6 and travel up the posterior column on the outside of the gracile fasciculus in a more

lateral Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...

section called the cuneate fasciculus. These fasciculi are in an area known as the posterior funiculus that lies between the posterolateral and the posterior median sulcus. They are separated by a partition of

glial cells Glia, also called glial cells (gliocytes) or neuroglia, are non-neuronal cells in the central nervous system (brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses. They maintain homeostasis, form mye ...

which places them on either side of the posterior intermediate sulcus. The column reaches the junction between the spinal cord and the

medulla oblongata The medulla oblongata or simply medulla is a long stem-like structure which makes up the lower part of the brainstem. It is anterior and partially inferior to the cerebellum. It is a cone-shaped neuronal mass responsible for autonomic (involun ...

, where lower body axons in the gracile fasciculus connect (

synapse In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell. Synapses are essential to the transmission of nervous impulses from ...

) with neurons in the

, and upper body axons in the cuneate fasciculus synapse with neurons in the

. First-order neurons secrete

substance P Substance P (SP) is an undecapeptide (a peptide composed of a chain of 11 amino acid residues) and a member of the tachykinin neuropeptide family. It is a neuropeptide, acting as a neurotransmitter and as a neuromodulator. Substance P and its clos ...

in the dorsal horn as a chemical mediator of pain signaling. The dorsal horn of the spinal cord transmits pain and non-noxious signals from the periphery to the spinal cord itself. Adenosine is another local molecule that modulates dorsal horn pain transmission

Second-order neurons

Brainstem

The neurons in these two nuclei (the

) are second-order neurons. Their axons cross over to the other side of the medulla and are now named as the

, that form the

on each side. This crossing over is known as the

. At the medulla, the medial lemniscus is orientated perpendicular to the way the fibres travelled in their tracts in the posterior column. For example, in the column,

lower limb The human leg, in the general word sense, is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb ext ...

is medial,

upper limb The upper limbs or upper extremities are the forelimbs of an upright-postured tetrapod vertebrate, extending from the scapulae and clavicles down to and including the digits, including all the musculatures and ligaments involved with the shoulde ...

is more lateral. At the medial lemniscus, axons from the leg are more ventral, and axons from the arm are more dorsal. Fibres from the

trigeminal nerve In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewin ...

(supplying the

head A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple animals may ...

) come in dorsal to the arm fibres, and travel up the lemniscus too. The medial lemniscus rotates 90 degrees at the

pons The pons (from Latin , "bridge") is part of the brainstem that in humans and other bipeds lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of Va ...

. The secondary axons from neurons giving sensation to the head, stay at around the same place, while the leg axons move outwards. The axons travel up the rest of the brainstem, and synapse at the

(at the

ventral posterolateral nucleus The ventral posterolateral nucleus (VPL) is a nucleus of the thalamus. Together with the ventral posteromedial nucleus (VPM), ventral posterior inferior nucleus (VPI) and ventromedial posterior nucleus (VMpo), it constitutes the ventral posterior ...

for sensation from the neck, trunk, and extremities, and at the

ventral posteromedial nucleus The ventral posteromedial nucleus (VPM) is a nucleus of the thalamus. Inputs and outputs The VPM contains synapses between second and third order neurons from the anterior (ventral) trigeminothalamic tract and posterior (dorsal) trigeminothalami ...

for sensation from the head).

Third-order neurons

Thalamus to cortex

Axons from the third-order neurons in the

ventral posterior nucleus The ventral posterior nucleus is the somato-sensory relay nucleus in thalamus of the brain. Input and output The ventral posterior nucleus receives neuronal input from the medial lemniscus, spinothalamic tracts, and trigeminothalamic tract. It p ...

in the thalamus, ascend the posterior limb of the

. Those originating from the head and the leg swap their relative positions. The axons synapse in the

, with lower body sensation most medial (e.g., the paracentral lobule) and upper body more lateral.

Function

Discriminative sensation is well developed in the fingers of

human Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...

s and allows the detection of fine textures. It also allows for the ability known as

stereognosis Stereognosis (also known as haptic perception or tactile gnosis) is the ability to perceive and recognize the form of an object in the absence of visual and auditory information, by using tactile information to provide cues from texture, size, spati ...

