Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions

The pathophysiology and pharmacological targets of disorders of the bladder and colon have focused predominantly on the periphery. However, these visc era are regulated by the CNS, which, in turn, must integrate their function s with compatible behaviours. This review focuses on the role of the pontin e micturition centre, Barrington's nucleus, as a key to this integration. T hrough its efferent network this pontine centre links parasympathetic prega nglionic neurones with forebrain-projecting nuclei, providing an anatomical substrate for coregulation of pelvic Visceral and forebrain activity. Diso rders characterized by multiple pelvic visceral symptoms and comorbidity wi th psychiatric disorders (for example functional bowel disorders) might hav e their roots in dysfunctions of this circuit, which could provide a novel target for pharmacological treatment.