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Klin Monbl Augenheilkd 2012; 229(11): 1083-1089
DOI: 10.1055/s-0032-1315252
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Der Okulomotoriuskern und seine Subnuklei beim Menschen

The Subnuclei of the Oculomotor Nucleus in Humans
C. Zeeh
1   Klinikum der Ludwig-Maximilians-Universität München, Deutsches Schwindelzentrum
2   Lehrstuhl I, Institut für Anatomie und Zellbiologie, Ludwig-Maximilians-Universität München
,
A. K. E. Horn
2   Lehrstuhl I, Institut für Anatomie und Zellbiologie, Ludwig-Maximilians-Universität München
› Author Affiliations
Further Information

Publication History

eingereicht 08 July 2012

akzeptiert 19 July 2012

Publication Date:
19 September 2012 (online)

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Zusammenfassung

Untersuchungen der Augenbewegungen sind eine einfach zu handhabende klinische Methode, die als wichtiges Diagnostikwerkzeug für Störungen in den Augenbewegungsbahnen dienen kann, bis hin zu den äußeren und inneren Augenmuskeln – vorausgesetzt, man kennt die Anatomie dieser Bahnen. Der Nucleus oculomotorius bildet dabei eine wichtige Station, er enthält zum einen die Motoneurone von 4 äußeren Augenmuskeln und des Lidhebers, aber auch die präganglionären Neurone des Ganglion ciliare zur Vermittlung der Pupillen- und Akkommodationsantwort. Neue Erkenntnisse über die Anatomie der äußeren Augenmuskeln sowie aktuelle histochemische Befunde zum Nucleus Edinger-Westphal (EW), die zeigen, dass dieser Kern nicht Sitz der präganglionären Neurone des Ganglion ciliare ist, machen die Entwicklung einer aktualisierten Karte zur Organisation des Nucleus oculomotorius notwendig. Die gravierendste Änderung dabei ist, dass die präganglionären Neurone in einer lockeren Gruppe außerhalb des EW liegen und damit entsprechend als EWpg bezeichnet wird. Der klassische zytoarchitektonisch abgegrenzte EW enthält beim Menschen peptiderge Neurone, die eine Rolle bei völlig anderen Funktionen innehaben, wie zum Beispiel bei Stress, und wird nun als EWcp (central projecting) bezeichnet. Die genaue Kenntnis über die Lage der Motoneurone und auch präganglionären Neurone ist essenziell für die korrekte Interpretation von klinisch-anatomischen Befunden.

Abstract

Examinations of eye movements offer an easy clinical method for the diagnosis of disturbances in the pathways for the generation of eye movements including the extraocular and inner eye muscles. A prerequisite is a good knowledge of the anatomy of the pathways for the generation of eye movements. The oculomotor nucleus represents an important relay station, which contains not only the motoneurons of four extraocular muscles and the levator palpebrae muscle, but also the preganglionic neurons of the ciliary ganglion for the mediation of the pupillary and accommodation response. Recent work about the special anatomy of the extraocular muscles and histochemical findings about the neurons in the Edinger-Westphal nucleus (EW), which indicated that this nucleus does not contain the preganglionic neurons of the ciliary ganglion, led to a new, modified map of the oculomotor nucleus complex. The most serious alteration refers to the location of the preganglionic neurons, which form a group of scattered neurons outside of the EW and now are termed EWpg. In contrast, the traditional cytoarchitectonically defined EW in the human eye contains peptidergic neurons with a completely different function, e.g., stress related, and is therefore termed EWcp (centrally projecting). A knowledge about the exact locations of extraocular motoneurons and preganglionic neurons is essential for the correct interpretation of clinico-anatomic findings.

