The spinothalamic tract is a

nerve tract A nerve tract is a bundle of nerve fibers (axons) connecting Nucleus (neuroanatomy), nuclei of the central nervous system. In the peripheral nervous system, this is known as a nerve fascicle, and has associated nervous tissue, connective tissue. T ...

in the anterolateral system in the

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal c ...

. This tract is an ascending sensory pathway to the

thalamus The thalamus (: thalami; from Greek language, Greek Wikt:θάλαμος, θάλαμος, "chamber") is a large mass of gray matter on the lateral wall of the third ventricle forming the wikt:dorsal, dorsal part of the diencephalon (a division of ...

. From the

ventral posterolateral nucleus The ventral posterolateral nucleus (VPL) is one of the subdivisions of the ventral posterior nucleus in the ventral nuclear group of the thalamus. It relays sensory information from the second-order neurons of the neospinothalamic tract and me ...

in the thalamus, sensory information is relayed upward to the

somatosensory cortex The somatosensory system, or somatic sensory system is a subset of the sensory nervous system. The main functions of the somatosensory system are the perception of external stimuli, the perception of internal stimuli, and the regulation of bod ...

of 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 sense of touch. Like other sensory area ...

. The spinothalamic tract consists of two adjacent pathways: anterior and lateral. The anterior spinothalamic tract carries information about crude touch. The lateral spinothalamic tract conveys

pain Pain is a distressing feeling often caused by intense or damaging Stimulus (physiology), stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sense, sensory and emotional experience associated with, or res ...

and

temperature Temperature is a physical quantity that quantitatively expresses the attribute of hotness or coldness. Temperature is measurement, measured with a thermometer. It reflects the average kinetic energy of the vibrating and colliding atoms making ...

. In the

, the spinothalamic tract has somatotopic organization. This is the segmental organization of its cervical,

thoracic The thorax (: thoraces or thoraxes) or chest is a part of the anatomy of mammals and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main ...

lumbar In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm (anatomy), diaphragm and the sacrum. Naming and location The lumbar region is sometimes referred to as the lowe ...

, and sacral components, which is arranged from most medial to most lateral respectively. The pathway crosses over ( decussates) at the level of the spinal cord, rather than 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 conti ...

like the

dorsal column-medial lemniscus pathway Dorsal (from Latin ''dorsum'' ‘back’) may refer to: * Dorsal (anatomy), an anatomical term of location referring to the back or upper side of an organism or parts of an organism * Dorsal, positioned on top of an aircraft's fuselage The fus ...

and lateral corticospinal tract. It is one of the three tracts which make up the anterolateral system: anterior and lateral spinothalamic tract,

spinotectal tract The spinomesencephalic pathway, spinomesencephalic tract or spino-quadrigeminal system of Mott, includes a number of ascending tracts in the spinal cord, including the spinotectal tract. The spinomesencephalic tract is one of the ascending tracts ...

spinoreticular tract The spinoreticular tract (also paleospinothalamic pathway, or indirect pathway of the anterolateral system) is a partially decussating (crossed-over) four-neuron sensory pathway of the central nervous system. The tract transmits slow nociceptive/ ...

Structure

There are two main parts of the spinothalamic tract: * The

lateral spinothalamic tract The spinothalamic tract is a nerve tract in the anterolateral system in the spinal cord. This tract is an ascending sensory pathway to the thalamus. From the ventral posterolateral nucleus in the thalamus, sensory information is relayed upwar ...

transmits

and

. * The

anterior spinothalamic tract The spinothalamic tract is a nerve tract in the anterolateral system in the spinal cord. This tract is an ascending sensory pathway to the thalamus. From the ventral posterolateral nucleus in the thalamus, sensory information is relayed upward ...

(or ''ventral'' spinothalamic tract) transmits crude touch and firm pressure. The spinothalamic tract, like the

, uses three neurons to convey sensory information from the periphery to conscious level at the cerebral cortex. Pseudounipolar

neuron A neuron (American English), neurone (British English), or nerve cell, is an membrane potential#Cell excitability, excitable cell (biology), cell that fires electric signals called action potentials across a neural network (biology), neural net ...

s 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 do ...

have axons that lead from 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 animal coverings, such as the arthropod exoskeleton, have different ...

into the dorsal

where they ascend or descend one or two vertebral levels via Lissauer's tract and then

synapse In the nervous system, a synapse is a structure that allows a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or a target effector cell. Synapses can be classified as either chemical or electrical, depending o ...

with secondary neurons in either the substantia gelatinosa of Rolando or the nucleus proprius. These secondary neurons are called ''tract cells''. The axons of the tract cells cross over (decussate) to the other side of the spinal cord via the

anterior white commissure The anterior white commissure (ventral white commissure) is a bundle of nerve fibers which cross the midline of the spinal cord just anterior (in front of) to the gray commissure ( Rexed lamina X). A delta fibers (Aδ fibers) and C fibers carr ...

