A review of otolith pathways to brainstem and cerebellum.

Our knowledge of otolith pathways is developing rapidly, but is still far from complete. Primary afferents from the sacculus and utricle terminate mainly in the lateral, inferior and caudal superior vestibular nuclei, and the ventral cerebellum, in particular the nodulus. Otolith signals descend via reticulo- and vestibulospinal pathways in the spinal cord to influence neck motoneurons and ascending proprioceptive afferents. Utricular information can reach the extraocular eye muscles via mono-, di-, and multisynaptic pathways, but saccular afferents probably only by multisynaptic pathways. The otolith signals are relayed from the vestibular nuclei, medullary reticular formation, inferior olive, and lateral reticular nucleus to sagittal zones in the caudal cerebellar vermis (nodulus and uvula), and influence the deep cerebellar nuclei. The graviceptive information could be channeled by the cerebellar efferents back to the vestibular and inferior olive complex, or fed into ascending pathways that would innervate the mescencephalon, the thalamus, and cerebral cortex.