Cholinergic cells of the pontomesencephalic tegmentum: Connections with auditory structures from cochlear nucleus to cortex

Acetylcholine (ACh) is a neuromodulator that is likely to play a role in plasticity as well as other phenomena at many sites in the auditory system. The auditory cortex receives cholinergic innervation from the basal forebrain, whereas the cochlea receives cholinergic innervation from the superior olivary complex. Much of the remainder of the auditory pathways receives innervation from the pedunculopontine and laterodorsal tegmental nuclei, two nuclei referred to collectively as the pontomesencephalic tegmentum (PMT). The PMT provides the major source of ACh to the auditory thalamus and the midbrain, and is a substantial source (in addition to the superior olivary complex) of ACh in the cochlear nucleus. Individual cholinergic cells in the PMT often have axon branches that innervate multiple auditory nuclei, including nuclei on both sides of the brain as well as nuclei at multiple levels of the auditory system. The auditory cortex has direct axonal projections to the PMT cells, including cholinergic cells that project to the inferior colliculus or cochlear nucleus. The divergent projections of PMT cholinergic cells suggest widespread effects on the auditory pathways. These effects are likely to include plasticity as well as novelty detection, sensory gating, reward behavior, arousal and attention. Descending projections from the forebrain, including the auditory cortex, are likely to provide a high level of cognitive input to these cholinergic effects. Dysfunction associated with the cholinergic system may play a role in disorders such as tinnitus and schizophrenia.