The sacral autonomic outflow: against premature oversimplification

Excerpt

Using developmental genetic criteria, Espinosa-Medina and co-workers have recently found that lumbar and sacral autonomic pathways show many similarities. Based on these data, they have put forward the idea that the preganglionic and postganglionic neurons of the autonomic nervous system in the sacral spinal cord and in the pelvic ganglia are sympathetic and not parasympathetic [1]. This idea seemingly challenges the traditional view established originally by Langley [2, 3] that the peripheral parasympathetic and sympathetic pathways are defined anatomically by the location of the preganglionic neurons in the spinal cord and brain stem. Now Espinosa-Medina and co-workers [2] critically review the arguments put forward more than 100 years ago by Gaskell, Langley and their followers. They come to the conclusion that their “reinterpretation of the sacral outflow in the light of embryonic development [namely as being in fact sympathetic]… [could be] a continuation of Gaskell´s and Langley´s vision”. They conclude furthermore that “Getting rid of the imaginary sympatho-parasympathetic complexity [i.e. generalized antagonistic action] in the [sacral] region will hopefully open the way to deciphering its real complexity: …”. …