Schlüsselwörter

Anatomie - Neuroophthalmologie - Pupille

Key words

anatomy - neuro-ophthalmology - pupil
 

  • Literatur

  • 1 Olszewski J, Baxter D. Cytoarchitecture of the human Brain Stem. Basel, München, Paris, London, New York, Sydney: S. Krager; 1982: 96-99
    Google Scholar
  • 2 Wermund TK, Wilhelm H. Pupillenstörungen – Diagnostik, Erkrankungen, Konsequenz. Klin Monatsbl Augenheilkd 2010; 227: 845-851
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Brouwer B. Klinisch-anatomische Untersuchung über den Oculomotoriuskern. Z Ges Neurol Psychiat 1918; 40: 152-193
    CrossrefPubMedGoogle Scholar
  • 4 Warwick R. Representation of the extraocular muscles in the oculomotor nuclei of the monkey. J Comp Neurol 1953; 98: 449-495
    CrossrefPubMedGoogle Scholar
  • 5 Büttner-Ennever JA, Akert K. Medial rectus subgroups of the oculomotor nucleus and their abducens internuclear input in the monkey. J Comp Neurol 1981; 197: 17-27
    CrossrefPubMedGoogle Scholar
  • 6 Büttner-Ennever JA. The extraocular motor nuclei: organization and functional neuroanatomy. Prog Brain Res 2006; 151: 95-125
    PubMedGoogle Scholar
  • 7 Spencer RF, Porter JD. Biological organization of the extraocular muscles. Prog Brain Res 2006; 151: 43-80
    PubMedGoogle Scholar
  • 8 Büttner-Ennever JA, Horn AKE, Scherberger H et al. Motoneurons of twitch and nontwitch extraocular muscle fibers in the abducens, trochlear, and oculomotor nuclei of monkeys. J Comp Neurol 2001; 438: 318-335
    CrossrefPubMedGoogle Scholar
  • 9 Horn AK, Eberhorn A, Härtig W et al. Perioculomotor cell groups in monkey and man defined by their histochemical and functional properties: reappraisal of the Edinger-Westphal nucleus. J Comp Neurol 2008; 507: 1317-1335
    CrossrefPubMedGoogle Scholar
  • 10 Demer JL, Yeul Oh S, Poukens V. Evidence for active control of rectus extraocular muscle pulleys. Invest Ophthal Vis Sci 2000; 41: 1280-1290
    PubMedGoogle Scholar
  • 11 Oh SY, Poukens V, Demer JL. Quantitative analysis of rectus extraocular muscle layers in monkey and humans. Invest Ophthal Vis Sci 2001; 42: 10-16
    PubMedGoogle Scholar
  • 12 Jacoby J, Chiarandini DJ, Stefani E. Electrical properties and innervation of fibers in the orbital layer of rat extraocular muscles. J Neurophysiol 1989; 61: 116-125
    PubMedGoogle Scholar
  • 13 Jacoby J, Ko K, Weiss C et al. Systematic variation in myosin expression along extraocular muscle fibres of the adult rat. J Muscle Res Cell Motil 1990; 11: 25-40
    CrossrefPubMedGoogle Scholar
  • 14 Jampel RS. Multiple motor systems in the extraocular muscles of man. Invest Ophthal & Vis Sci 1967; 6: 288-293
    PubMedGoogle Scholar
  • 15 Scott AB, Collins CC. Division of labor in human extraocular muscle. Arch Ophthal 1973; 90: 319-322
    CrossrefPubMedGoogle Scholar
  • 16 Sharpe J, Wong AMF. Anatomy and Physiology of ocular Motor Systems. In: Miller NR, Newman NJ, eds. Walsh and Hoytʼs clinical neuro-ophthalmology, 1st ed. Philadelphia; Baltimore: Lippincott Williams & Wilkins; 2005: 809-885
    Google Scholar
  • 17 Büttner-Ennever JA, Horn AKE. The neuroanatomical basis of oculomotor disorders: the dual motor control of extraocular muscles and its possible role in proprioception. Curr Opin Neurol 2002; 15: 35-43
    PubMedGoogle Scholar
