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Chen VCH, Chuang W, Chen CW, Tsai YH, McIntyre RS, Weng JC. Detecting microstructural alterations of cerebral white matter associated with breast cancer and chemotherapy revealed by generalized q-sampling MRI. Front Psychiatry 2023; 14:1161246. [PMID: 37363171 PMCID: PMC10289548 DOI: 10.3389/fpsyt.2023.1161246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Objective Previous studies have discussed the impact of chemotherapy on the brain microstructure. There is no evidence of the impact regarding cancer-related psychiatric comorbidity on cancer survivors. We aimed to evaluate the impact of both chemotherapy and mental health problem on brain microstructural alterations and consequent cognitive dysfunction in breast cancer survivors. Methods In this cross-sectional study conducted in a tertiary center, data from 125 female breast cancer survivors who had not received chemotherapy (BB = 65; 49.86 ± 8.23 years) and had received chemotherapy (BA = 60; 49.82 ± 7.89 years) as well as from 71 age-matched healthy controls (47.18 ± 8.08 years) was collected. Chemotherapeutic agents used were docetaxel and epirubicin. We used neuropsychological testing and questionnaire to evaluate psychiatric comorbidity, cognitive dysfunction as well as generalized sampling imaging (GQI) and graph theoretical analysis (GTA) to detect microstructural alterations in the brain. Findings Cross-comparison between groups revealed that neurotoxicity caused by chemotherapy and cancer-related psychiatric comorbidity may affect the corpus callosum and middle frontal gyrus. In addition, GQI indices were correlated with the testing scores of cognitive function, quality of life, anxiety, and depression. Furthermore, weaker connections between brain regions and lower segregated ability were found in the post-treatment group. Conclusion This study suggests that chemotherapy and cancer-related mental health problem both play an important role in the development of white matter alterations and cognitive dysfunction.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Wei Chuang
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Wei Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Roger S. McIntyre
- Mood Disorder Psychopharmacology Unit, Department of Psychiatry, University Health Network, University of Toronto, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Medical Imaging and Radiological Sciences, Department of Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University, Taoyuan, Taiwan
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Anterior transtemporal endoscopic selective amygdalohippocampectomy: a virtual and cadaveric feasibility study. Acta Neurochir (Wien) 2022; 164:2841-2849. [PMID: 35809147 DOI: 10.1007/s00701-022-05295-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 06/20/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE Selective amygdalohippocampectomy (SelAH) is one of the most common surgical treatments for mesial temporal sclerosis. Microsurgical approaches are associated with the risk of cognitive and visual deficits due to damage to the cortex and white matter (WM) pathways. Our objective is to test the feasibility of an endoscopic approach through the anterior middle temporal gyrus (aMTG) to perform a SelAH. METHODS Virtual simulation with MRI scans of ten patients (20 hemispheres) was used to identify the endoscopic trajectory through the aMTG. A cadaveric study was performed on 22 specimens using a temporal craniotomy. The anterior part of the temporal horn was accessed using a tubular retractor through the aMTG after performing a 1.5 cm corticectomy at 1.5 cm posterior to the temporal pole. Then, an endoscope was introduced. SeIAH was performed in each specimen. The specimens underwent neuronavigation-assisted endoscopic SeIAH to confirm our surgical trajectory. WM dissection using Klingler's technique was performed on five specimens to assess WM integrity. RESULTS This approach allowed the identification of collateral eminence, lateral ventricular sulcus, choroid plexus, inferior choroidal point, amygdala, hippocampus, and fimbria. SelAH was successfully performed on all specimens, and CT neuronavigation confirmed the planned trajectory. WM dissection confirmed the integrity of language pathways and optic radiations. CONCLUSIONS Endoscopic SelAH through the aMTG can be successfully performed with a corticectomy of 15 mm, presenting a reduced risk of vascular injury and damage to WM pathways. This could potentially help to reduce cognitive and visual deficits associated with SelAH.
