Morphology and distribution of nicotinamide adenine dinucleotide phosphate (reduced form) diaphorase reactive neurons in human brainstem.

Nicotinamide adenine dinucleotide phosphate diaphorase reactive neurons were found in several regions of human brainstem. Three major groups were located in the medulla: a dorsomedial group in the central gray and floor of the fourth ventricle, a ventromedial group in the vicinity of the medullary raphe, and a lateral group in the lateral reticular nucleus. In the upper pons a large cluster of reactive neurons was centered in the nucleus centralis oralis extending into the locus coeruleus and dorsal tegmental region. A second cluster in the lateral parabrachial nucleus merged with this group more rostrally and continued into the midbrain tegmentum (paracoeruleus-cuneiform group). Nicotinamide adenine dinucleotide phosphate diaphorase neurons in this region often contained acetylcholinesterase activity. A second midbrain group was seen in the nucleus paranigralis. Aside from these discrete neuronal collections, scattered reactive neurons were found in the medullary reticular formation, periaqueductal gray, inferior colliculus and superior colliculus. Nicotinamide adenine dinucleotide phosphate diaphorase neurons were classified into three groups based on somal size. Parvocellular neurons (10-20 micron) were primarily found in the ventromedial medulla and lateral parabrachial nucleus. Intermediate neurons (20-25 micron) were located in the paranigralis nucleus and dorsomedial medulla. Magnocellular neurons (25-35 micron) were characteristically found in the lateral reticular nucleus and paracoeruleus-cuneiform region. Nicotinamide adenine dinucleotide phosphate diaphorase reactive neurons are present in substantial numbers in human brainstem and their distribution is complex. They represent the caudal end of a widespread network of nicotinamide adenine dinucleotide phosphate diaphorase-enriched neurons that extend rostrally from the brainstem reticular formation into the basal forebrain, striatum, and cerebral cortex.