Medial vestibulospinal tract

The medial vestibulospinal tract (also referred to as the anterior vestibulospinal tract) is a descending motor pathway that originates in the medial and inferior vestibular nuclei, located within the floor of the fourth ventricle at the junction of the pons and medulla oblongata. From its origin, the tract descends primarily uncrossed through the anterior funiculus (or anterior white column) of the spinal cord, projecting only as far as the cervical and upper thoracic spine. It terminates within the anterior gray horns, synapsing on alpha and gamma motor neurons that control muscles of the neck and upper back.

The primary function of the medial vestibulospinal tract is to regulate muscle tone in the neck and upper back, contributing to the stabilization of the head and upper body during movement. Together with the lateral vestibulospinal tract, it plays a crucial role in maintaining axial posture and head positioning. Furthermore, connections between the vestibular nuclei and the extraocular motor nuclei, mediated via the medial longitudinal fasciculus (MLF), facilitate the vestibulo-ocular reflex (VOR). This reflex ensures precise eye movement adjustments to stabilize gaze during head movements, supporting coordination between posture and visual focus.