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Filipiak P, Shepherd T, Lin YC, Placantonakis DG, Boada FE, Baete SH. Performance of orientation distribution function-fingerprinting with a biophysical multicompartment diffusion model. Magn Reson Med 2022; 88:418-435. [PMID: 35225365 PMCID: PMC9142101 DOI: 10.1002/mrm.29208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Orientation Distribution Function (ODF) peak finding methods typically fail to reconstruct fibers crossing at shallow angles below 40°, leading to errors in tractography. ODF-Fingerprinting (ODF-FP) with the biophysical multicompartment diffusion model allows for breaking this barrier. METHODS A randomized mechanism to generate a multidimensional ODF-dictionary that covers biologically plausible ranges of intra- and extra-axonal diffusivities and fraction volumes is introduced. This enables ODF-FP to address the high variability of brain tissue. The performance of the proposed approach is evaluated on both numerical simulations and a reconstruction of major fascicles from high- and low-resolution in vivo diffusion images. RESULTS ODF-FP with the suggested modifications correctly identifies fibers crossing at angles as shallow as 10 degrees in the simulated data. In vivo, our approach reaches 56% of true positives in determining fiber directions, resulting in visibly more accurate reconstruction of pyramidal tracts, arcuate fasciculus, and optic radiations than the state-of-the-art techniques. Moreover, the estimated diffusivity values and fraction volumes in corpus callosum conform with the values reported in the literature. CONCLUSION The modified ODF-FP outperforms commonly used fiber reconstruction methods at shallow angles, which improves deterministic tractography outcomes of major fascicles. In addition, the proposed approach allows for linearization of the microstructure parameters fitting problem.
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Affiliation(s)
- Patryk Filipiak
- Center for Advanced Imaging Innovation and Research (CAIR), Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Timothy Shepherd
- Center for Advanced Imaging Innovation and Research (CAIR), Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Ying-Chia Lin
- Center for Advanced Imaging Innovation and Research (CAIR), Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Dimitris G. Placantonakis
- Department of Neurosurgery, Perlmutter Cancer Center, Neuroscience Institute, Kimmel Center for Stem Cell Biology, NYU Langone Health, New York, NY, USA
| | - Fernando E. Boada
- Center for Advanced Imaging Innovation and Research (CAIR), Department of Radiology, NYU Langone Health, New York, NY, USA,Radiological Sciences Laboratory and Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, CA
| | - Steven H. Baete
- Center for Advanced Imaging Innovation and Research (CAIR), Department of Radiology, NYU Langone Health, New York, NY, USA
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Janelle F, Iorio-Morin C, D'amour S, Fortin D. Superior Longitudinal Fasciculus: A Review of the Anatomical Descriptions With Functional Correlates. Front Neurol 2022; 13:794618. [PMID: 35572948 PMCID: PMC9093186 DOI: 10.3389/fneur.2022.794618] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 12/20/2022] Open
Abstract
The superior longitudinal fasciculus (SLF) is part of the longitudinal association fiber system, which lays connections between the frontal lobe and other areas of the ipsilateral hemisphere. As a dominant association fiber bundle, it should correspond to a well-defined structure with a clear anatomical definition. However, this is not the case, and a lot of confusion and overlap surrounds this entity. In this review/opinion study, we survey relevant current literature on the topic and try to clarify the definition of SLF in each hemisphere. After a comparison of postmortem dissections and data obtained from diffusion MRI studies, we discuss the specifics of this bundle regarding its anatomical landmarks, differences in lateralization, as well as individual variability. We also discuss the confusion regarding the arcuate fasciculus in relation to the SLF. Finally, we recommend a nomenclature based on the findings exposed in this review and finalize with a discussion on relevant functional correlates of the structure.
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Mahdy Ali K, Avesani P. The vertical superior longitudinal fascicle and the vertical occipital fascicle. J Neurosurg Sci 2022; 65:581-589. [PMID: 35128919 DOI: 10.23736/s0390-5616.21.05368-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
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).
