Periaqueductal gray matter

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Periaqueductal gray matter (PAG) is a structure located around the cerebral aqueduct within the tegmentum of the midbrain. It plays a crucial role in the modulation of pain and in defensive and reproductive behaviors.

Anatomy[edit | edit source]

The periaqueductal gray is so named because it is gray matter situated around the cerebral aqueduct. This structure is divided into four columns: the dorsal, lateral, ventrolateral, and ventral columns. Each column has a different function and projects to different areas of the brain.

Function[edit | edit source]

The PAG plays a role in many functions, including pain modulation, defensive behavior, reproductive behavior, and cardiovascular control. It is also involved in the body's response to stress and panic.

Pain modulation[edit | edit source]

The PAG is a major component of the descending pain modulation system. It receives inputs from the cortex, hypothalamus, and amygdala, and sends outputs to the rostral ventromedial medulla (RVM) and the spinal cord. Activation of the PAG can produce powerful analgesia.

Defensive behavior[edit | edit source]

The PAG is involved in defensive behaviors such as freezing and flight. It receives inputs from the amygdala, which is involved in fear conditioning, and sends outputs to areas of the brainstem that control cardiovascular and respiratory responses to stress.

Reproductive behavior[edit | edit source]

The PAG is involved in reproductive behaviors such as mating and parental care. It receives inputs from the medial preoptic area and sends outputs to the ventromedial hypothalamus and other areas involved in these behaviors.

Clinical significance[edit | edit source]

The PAG is a target for deep brain stimulation in the treatment of chronic pain conditions. It is also implicated in panic disorder and post-traumatic stress disorder.

See also[edit | edit source]

References[edit | edit source]

Periaqueductal gray matter Resources
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Contributors: Prab R. Tumpati, MD