  • 18 Eberhorn AC, Ardelenanu P, Büttner-Ennever JA et al. Histochemical differences between motoneurons supplying multiply and singly innervated extraocular muscle fibers. J Comp Neurol 2005; 491: 352-366
    CrossrefPubMedGoogle Scholar
  • 19 Schmidtke K, Büttner-Ennever JA. Nervous control of eyelid function – a review of clinical, experimental and pathological data. Brain 1992; 115: 227-247
    CrossrefPubMedGoogle Scholar
  • 20 Porter JD, Burns LA, May PJ. Morphological substrate for eyelid movements: innervation and structure of primate levator palpebrae superioris and orbicularis oculi muscles. J Comp Neurol 1989; 287: 64-81
    CrossrefPubMedGoogle Scholar
  • 21 Edinger L. Über den Verlauf der centralen Hirnnervenbahnen mit Demonstrationen von Präparaten. Arch Psychiat Nervenkr 1885; 16: 858-859
    PubMedGoogle Scholar
  • 22 Westphal C. Über einen Fall von chronischer progressiver Lähmung der Augenmuskeln (Ophthalmoplegia externa) nebst Beschreibung von Ganglienzellengruppen im Bereiche des Oculomotoriuskerns. Arch Psychiat Nervenheilk 1887; 98: 846-871
    PubMedGoogle Scholar
  • 23 May PJ, Sun W, Erichsen JT. Defining the pupillary Component of the perioculomotor preganglionic Population within a unitary primate Edinger-Westphal Nucleus. In: Using eye movements as an experimental probe of brain function. Amsterdam: Elsevier; 2008. (Vol 171). 97-106
    CrossrefGoogle Scholar
  • 24 Kozicz T, Bittencourt JC, May PJ et al. The Edinger-Westphal nucleus: A historical, structural, and functional perspective on a dichotomous terminology. J Comp Neurol 2011; 519: 1413-1434
    CrossrefPubMedGoogle Scholar
  • 25 Vaughan J, Donaldson C, Bittencourt JC et al. Urocortin, a mammalian neuropeptide related to fish urotensin I and to corticotropin-releasing factor. Nature 1995; 378: 287-292
    CrossrefPubMedGoogle Scholar
  • 26 Scinto LFM, Frosch M, Wu CK et al. Selective cell loss in Edinger-Westphal in asymptomatic elders and Alzheimerʼs patients. Neurobiol Aging 2001; 22: 729-736
    CrossrefPubMedGoogle Scholar
  • 27 Scinto LFM, Rentz DM, Potter H et al. Pupil assay and Alzheimerʼs disease: a critical analysis. Neurology 1999; 52: 673-675
    PubMedGoogle Scholar
  • 28 Rüb U, Del Tredici K, Schultz C et al. The premotor region essential for rapid vertical eye movements shows early involvement in Alzheimerʼs disease-related cytoskeletal pathology. Vision Research 2001; 41: 2149-2156
    CrossrefPubMedGoogle Scholar
  • 29 Ryabinin AE, Tsoory MM, Kozicz T et al. Urocortins: CRFʼs siblings and their potential role in anxiety, depression and alcohol drinking behavior. Alcohol (Fayetteville, NY) 2012; 46: 349-357
    CrossrefPubMedGoogle Scholar
  • 30 Perlia D. Die Anatomie des Oculomotoriuscentrum beim Menschen. Arch f Ophthalmol 1889; 35: 287-308
    PubMedGoogle Scholar
  • 31 Adler A. Zur Lokalisation des Konvergenzzentrums und der Kerne der glatten Augenmuskeln. Zeits ges Neurol Psychiat 1933; 145: 186-207
    PubMedGoogle Scholar
  • 32 Warwick R. The so-called nucleus of convergence. Brain 1955; 78: 92-114
    CrossrefPubMedGoogle Scholar
  • 33 Lienbacher K, Mustari M, Ying HS et al. Do palisade endings in extraocular muscles arise from neurons in the motor nuclei?. Invest Ophthal & Vis Sci 2011; 52: 2510-2519
    PubMedGoogle Scholar