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Affiliation(s)
- Kariem Mahdy Ali
- Department of Neurosurgery, Medical University of Graz, Graz, Austria -
| | - Paolo Avesani
- Center for Information Technology, Fondazione Bruno Kessler (FBK), Trento, Italy
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Landers MJ, Baene WD, Rutten GJ, Mandonnet E. The third branch of the superior longitudinal system. J Neurosurg Sci 2022; 65:548-559. [PMID: 35128918 DOI: 10.23736/s0390-5616.21.05423-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One of the major associative fiber pathways in the brain is the superior longitudinal system. This review discusses the current knowledge gained from studies on the third branch of the superior longitudinal system (SLS) regarding its anatomy, functional role in healthy individuals, results from lesion-symptom mapping studies and intraoperative electrostimulation studies. The results of these studies clearly indicate that the third branch of the SLS is a distinct pathway, as seen both from a functional and anatomical perspective. The third branch of the SLS should be distinguished from the long segment of the arcuate fasciculus, that courses along its trajectory but seems implicated in different functions. Moreover, these studies also provide substantial evidence that the right and left third branch of the SLS have different functional roles. Finally, a hypothesis for an integrated anatomo-functional model is proposed, that describes three subcomponents of the third branch of the superior longitudinal system.
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Affiliation(s)
- Maud J Landers
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Wouter de Baene
- Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Geert J Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, University of Tilburg, Tilburg, the Netherlands
| | - Emmanuel Mandonnet
- University of Paris, Paris, France - .,Frontlab, Institut du Cerveau (ICM), CNRS UMR 7225, INSERM U1127, Paris, France.,Service of Neurosurgery, Lariboisière Hospital, Paris, France
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Becker Y, Loh KK, Coulon O, Meguerditchian A. The Arcuate Fasciculus and language origins: Disentangling existing conceptions that influence evolutionary accounts. Neurosci Biobehav Rev 2021; 134:104490. [PMID: 34914937 DOI: 10.1016/j.neubiorev.2021.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/30/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022]
Abstract
The Arcuate Fasciculus (AF) is of considerable interdisciplinary interest, because of its major implication in language processing. Theories about language brain evolution are based on anatomical differences in the AF across primates. However, changing methodologies and nomenclatures have resulted in conflicting findings regarding interspecies AF differences: Historical knowledge about the AF originated from human blunt dissections and later from monkey tract-tracing studies. Contemporary tractography studies reinvestigate the fasciculus' morphology, but remain heavily bound to unclear anatomical priors and methodological limitations. First, we aim to disentangle the influences of these three epistemological steps on existing AF conceptions, and to propose a contemporary model to guide future work. Second, considering the influence of various AF conceptions, we discuss four key evolutionary changes that propagated current views about language evolution: 1) frontal terminations, 2) temporal terminations, 3) greater Dorsal- versus Ventral Pathway expansion, 4) lateralisation. We conclude that new data point towards a more shared AF anatomy across primates than previously described. Language evolution theories should incorporate this continuous AF evolution across primates.
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Affiliation(s)
- Yannick Becker
- Laboratoire de Psychologie Cognitive, Aix-Marseille Univ, CNRS UMR 7290, Marseille, France; Institut de Neurosciences de la Timone, Aix-Marseille Univ, CNRS UMR 7289, Marseille, France.
