Spinothalamic tract

The spinothalamic tract is a part of the

anterolateral system or the ventrolateral
system, a sensory pathway to the
thalamus. From the ventral posterolateral
nucleus in the thalamus, sensory
information is relayed upward to the
somatosensory cortex of the postcentral
gyrus.
 Spinothalamic tract

Diagram of the main tracts within the spinal

cord - spinothalamic fasciculus is labelled at
bottom left

Details

Part of Spinal cord

System Somatosensory
system

Decussation Anterior white

commissure

Parts Anterior and lateral

tracts
From Skin

To Thalamus

Artery Anterior spinal artery

Function Gross touch and

temperature

Identifiers

Latin Tractus
spinothalamicus

MeSH D013133 (https://mes

hb.nlm.nih.gov/recor
d/ui?ui=D013133)

NeuroNames 2058 (http://braininfo.

rprc.washington.edu/
centraldirectory.aspx?
ID=2058) , 810 (http://
 braininfo.rprc.washing
ton.edu/centraldirecto
ry.aspx?ID=810)

TA98 A14.1.04.138 (https://

ifaa.unifr.ch/Public/E
ntryPage/TA98%20Tr
ee/Entity%20TA98%2
0EN/14.1.04.138%20
Entity%20TA98%20E
N.htm)

TA2 6102 (https://ta2view

er.openanatomy.org/?
id=6102)

FMA 72644 (https://bioport

al.bioontology.org/ont
ologies/FMA/?p=clas
ses&conceptid=http%
 3A%2F%2Fpurl.org%2
Fsig%2Font%2Ffma%
2Ffma72644)

Anatomical terms of neuroanatomy

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 and
temperature.

In the spinal cord, the spinothalamic tract

has somatotopic organization. This is the
segmental organization of its cervical,
thoracic, lumbar, 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 like the dorsal column-
medial lemniscus pathway and lateral
corticospinal tract. It is one of the three
tracts which make up the anterolateral
system.

Structure

The anterior and lateral spinothalamic tracts labelled at lower right as

tracts of the anterolateral system.
There are two main parts of the
spinothalamic tract:

The lateral spinothalamic tract transmits

pain and temperature.
The anterior spinothalamic tract (or
ventral spinothalamic tract) transmits
crude touch and firm pressure.

The spinothalamic tract, like the dorsal

column-medial lemniscus pathway, uses
three neurons to convey sensory
information from the periphery to
conscious level at the cerebral cortex.

Pseudounipolar neurons in the dorsal root

ganglion have axons that lead from the
skin into the dorsal spinal cord where they
ascend or descend one or two vertebral
levels via Lissauer's tract and then
synapse 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,
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 brainstem, 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
primary somatosensory cortex, and insular
cortex 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
anterior white commissure. These second
order neurons ascend synapsing in the
VPL of the thalamus. Incoming first order
neurons can ascend or descend via the
Lissauer tract.

This is a somewhat doubtful fasciculus

and its fibers are supposed to end in the
thalamus and to conduct certain of the
touch impulses. More specifically, its
fibers convey crude touch information to
the VPL (ventral posterolateral nucleus)
part of the thalamus.

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.
Lateral spinothalamic tract

The lateral spinothalamic tract (or lateral

spinothalamic fasciculus), is a bundle of
afferent nerve fibers ascending through
the white matter of the spinal cord, in the
spinothalamic tract, carrying sensory
information to the brain. It carries pain,
and temperature sensory information
(protopathic sensation) to the thalamus. It
is composed primarily of fast-conducting,
sparsely myelinated A delta fibers and
slow-conducting, unmyelinated C fibers.
These are secondary sensory neurons
which have already synapsed with the
primary sensory neurons of the peripheral
nervous system in the posterior horn of
the spinal cord (one of the three grey
columns).

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
interneurons, 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 anterior white
commissure and ascend in the (now
contralateral) lateral spinothalamic tract.
These fibers will ascend through the
brainstem, including the medulla
oblongata, pons and midbrain, as the
spinal lemniscus until synapsing in the
ventroposteriorlateral (VPL) nucleus of the
thalamus. The third order neurons in the
thalamus will then project through the
internal capsule and corona radiata to
various regions of the cortex, primarily the
main somatosensory cortex, Brodmann
areas 3, 1, and 2.

Function
The types of sensory information means
that the sensation is accompanied by a
compulsion to act. For instance, an itch is
accompanied by a need to scratch, and a
painful stimulus makes us want to
withdraw from the pain.

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
arousal system, also known as
ARAS)
 Spino-Mesencephalic-Limbic (for
affective impact of pain).

Anterolateral system

In the nervous system, the anterolateral

system is an ascending pathway that
conveys pain,[1] temperature (protopathic
sensation), and crude touch from the
periphery to the brain. It comprises three
main pathways:

Name Destination Function

spinothalamic tract (lateral and important in the localization of painful or

thalamus
anterior) thermal stimuli

reticular causes alertness and arousal in response to

spinoreticular tract
formation painful stimuli

orients the eyes and head towards the

spinotectal tract tectum
stimuli
Clinical significance
In contrast to the axons of second-order
neurons in dorsal column-medial
lemniscus pathway, 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 (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.

See also
Rostral ventromedial medulla
Periaqueductal gray
 Neothalamus

References
This article incorporates text in the public
domain from page 760 (https://archive.org/
stream/anatomyofhumanbo1918gray#pag
e/760/mode/2up) of the 20th edition of
Gray's Anatomy (1918)

1. "Chapter 25:Neural Mechanisms of Cardiac

Pain: The Anterolateral System" (https://we
b.archive.org/web/20100811084717/http://
symptomresearch.nih.gov/chapter_25/sec
3/crfs3pg1.htm) . Archived from the
original (http://symptomresearch.nih.gov/c
hapter_25/sec3/crfs3pg1.htm) on 2010-
08-11. Retrieved 2009-11-26.
External links
ancil-964 (http://braininfo.rprc.washingt
on.edu/Scripts/ancilcentraldirectory.asp
x?ID=964) at NeuroNames
Diagram at mfi.ku.dk (https://web.archiv
e.org/web/20060828114210/http://ww
w.mfi.ku.dk/ppaulev/chapter3/images/f
p3-9.jpg)
Overview at uwm.edu (https://web.archi
ve.org/web/20050910003921/http://ww
w.uwm.edu/~tking/king3_6.htm)

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