journal of mtu

Journal of Medical Topics and Updates

2822-4094

Malatya Turgut Özal Üniversitesi

10.58651/jomtu.1920018

Anatomy

Anatomi

FUNCTIONAL ORGANIZATION OF THE RETICULAR FORMATION: ROLES IN CONSCIOUSNESS, PAIN MODULATION, AND AUTONOMIC REGULATION

Functional Organızation of The Reticular Formation: Roles in Consciousness, Pain Modulation, and Autonomic Regulation

https://orcid.org/0000-0001-8048-2713

Kaya

Anıl

İNÖNÜ ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ

https://orcid.org/0000-0002-1480-606X

Karataş

Turgay

İNÖNÜ ÜNİVERSİTESİ, TIP FAKÜLTESİ

05 01 2026

5 1 15 19 03 31 2026 04 30 2026

2022

Journal of Medical Topics and Updates

Objective: This review aims to examine the anatomical and functional organization of the reticular formation and to elucidate its role in consciousness, pain modulation, motor control, and autonomic regulation.Materials and Methods: A comprehensive literature search was conducted across national and international databases. Clinical and experimental studies, as well as relevant review articles addressing the structure and functions of the reticular formation, were systematically evaluated.Results: The findings indicate that the reticular formation regulates consciousness and arousal primarily through the ascending reticular activating system (ARAS). It plays a pivotal role in pain modulation via its connections with the raphe nuclei and the periaqueductal gray (PAG). In addition, it contributes to the regulation of muscle tone and posture through reticulospinal pathways and is involved in balance and coordination through its interactions with the vestibular system and cerebellum. Regarding autonomic functions, the reticular formation is essential for the regulation of cardiovascular activity, respiration, and visceral processes.Conclusions: The reticular formation is a fundamental neuroanatomical structure that integrates consciousness, pain, motor, and autonomic systems. Further studies are warranted to better elucidate its functional organization and clinical relevance.

Amaç: Bu derlemenin amacı, retiküler formasyonun anatomik ve fonksiyonel organizasyonunu inceleyerek bilinç, ağrı modülasyonu, motor kontrol ve otonomik fonksiyonlar üzerindeki rolünü ortaya koymaktır.Materyal ve Metod: Çalışmada ulusal ve uluslararası veri tabanlarında yer alan literatür taranmış, retiküler formasyonun yapısı ve fonksiyonlarına ilişkin klinik ve deneysel çalışmalar ile derlemeler değerlendirilmiştir.Bulgular: Literatür bulguları, retiküler formasyonun çıkan retiküler aktivasyon sistemi aracılığıyla bilinç ve uyanıklık düzeyini düzenlediğini; raphe çekirdekleri ve periaqueductal gri madde ile olan bağlantıları sayesinde ağrı modülasyonunda rol oynadığını göstermektedir. Ayrıca retikülospinal yollar aracılığıyla kas tonusu ve postürün düzenlenmesine katkı sağladığı, vestibüler sistem ve serebellum ile ilişkisi sayesinde denge ve koordinasyonda etkili olduğu belirlenmiştir. Otonomik fonksiyonlar açısından ise kardiyovasküler kontrol, solunum ve visseral aktivitelerin düzenlenmesinde önemli rol oynadığı saptanmıştır.Sonuç: Retiküler formasyon, bilinç, ağrı, motor ve otonomik sistemler arasında entegrasyon sağlayan temel bir nöroanatomik yapı olarak öne çıkmaktadır. Güncel çalışmalar, bu yapının fonksiyonel organizasyonunun daha iyi anlaşılması için ileri araştırmalara ihtiyaç olduğunu göstermektedir.

Retiküler formasyon beyinsapı ağrı motor aktivite

Keywords: Reticular formation brainstem pain motor activity

1. Mangold SA, Das JM. Neuroanatomy, reticular formation. StatPearls [Internet]: StatPearls Publishing; 2023.

2. Horn AK. The reticular formation. Progress in brain research. 2006;151:127- 55.

3. Bowsher D. Role of the reticular formation in responses to noxious stimulation. Pain. 1976;2(4):361-78.

4. French J. The Reticular Formation: The Nature of the Reticular Activating System. Journal of neurosurgery. 1958;15(1):97-115.

5. Maldonato M, editor The ascending reticular activating system: the common root of consciousness and attention. Recent Advances of Neural Network Models and Applications: Proceedings of the 23rd Workshop of the Italian Neural Networks Society (SIREN), May 23-25, Vietri sul Mare, Salerno, Italy; 2014: Springer.

6. Taran S, Gros P, Gofton T, Boyd G, Briard JN, Chassé M, et al. The reticular activating system: a narrative review of discovery, evolving understanding, and relevance to current formulations of brain death. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2023;70(4):788-95.

7. Jang SH, Kim OL, Kim SH, Kim JB. The relation between loss of consciousness, severity of traumatic brain injury, and injury of ascending reticular activating system in patients with traumatic brain injury. American Journal of Physical Medicine & Rehabilitation. 2019;98(12):1067-71.