| | - Kep Kee Loh
- Laboratoire de Psychologie Cognitive, Aix-Marseille Univ, CNRS UMR 7290, Marseille, France; Institut de Neurosciences de la Timone, Aix-Marseille Univ, CNRS UMR 7289, Marseille, France; Institute for Language, Communication, and the Brain, Aix-Marseille Univ, Marseille, France
| | - Olivier Coulon
- Institut de Neurosciences de la Timone, Aix-Marseille Univ, CNRS UMR 7289, Marseille, France; Institute for Language, Communication, and the Brain, Aix-Marseille Univ, Marseille, France
| | - Adrien Meguerditchian
- Laboratoire de Psychologie Cognitive, Aix-Marseille Univ, CNRS UMR 7290, Marseille, France; Institute for Language, Communication, and the Brain, Aix-Marseille Univ, Marseille, France; Station de Primatologie CNRS, Rousset, France
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8
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Atar M, Kızmazoglu C, Kaya I, Cıngoz ID, Uzunoglu I, Kalemcı O, Eroglu A, Pusat S, Atabey C, Yuceer N. The importance of preoperative planning to perform safely temporal lobe surgery. J Clin Neurosci 2021; 93:61-69. [PMID: 34656263 DOI: 10.1016/j.jocn.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/11/2021] [Accepted: 09/04/2021] [Indexed: 02/07/2023]
Abstract
Neurosurgeons should know the anatomy required for safe temporal lobe surgery approaches. The present study aimed to determine the angles and distances necessary to reach the temporal stem and temporal horn in surgical approaches for safe temporal lobe surgery by using a 3.0 T magnetic resonance imaging technique in post-mortem human brain hemispheres fixed by the Klingler method. In our study, 10 post-mortem human brain hemisphere specimens were fixed according to the Klingler method. Magnetic resonance images were obtained using a 3.0 T magnetic resonance imaging scanner after fixation. Surgical measurements were conducted for the temporal stem and temporal horn by magnetic resonance imaging, and dissection was then performed under a surgical microscope for the temporal stem. Each stage of dissection was achieved in high-quality three-dimensional images. The angles and distances to reach the temporal stem and temporal horn were measured in transcortical T1, trans-sulcal T1-2, transcortical T2, trans-sulcal T2-3, transcortical T3, and subtemporal trans-collateral sulcus approaches. The safe maximum posterior entry point for anterior temporal lobectomy was measured as 47.16 ± 5.00 mm. Major white-matter fibers in this region and their relations with each other are shown. The distances to the temporal stem and temporal horn, which are important in temporal lobe surgical interventions, were measured radiologically, and safe borders were determined. Surgical strategy and preoperative planning should consider the relationship of the lesion and white-matter pathways.
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Affiliation(s)
- Murat Atar
- Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery , Istanbul, Turkey.
| | - Ceren Kızmazoglu
- Dokuz Eylul University School of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Ismail Kaya
- Usak University School of Medicine, Department of Neurosurgery, Usak, Turkey
| | - Ilker Deniz Cıngoz
- Usak University School of Medicine, Department of Neurosurgery, Usak, Turkey
| | - Inan Uzunoglu
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
| | - Orhan Kalemcı
- Dokuz Eylul University School of Medicine, Department of Neurosurgery, Izmir, Turkey
| | - Ahmet Eroglu
- Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery , Istanbul, Turkey
| | - Serhat Pusat
- Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery , Istanbul, Turkey
| | - Cem Atabey
- Sultan Abdulhamid Han Training and Research Hospital, Department of Neurosurgery , Istanbul, Turkey
| | - Nurullah Yuceer
- Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
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9
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Yang JYM, Yeh CH, Poupon C, Calamante F. Diffusion MRI tractography for neurosurgery: the basics, current state, technical reliability and challenges. Phys Med Biol 2021; 66. [PMID: 34157706 DOI: 10.1088/1361-6560/ac0d90] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/22/2021] [Indexed: 01/20/2023]
Abstract
Diffusion magnetic resonance imaging (dMRI) tractography is currently the only imaging technique that allows for non-invasive delineation and visualisation of white matter (WM) tractsin vivo,prompting rapid advances in related fields of brain MRI research in recent years. One of its major clinical applications is for pre-surgical planning and intraoperative image guidance in neurosurgery, where knowledge about the location of WM tracts nearby the surgical target can be helpful to guide surgical resection and optimise post-surgical outcomes. Surgical injuries to these WM tracts can lead to permanent neurological and functional deficits, making the accuracy of tractography reconstructions paramount. The quality of dMRI tractography is influenced by many modifiable factors, ranging from MRI data acquisition through to the post-processing of tractography output, with the potential of error propagation based on decisions made at each and subsequent processing steps. Research over the last 25 years has significantly improved the anatomical accuracy of tractography. An updated review about tractography methodology in the context of neurosurgery is now timely given the thriving research activities in dMRI, to ensure more appropriate applications in the clinical neurosurgical realm. This article aims to review the dMRI physics, and tractography methodologies, highlighting recent advances to provide the key concepts of tractography-informed neurosurgery, with a focus on the general considerations, the current state of practice, technical challenges, potential advances, and future demands to this field.
