Premotor neurons for vertical eye movements in the rostral mesencephalon of monkey and human: histologic identification by parvalbumin immunostaining.

In the monkey, premotor neurons for vertical gaze are located in the mesencephalic reticular formation: the rostral interstitial nucleus of the medial longitudinal fascicle (riMLF) contains medium-lead burst neurons, and the interstitial nucleus of Cajal (iC) acts as integrator for the eye-velocity signals to eye-position signals. Both nuclei lie adjacent to each other and are similar in appearance at the transition zone in Nissl-stained sections, which makes a delineation of the functionally different nuclei difficult in human. For a neuropathologic analysis of degenerative changes in saccadic disorders of patients, the histologic identification of the riMLF and the iC is important. The aim of this study is to identify both nuclei in human by using parvalbumin as a histologic marker. First, in monkeys the premotor neurons in riMLF and iC were identified by trans-synaptic labelling after injections of tetanus toxin fragment C into vertical-pulling eye muscles. Premotor neurons were found in the riMLF mainly ipsilateral to the corresponding eye muscle motoneurons and on both sides within the iC, but here the labelled cell populations differed: the contralateral side contained more medium-sized cells compared with the mainly small-sized cell population on the ipsilateral side. Double labelling showed that almost all premotor neurons in the iC and all premotor neurons in the riMLF were parvalbumin-immunoreactive. The immunocytochemical staining of human brainstem sections revealed the riMLF as a cluster of medium-sized, elongated parvalbumin-positive cells, with a similar appearance and at a similar location as that in monkey: a wing-shaped nucleus dorsomedial to the red nucleus, rostral to the traversing tractus retroflexus, dorsally bordered by the thalamo-subthalamic paramedian artery. The adjacent iC could be distinguished easily by its more densely packed, round parvalbumin-immunoreactive neurons. The exact identification of premotor neurons of the vertical system in the normal human brain provides a reference basis for the neuropathologic analysis of vertical gaze disorders at a cellular level.