8. Sciacca S, Lynch J, Davagnanam I, Barker R. Midbrain, pons, and medulla: anatomy and syndromes. Radiographics. 2019;39(4):1110-25.

9. Zaaimi B, Dean LR, Baker SN. Different contributions of primary motor cortex, reticular formation, and spinal cord to fractionated muscle activation. Journal of neurophysiology. 2018;119(1):235-50.

10. Brownstone RM, Chopek JW. Reticulospinal systems for tuning motor commands. Frontiers in neural circuits. 2018;12:30.

11. Fregosi M, Contestabile A, Hamadjida A, Rouiller EM. Corticobulbar projections from distinct motor cortical areas to the reticular formation in macaque monkeys. European Journal of Neuroscience. 2017;45(11):1379-95.

12. Martins I, Tavares I. Reticular formation and pain: the past and the future. Frontiers in neuroanatomy. 2017;11:51.

13. Wang D. Reticular formation and spinal cord injury. Spinal cord. 2009;47(3):204-12.

14. Vanegas H, Schaible H-G. Descending control of persistent pain: inhibitory or facilitatory? Brain research reviews. 2004;46(3):295-309.

15. Porreca F, Ossipov MH, Gebhart G. Chronic pain and medullary descending facilitation. Trends in neurosciences. 2002;25(6):319-25.

16. Bannister K, Patel R, Hughes S. The descending modulation of pain. Pain. 2025;166(11S):S55-S9.

17. Heinricher M, Tavares I, Leith J, Lumb B. Descending control of nociception: specificity, recruitment and plasticity. Brain research reviews. 2009;60(1):214-25.

18. Kabakçı ADA, Saygın DA. Beyin Sapı (Truncus Cerebri/Encephali): Anatomik ve Fonksiyonel Bir Bakış. Fonksiyonel Nöroanatomi ve Klinik Bağlantılar. 2025:29.

19. Grill H, Hayes M. The nucleus tractus solitarius: a portal for visceral afferent signal processing, energy status assessment and integration of their combined effects on food intake. International journal of obesity. 2009;33(1):S11-S5.

20. Whitehead MC. Functional connections of the rostral nucleus of the solitary tract in viscerosensory integration of ingestion reflexes. Nucleus of the solitary tract: CRC Press; 2019. p. 105-18.

21. Cutsforth-Gregory JK, Benarroch EE. Nucleus of the solitary tract, medullary reflexes, and clinical implications. Neurology. 2017;88(12):1187-96.

22. Orquiza JC. The Importance of the Reticular Formation, Intermediolateral Nucleus, and Hypothalamic-Pituitary-Adrenal Axis in Homeostasis and Cellular Organization.

23. Karim S, Chahal A, Khanji MY, Petersen SE, Somers VK. Autonomic cardiovascular control in health and disease. Comprehensive physiology. 2023;13(2):4493-511.

24. Kovalzon VM. Ascending reticular activating system of the brain. Translational Neuroscience and Clinics. 2016;2(4):275-85.

25. Yeo SS, Chang PH, Jang SH. The ascending reticular activating system from pontine reticular formation to the thalamus in the human brain. Frontiers in human neuroscience. 2013;7:416.

26. Yao D, Chen Y, Chen G. The role of pain modulation pathway and related brain regions in pain. Reviews in the Neurosciences. 2023;34(8):899-914.

27. Viseux F, Simoneau M, Pamboris GM, Sturbois-Nachef N, Bonnet CT, Carrasco MM, et al. The Reticular formation: An integrative network for postural control. Neurophysiologie Clinique. 2025;55(5):103100.

28. Orquiza J. The Essential Interconnection of the Reticular Formation, Intermediolateral Nucleus, and Hypothalamus-Pituitary-Adrenal Axis: A Comprehensive View on Cellular Homeostasis. International Journal of Psychiatry. 2023.

29. Starinets A, Odrinskaya M, Manzhulo I, Milkina E. Morphochemical Characteristics of the Ventral Reticular Formation of the Medulla Oblongata Following Acute Pain Reaction and Diclofenac Therapy. Cell and Tissue Biology. 2025;19(4):336-46.

30. Bon E, Maksimovich NY, Zimatkin S, Hubarevich IY, Narbutovich A, Otlivanchik N. Functional Organization of The Reticular Formation. Clinical Trials and Clinical Research. 2025;4(1):1-4.

31. Glover IS, Baker SN. Both corticospinal and reticulospinal tracts control force of contraction. Journal of Neuroscience. 2022;42(15):3150-64.

32. Çiçek F, Uçar İ, Seber T, Demir FGÜ, Çiftçi AT. Investigation of the relationship of sleep disorder occurring in fibromyalgia with central nervous system and pineal gland volume. Acta Neuropsychiatrica. 2025;37:e17.

33. Gebhart G. Descending modulation of pain. Neuroscience & Biobehavioral Reviews. 2004;27(8):729-37.

34. Schiff ND. Recovery of consciousness after brain injury: a mesocircuit hypothesis. Trends in neurosciences. 2010;33(1):1-9.

35. Halassa MM, Kastner S. Thalamic functions in distributed cognitive control.Nature neuroscience. 2017;20(12):1669-79.