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Affiliation(s)
- Joseph Yuan-Mou Yang
- Department of Neurosurgery, The Royal Children's Hospital, Melbourne, Australia.,Neuroscience Research, Murdoch Children's Research Institute, Melbourne, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Chun-Hung Yeh
- Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Cyril Poupon
- NeuroSpin, Frédéric Joliot Life Sciences Institute, CEA, CNRS, Paris-Saclay University, Gif-sur-Yvette, France
| | - Fernando Calamante
- The University of Sydney, Sydney Imaging, Sydney, Australia.,The University of Sydney, School of Biomedical Engineering, Sydney, Australia
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10
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Voets NL, Pretorius P, Birch MD, Apostolopoulos V, Stacey R, Plaha P. Diffusion tractography for awake craniotomy: accuracy and factors affecting specificity. J Neurooncol 2021; 153:547-557. [PMID: 34196915 PMCID: PMC8280000 DOI: 10.1007/s11060-021-03795-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 11/30/2022]
Abstract
Introduction Despite evidence of correspondence with intraoperative stimulation, there remains limited data on MRI diffusion tractography (DT)’s sensitivity to predict morbidity after neurosurgical oncology treatment. Our aims were: (1) evaluate DT against subcortical stimulation mapping and performance changes during and after awake neurosurgery; (2) evaluate utility of early post-operative DT to predict recovery from post-surgical deficits. Methods We retrospectively reviewed our first 100 awake neurosurgery procedures using DT- neuronavigation. Intra-operative stimulation and performance outcomes were assessed to classify DT predictions for sensitivity and specificity calculations. Post-operative DT data, available in 51 patients, were inspected for tract damage. Results 91 adult brain tumor patients (mean 49.2 years, 43 women) underwent 100 awake surgeries with subcortical stimulation between 2014 and 2019. Sensitivity and specificity of pre-operative DT predictions were 92.2% and 69.2%, varying among tracts. Post-operative deficits occurred after 41 procedures (39%), but were prolonged (> 3 months) in only 4 patients (4%). Post-operative DT in general confirmed surgical preservation of tracts. Post-operative DT anticipated complete recovery in a patient with supplementary motor area syndrome, and indicated infarct-related damage to corticospinal fibers associated with delayed, partial recovery in a second patient. Conclusions Pre-operative DT provided very accurate predictions of the spatial location of tracts in relation to a tumor. As expected, however, the presence of a tract did not inform its functional status, resulting in variable DT specificity among individual tracts. While prolonged deficits were rare, DT in the immediate post-operative period offered additional potential to monitor neurological deficits and anticipate recovery potential. Supplementary Information The online version contains supplementary material available at 10.1007/s11060-021-03795-7.
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Affiliation(s)
- Natalie L Voets
- Department of Neurosurgery, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, West Wing, L3, Oxford, Oxfordshire, OX3 9DU, UK
| | - Pieter Pretorius
- Department of Neuroradiology, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Martin D Birch
- Nuffield Department of Anaesthesia, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, Oxford, Oxfordshire, UK
| | - Vasileios Apostolopoulos
- Department of Neurosurgery, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, West Wing, L3, Oxford, Oxfordshire, OX3 9DU, UK
| | - Richard Stacey
- Department of Neurosurgery, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, West Wing, L3, Oxford, Oxfordshire, OX3 9DU, UK
| | - Puneet Plaha
- Department of Neurosurgery, Oxford University Hospital NHS Foundation Trust, John Radcliffe Hospital, West Wing, L3, Oxford, Oxfordshire, OX3 9DU, UK. .,Nuffield Department of Surgery, University of Oxford, Oxford, Oxfordshire, UK.