, and to the anterolateral corner of the spinal cord (hence the spinothalamic tract being part of the anterolateral system). Decussation usually occurs 1-2 spinal nerve segments above the point of entry. The axons travel up the length of the spinal cord into the

, specifically the rostral ventromedial medulla. Traveling up the brainstem, the tract moves dorsally. The neurons ultimately synapse with third-order neurons in several nuclei of the thalamus—including the medial dorsal, ventral posterior lateral, and ventral posterior medial nuclei. From there, signals go to the

cingulate cortex The cingulate cortex is a part of the brain situated in the medial aspect of the cerebral cortex. The cingulate cortex includes the entire cingulate gyrus, which lies immediately above the corpus callosum, and the continuation of this in the cin ...

, 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 parallel ...

, and

insular cortex The insular cortex (also insula and insular lobe) is a portion of the cerebral cortex folded deep within the lateral sulcus (the fissure separating the temporal lobe from the parietal lobe, parietal and frontal lobes) within each brain hemisphere ...

respectively.

Anterior spinothalamic tract

The anterior spinothalamic tract (Latin: ''tractus spinothalamicus anterior'') or ventral spinothalamic fasciculus situated in the marginal part of the anterior funiculus and intermingled more or less with the vestibulospinal tract, is derived from cells in the posterior column or intermediate gray matter of the opposite side. Aβ fibres carry sensory information pertaining to crude touch from the skin. After entering the spinal cord the first order neurons synapse (in the nucleus proprius), and the second order neurons decussate via the

. These second order neurons ascend synapsing in the VPL of the thalamus. Incoming first order neurons can ascend or descend via the Lissauer tract. Its fibers convey crude touch information to the VPL (

) of the

. The fibers of the anterior spinothalamic tract conduct information about pressure and crude touch (protopathic). The fine touch (epicritic) is conducted by fibers of the medial lemniscus. The medial lemniscus is formed by the axons of the neurons of the gracilis and cuneatus nuclei of the medulla oblongata which receive information about light touch, vibration and conscient proprioception from the gracilis and cuneatus fasciculus of the spinal cord. This fasciculus receive the axons of the first order neuron which is located in the dorsal root ganglion that receives afferent fibers from receptors in the skin, muscles and joints. High-resolution RNA sequencing finds the anterior spinothalamic tract has five distinct types of neurons. Three clusters of which are located mainly in laminae I–III of the dorsal horn and two clusters in deeper laminae.

Lateral spinothalamic tract

The lateral spinothalamic tract (or lateral spinothalamic fasciculus), is a bundle of

afferent nerve fiber Afferent nerve fibers are axons (nerve fibers) of sensory neurons that carry sensory information from sensory receptors to the central nervous system. Many afferent projections ''arrive'' at a particular brain region. In the peripheral nerv ...

s ascending through the white matter of the

, in the spinothalamic tract, carrying sensory information to the

brain The brain is an organ (biology), organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It consists of nervous tissue and is typically located in the head (cephalization), usually near organs for ...

. It carries pain, and temperature sensory information ( protopathic sensation) to the

. It is composed primarily of fast-conducting, sparsely myelinated

A delta fiber Group A nerve fibers are one of the three classes of nerve fiber as ''generally classified'' by Erlanger and Gasser. The other two classes are the group B nerve fibers, and the group C nerve fibers. Group A are heavily myelinated, group B ar ...

s and slow-conducting, unmyelinated C fibers. These are secondary sensory neurons which have already

d with the primary

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 receptor potentials. This process is called sensory transduc ...

s of the

peripheral nervous system The peripheral nervous system (PNS) is one of two components that make up the nervous system of Bilateria, bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside t ...

in the posterior horn of the spinal cord (one of the three

grey column The grey columns are three regions of the somewhat ridge-shaped mass of grey matter in the spinal cord. These regions present as three columns: the anterior grey column, the posterior grey column, and the lateral grey column, all of which ...

s). There is evidence to suggest the existence of a projection from lamina I and deeper layers of the dorsal horn to the ventrobasal complex and other thalamic nuclei, eventually passing pain and temperature information to the SI and SII somatosensory cortices. In macaque monkeys, neurons from the posterior part of the ventral medial nucleus terminate at the posterior half of the superior limiting sulcus that bounds the dorsal insular cortext. Together with the anterior spinothalamic tract, the lateral spinothalamic tract is sometimes termed the ''secondary sensory fasciculus'' or ''spinal lemniscus''.