, to determine what an unknown object is, using the hands without visual or audio input. This fine sensation is detected by

s called

tactile corpuscle Tactile corpuscles or Meissner's corpuscles are a type of mechanoreceptor discovered by anatomist Georg Meissner (1829–1905) and Rudolf Wagner. This corpuscle is a type of nerve ending in the skin that is responsible for sensitivity to pressure. ...

s that lie in the

dermis The dermis or corium is a layer of skin between the epidermis (with which it makes up the cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from stress and strain. It is divided i ...

of the

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other cuticle, animal coverings, such as the arthropod exoskeleton, have diffe ...

close to the

epidermis The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water rele ...

. When these structures are stimulated by slight pressure, an

is started. Alternatively, proprioceptive

muscle spindles Muscle spindles are stretch receptors within the body of a skeletal muscle that primarily detect changes in the length of the muscle. They convey length information to the central nervous system via afferent nerve fibers. This information can be ...

and other skin surface touch

receptors Receptor may refer to: *Sensory receptor, in physiology, any structure which, on receiving environmental stimuli, produces an informative nerve impulse *Receptor (biochemistry), in biochemistry, a protein molecule that receives and responds to a n ...

such as

Merkel cells Merkel cells, also known as Merkel-Ranvier cells or tactile epithelial cells, are oval-shaped mechanoreceptors essential for light touch sensation and found in the skin of vertebrates. They are abundant in highly sensitive skin like that of the f ...

bulbous corpuscle The Bulbous corpuscle or Ruffini ending or Ruffini corpuscle is a slowly adapting mechanoreceptor located in the cutaneous tissue between the dermal papillae and the hypodermis. It is named after Angelo Ruffini Angelo Ruffini (Pretare of Arquata ...

lamellar corpuscle Pacinian corpuscle or lamellar corpuscle or Vater-Pacini corpuscle; is one of the four major types of mechanoreceptors (specialized nerve ending with adventitious tissue for mechanical sensation) found in mammalian skin. This type of mechanorecept ...

s, and hair follicle receptors (peritrichial endings) may involve the first neuron in this pathway. The sensory neurons in this pathway are

, meaning that they have a single process emanating from the cell body with two distinct branches: one peripheral branch that functions somewhat like a

dendrite Dendrites (from Greek δένδρον ''déndron'', "tree"), also dendrons, are branched protoplasmic extensions of a nerve cell that propagate the electrochemical stimulation received from other neural cells to the cell body, or soma, of the n ...

of a typical neuron by receiving input (although it should ''not'' be confused with a true dendrite), and one central branch that functions like a typical axon by carrying information to other neurons (again, both branches are actually part of one axon).

Clinical significance

Damage to the dorsal column-medial lemniscus pathway below the crossing point of its fibers results in loss of vibration and joint sense (proprioception) on the same side of the body as the lesion. Damage above the crossing point result a loss of vibration and joint sense on the opposite side of the body to the lesion. The pathway is tested with

Romberg's test Romberg's test, Romberg's sign, or the Romberg maneuver is a test used in an exam of neurological function for balance, and also as a test for driving under the influence of an intoxicant. The exam is based on the premise that a person requires ...

. Damage to either of the dorsal column tracts can result in the permanent loss of sensation in the limbs. See

Brown-Séquard syndrome Brown-Séquard syndrome (also known as Brown-Séquard's hemiplegia, Brown-Séquard's paralysis, hemiparaplegic syndrome, hemiplegia et hemiparaplegia spinalis, or spinal hemiparaplegia) is caused by damage to one half of the spinal cord, i.e. hem ...

Additional information

The cuneate fasciculus, fasciculus cuneatus, cuneate tract, tract of Burdach, was named for

Karl Friedrich Burdach Karl Friedrich Burdach (12 June 1776 – 16 July 1847) was a German physiologist. He was born in Leipzig and died in Königsberg. He was the first to use the word "biology" and was a pioneer of neuroanatomy. Life Burdach came from a family of ...

. The gracile fasciculus, the tract of Goll, was named after Swiss neuroanatomist Friedrich Goll (1829–1903).

References

External links

* {{DEFAULTSORT:Posterior column-medial lemniscus pathway Spinal cord tracts Sensory systems Thalamus