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11
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Liakos F, Komaitis S, Drosos E, Neromyliotis E, Skandalakis GP, Gerogiannis AI, Kalyvas AV, Troupis T, Stranjalis G, Koutsarnakis C. The Topography of the Frontal Terminations of the Uncinate Fasciculus Revisited Through Focused Fiber Dissections: Shedding Light on a Current Controversy and Introducing the Insular Apex as a Key Anatomoclinical Area. World Neurosurg 2021; 152:e625-e634. [PMID: 34144169 DOI: 10.1016/j.wneu.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recent studies advocate a connectivity pattern wider than previously believed of the uncinate fasciculus that extends to the ventrolateral and dorsolateral prefrontal cortices. These new percepts on the connectivity of the tract suggest a more expansive role for the uncinate fasciculus. Our aim was to shed light on this controversy through fiber dissections. METHODS Twenty normal adult human formalin-fixed cerebral hemispheres were used. Focused dissections on the insular, orbitofrontal, ventromedial, ventrolateral, and dorsolateral prefrontal areas were performed to record the topography of the frontal terminations of the uncinate fasciculus. RESULTS Three discrete fiber layers were consistently disclosed: the first layer was recorded to terminate at the posterior orbital gyrus and pars orbitalis, the second layer at the posterior two thirds of the gyrus rectus, and the last layer at the posterior one third of the paraolfactory gyrus. The insular apex was documented as a crucial landmark regarding the topographic differentiation of the uncinate and occipitofrontal fasciculi (i.e., fibers that travel ventrally belong to the uncinate fasciculus whereas those traveling dorsally are occipitofrontal fibers). CONCLUSIONS The frontal terminations of the uncinate fasciculus were consistently documented to project to the posterior orbitofrontal area. The area of the insular apex is introduced for the first time as a crucial surface landmark to effectively distinguish the stems of the uncinate and occipitofrontal fasciculi. This finding could refine the spatial resolution of awake subcortical mapping, especially for insular lesions, and improve the accuracy of in vivo diffusion tensor imaging protocols.
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Affiliation(s)
- Faidon Liakos
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Komaitis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Drosos
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Neromyliotis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece
| | | | | | - Aristotelis V Kalyvas
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore Troupis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Stranjalis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece
| | - Christos Koutsarnakis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece; Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece; Edinburgh Microneurosurgery Education Laboratory, Department of Clinical Neurosciences, Edinburgh, United Kingdom; Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Hellenic Center for Neurosurgical Research, "Petros Kokkalis", Athens, Greece.
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12
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Postans M, Parker GD, Lundell H, Ptito M, Hamandi K, Gray WP, Aggleton JP, Dyrby TB, Jones DK, Winter M. Uncovering a Role for the Dorsal Hippocampal Commissure in Recognition Memory. Cereb Cortex 2021; 30:1001-1015. [PMID: 31364703 PMCID: PMC7132945 DOI: 10.1093/cercor/bhz143] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 01/24/2023] Open
Abstract
The dorsal hippocampal commissure (DHC) is a white matter tract that provides interhemispheric connections between temporal lobe brain regions. Despite the importance of these regions for learning and memory, there is scant evidence of a role for the DHC in successful memory performance. We used diffusion-weighted magnetic resonance imaging (DW-MRI) and white matter tractography to reconstruct the DHC in both humans (in vivo) and nonhuman primates (ex vivo). Across species, our findings demonstrate a close consistency between the known anatomy and tract reconstructions of the DHC. Anterograde tract-tracer techniques also highlighted the parahippocampal origins of DHC fibers in nonhuman primates. Finally, we derived diffusion tensor MRI metrics from the DHC in a large sample of human subjects to investigate whether interindividual variation in DHC microstructure is predictive of memory performance. The mean diffusivity of the DHC correlated with performance in a standardized recognition memory task, an effect that was not reproduced in a comparison commissure tract—the anterior commissure. These findings highlight a potential role for the DHC in recognition memory, and our tract reconstruction approach has the potential to generate further novel insights into the role of this previously understudied white matter tract in both health and disease.
