A Connectomic Atlas of the Human Cerebrum-Chapter 16: Tractographic Description of the Vertical Occipital Fasciculus

The vertical superior longitudinal fascicle and the vertical occipital fascicle

Association fibers of the human brain have long been considered to exclusively follow an anterior-posterior direction. Using magnetic resonance imaging techniques that allow in-vivo fiber dissection, vertically oriented association fibers have been rediscovered or newly described. Aside from the frontal aslant tract (FAT) in the frontal lobe, the vertical occipital fascicle (VOF) and the vertical portion of the superior longitudinal fascicle system (vSLF) have been studied in recent years. The aim of this review was to give an overview on the current knowledge regarding these two fiber tracts. A review of the available literature in the Medline database was conducted to gather all available publications dealing with either the VOF or the vSLF. One thousand two hundred seventy-three articles were obtained from the literature search of which a total of 71 articles met the final inclusion criteria of this review. We describe the history of the discovery of the respective fiber tract, its anatomical course and its boundaries integrating blunt fiber dissection studies and functional MRI/tractography studies. We discuss the functional properties of the respective fiber tract and its relevance in neurosurgery. The VOF is a fiber tract that has been discovered in the late XIX century and long been forgotten before being rediscovered in the 1970's. It lies lateral to the fibers of the sagittal stratum and mainly connects the superior and inferior occipital lobe. It plays a major role in reading and visual word and language comprehension and is said to be the main link between dorsal and ventral visual streams. The vSLF has many synonyms and is part of the superior longitudinal fascicle system. Recent studies were able to provide more insight into this set of fiber tracts showing distinct connections running from the superior and inferior parietal lobule to the posterior part of the temporal lobe. Its functional role is still not completely cleared. It is said to play a role in visual and auditory semantic language comprehension. It lies directly lateral to the arcuate fascicle. The VOF and the vSLF are vertically oriented fiber tracts connecting the temporo-parieto-occipital region and play a major role in the communication of dorsal and ventral visual streams (VOF), reading (VOF, vSLF) and visual and auditory semantic language comprehension (vSLF). They can consistently be identified using ex vivo blunt dissection techniques and in-vivo fiber tractography. Because of their localization and orientation these two fiber tracts can be combined to a fiber bundle system called posterior transverse system (PTS).

Connectivity-based parcellation of normal and anatomically distorted human cerebral cortex

For over a century, neuroscientists have been working toward parcellating the human cortex into distinct neurobiological regions. Modern technologies offer many parcellation methods for healthy cortices acquired through magnetic resonance imaging. However, these methods are suboptimal for personalized neurosurgical application given that pathology and resection distort the cerebrum. We sought to overcome this problem by developing a novel connectivity‐based parcellation approach that can be applied at the single‐subject level. Utilizing normative diffusion data, we first developed a machine‐learning (ML) classifier to learn the typical structural connectivity patterns of healthy subjects. Specifically, the Glasser HCP atlas was utilized as a prior to calculate the streamline connectivity between each voxel and each parcel of the atlas. Using the resultant feature vector, we determined the parcel identity of each voxel in neurosurgical patients (n = 40) and thereby iteratively adjusted the prior. This approach enabled us to create patient‐specific maps independent of brain shape and pathological distortion. The supervised ML classifier re‐parcellated an average of 2.65% of cortical voxels across a healthy dataset (n = 178) and an average of 5.5% in neurosurgical patients. Our patient dataset consisted of subjects with supratentorial infiltrating gliomas operated on by the senior author who then assessed the validity and practical utility of the re‐parcellated diffusion data. We demonstrate a rapid and effective ML parcellation approach to parcellation of the human cortex during anatomical distortion. Our approach overcomes limitations of indiscriminately applying atlas‐based registration from healthy subjects by employing a voxel‐wise connectivity approach based on individual data.

White matter variability, cognition, and disorders: a systematic review

Inter-individual differences can inform treatment procedures and—if accounted for—have the potential to significantly improve patient outcomes. However, when studying brain anatomy, these inter-individual variations are commonly unaccounted for, despite reports of differences in gross anatomical features, cross-sectional, and connectional anatomy. Brain connections are essential to facilitate functional organization and, when severed, cause impairments or complete loss of function. Hence, the study of cerebral white matter may be an ideal compromise to capture inter-individual variability in structure and function. We reviewed the wealth of studies that associate cognitive functions and clinical symptoms with individual tracts using diffusion tractography. Our systematic review indicates that tractography has proven to be a sensitive method in neurology, psychiatry, and healthy populations to identify variability and its functional correlates. However, the literature may be biased, as the most commonly studied tracts are not necessarily those with the highest sensitivity to cognitive functions and pathologies. Additionally, the hemisphere of the studied tract is often unreported, thus neglecting functional laterality and asymmetries. Finally, we demonstrate that tracts, as we define them, are not correlated with one, but multiple cognitive domains or pathologies. While our systematic review identified some methodological caveats, it also suggests that tract–function correlations might still be a promising tool in identifying biomarkers for precision medicine. They can characterize variations in brain anatomy, differences in functional organization, and predicts resilience and recovery in patients.

Occipital Intralobar fasciculi: a description, through tractography, of three forgotten tracts

Diffusion MRI paired with tractography has facilitated a non-invasive exploration of many association, projection, and commissural fiber tracts. However, there is still a scarcity of research studies related to intralobar association fibers. The Dejerines' (two of the most notable neurologists of 19^th century France) gave an in-depth description of the intralobar fibers of the occipital lobe. Unfortunately, their exquisite work has since been sparsely cited in the modern literature. This work gives a modern description of many of the occipital intralobar lobe fibers described by the Dejerines. We perform a virtual dissection and reconstruct the tracts using diffusion MRI tractography. The dissection is guided by the Dejerines' treatise, Anatomie des Centres Nerveux. As an accompaniment to this article, we provided a French-to-English translation of the treatise portion concerning five intra-occipital tracts, namely: the stratum calcarinum, the stratum proprium cunei, the vertical occipital fasciculus of Wernicke, the transverse fasciculus of the cuneus and the transverse fasciculus of the lingual lobule of Vialet. It was possible to reconstruct all but one of these tracts. For completeness, the recently described sledge runner fasciculus, although not one of the Dejerines' tracts, was identified and successfully reconstructed.

White matter dissection and structural connectivity of the human vertical occipital fasciculus to link vision-associated brain cortex

The vertical occipital fasciculus (VOF) is an association fiber tract coursing vertically at the posterolateral corner of the brain. It is re-evaluated as a major fiber tract to link the dorsal and ventral visual stream. Although previous tractography studies showed the VOF’s cortical projections fall in the dorsal and ventral visual areas, the post-mortem dissection study for the validation remains limited. First, to validate the previous tractography data, we here performed the white matter dissection in post-mortem brains and demonstrated the VOF’s fiber bundles coursing between the V3A/B areas and the posterior fusiform gyrus. Secondly, we analyzed the VOF’s structural connectivity with diffusion tractography to link vision-associated cortical areas of the HCP MMP1.0 atlas, an updated map of the human cerebral cortex. Based on the criteria the VOF courses laterally to the inferior longitudinal fasciculus (ILF) and craniocaudally at the posterolateral corner of the brain, we reconstructed the VOF’s fiber tracts and found the widespread projections to the visual cortex. These findings could suggest a crucial role of VOF in integrating visual information to link the broad visual cortex as well as in connecting the dual visual stream.