Anatomy

The neurons of the lateral spinothalamic tract originate in the spinal dorsal root ganglia. They project peripheral processes to the tissues in the form of free nerve endings which are sensitive to molecules indicative of cell damage. The central processes enter the spinal cord in an area at the back of the posterior horn known as the posterolateral tract. Here, the processes ascend approximately two levels before synapsing on second-order neurons. These secondary neurons are situated in the posterior horn, specifically in the Rexed laminae regions I, IV, V and VI. Region II is primarily composed of Golgi II

interneuron Interneurons (also called internuncial neurons, association neurons, connector neurons, or intermediate neurons) are neurons that are not specifically motor neurons or sensory neurons. Interneurons are the central nodes of neural circuits, enab ...

s, which are primarily for the modulation of pain, and largely project to secondary neurons in regions I and V. Secondary neurons from regions I and V decussate across the

and ascend in the (now contralateral) lateral spinothalamic tract. These fibers will ascend through the

, including 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 ...

pons The pons (from Latin , "bridge") is part of the brainstem that in humans and other mammals, 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 ...

and

midbrain The midbrain or mesencephalon is the uppermost portion of the brainstem connecting the diencephalon and cerebrum with the pons. It consists of the cerebral peduncles, tegmentum, and tectum. It is functionally associated with vision, hearing, mo ...

, as the spinal lemniscus until synapsing in the ventroposteriorlateral (VPL) nucleus of the

. The third order neurons in the thalamus will then project through the

internal capsule The internal capsule is a paired white matter structure, as a two-way nerve tract, tract, carrying afferent nerve fiber, ascending and efferent nerve fiber, descending axon, fibers, to and from the cerebral cortex. The internal capsule is situate ...

and corona radiata to various regions of the

cortex Cortex or cortical may refer to: Biology * Cortex (anatomy), the outermost layer of an organ ** Cerebral cortex, the outer layer of the vertebrate cerebrum, part of which is the ''forebrain'' *** Motor cortex, the regions of the cerebral cortex i ...

, primarily the

(

Brodmann area A Brodmann area is a region of the cerebral cortex, in the human or other primate brain, defined by its cytoarchitecture, or histological structure and organization of cells. The concept was first introduced by the German anatomist Korbinian B ...

s 3, 1, and 2).

Function

The types of sensory information means that the sensation is accompanied by a

reflex In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus. Reflexes are found with varying levels of complexity in organisms with a nervous system. A reflex occurs ...

. There are two sub-systems identified: * Direct (for direct conscious appreciation of pain) * Indirect (for affective and arousal impact of pain). Indirect projections include ** Spino-Reticulo-Thalamo-Cortical (part of the ascending reticular activating system (ARAS) ** Spino-Mesencephalic-Limbic (for affective impact of pain).

Anterolateral system

The anterolateral system (ALS) is an ascending bundle of fibers in the spinal cord, carried in three main pathways or tracts. The tracts convey

( protopathic sensation), and crude touch from the periphery to the

. The most important of these is the spinothalamic tract.

Clinical significance

In contrast to the axons of second-order neurons in

, the axons of second-order neurons in the spinothalamic tracts cross at every segmental level in the spinal cord. This fact aids in determining whether a lesion is in the brain or the spinal cord. With lesions in the brain stem or higher, deficits of pain perception, touch sensation, and proprioception are all contralateral to the lesion. With spinal cord lesions, however, the deficit in pain perception is contralateral to the lesion, whereas the other deficits are ipsilateral. See Brown-Séquard syndrome. Unilateral lesions usually cause contralateral

anaesthesia Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...

(loss of pain and temperature). Anaesthesia will normally begin 1-2 segments below the level of lesion, due to the sensory fibers being carried by dorsal-lateral tract of Lissauer up several levels upon entry into the spinal cord, and will affect all caudal body areas. This is clinically tested by using pin pricks.

References

External links

*
Diagram at mfi.ku.dk

{{Authority control Spinal cord tracts Sensory systems Thalamic connections