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Affiliation(s)
- M Postans
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,School of Psychology, CF10 3AS
| | - G D Parker
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,Experimental MRI Centre, School of Biosciences, Cardiff University, Cardiff CF10 3AX, UK
| | - H Lundell
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, DK-2650, Denmark
| | - M Ptito
- School of Optometry, University of Montreal, H3T 1J4 Montreal, Canada.,Department of Neurology and Neurosurgery, Montreal Neurological Institute, H3A 2B4 Montreal, Canada
| | - K Hamandi
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,The Alan Richens Welsh Epilepsy Centre, Department of Neurology, University Hospital of Wales, Cardiff CF14 4XW, UK.,Institute of Psychological Medicine and Clinical Neurosciences.,Brain Repair And Intracranial Neurotherapeutics Unit, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK
| | - W P Gray
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,The Alan Richens Welsh Epilepsy Centre, Department of Neurology, University Hospital of Wales, Cardiff CF14 4XW, UK.,Institute of Psychological Medicine and Clinical Neurosciences.,Brain Repair And Intracranial Neurotherapeutics Unit, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Neurosurgery, Neurosciences Division, University Hospital Wales, Cardiff, CF14 4XW, UK
| | - J P Aggleton
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,School of Psychology, CF10 3AS
| | - T B Dyrby
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, DK-2650, Denmark.,Department of Applied Mathematics and Computer Science, Technical University of Denmark, Kongens Lyngby, Denmark, DK-2800
| | - D K Jones
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,School of Psychology, CF10 3AS.,Brain Repair And Intracranial Neurotherapeutics Unit, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia
| | - M Winter
- Cardiff University Brain Research Imaging Centre, CF24 4HQ.,School of Psychology, CF10 3AS.,Brain Repair And Intracranial Neurotherapeutics Unit, School of Medicine, Cardiff University, Cardiff CF24 4HQ, UK.,Department of Clinical Neuropsychology, University Hospital of Wales, Cardiff, CF14 4XW, UK
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13
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Delineating the Decussating Dentato-rubro-thalamic Tract and Its Connections in Humans Using Diffusion Spectrum Imaging Techniques. THE CEREBELLUM 2021; 21:101-115. [PMID: 34052968 DOI: 10.1007/s12311-021-01283-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/26/2022]
Abstract
The objective of this study was to identify the decussating dentato-rubro-thalamic tract (d-DRTT) and its afferent and efferent connections in healthy humans using diffusion spectrum imaging (DSI) techniques. In the present study, the trajectory and lateralization of the d-DRTT was explored using data from subjects in the Massachusetts General Hospital-Human Connectome Project adult diffusion dataset. The afferent and efferent networks that compose the cerebello-thalamo-cerebral pathways were also reconstructed. Correlation analysis was performed to identify interrelationships between subdivisions of the cerebello-dentato-rubro-thalamic and thalamo-cerebral connections. The d-DRTT was visualized bilaterally in 28 subjects. According to a normalized quantitative anisotropy and lateralization index evaluation, the left and right d-DRTT were relatively symmetric. Afferent regions were found mainly in the posterior cerebellum, especially the entire lobule VII (crus I, II and VIIb). Efferent fibers mainly are projected to the contralateral frontal cortex, including the motor and nonmotor regions. Correlations between cerebello-thalamic connections and thalamo-cerebral connections were positive, including the lobule VIIa (crus I and II) to the medial prefrontal cortex (MPFC) and the dorsolateral prefrontal cortex and lobules VI, VIIb, VIII, and IX, to the MPFC and motor and premotor areas. These results provide DSI-based tratographic evidence showing segregated and parallel cerebellar outputs to cerebral regions. The posterior cerebellum may play an important role in supporting and handling cognitive activities through d-DRTT. Future studies will allow for a more comprehensive understanding of cerebello-cerebral connections.
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14
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Clinical applications of neurolinguistics in neurosurgery. Front Med 2021; 15:562-574. [PMID: 33983605 DOI: 10.1007/s11684-020-0771-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/05/2020] [Indexed: 11/27/2022]
Abstract
The protection of language function is one of the major challenges of brain surgery. Over the past century, neurosurgeons have attempted to seek the optimal strategy for the preoperative and intraoperative identification of language-related brain regions. Neurosurgeons have investigated the neural mechanism of language, developed neurolinguistics theory, and provided unique evidence to further understand the neural basis of language functions by using intraoperative cortical and subcortical electrical stimulation. With the emergence of modern neuroscience techniques and dramatic advances in language models over the last 25 years, novel language mapping methods have been applied in the neurosurgical practice to help neurosurgeons protect the brain and reduce morbidity. The rapid advancements in brain-computer interface have provided the perfect platform for the combination of neurosurgery and neurolinguistics. In this review, the history of neurolinguistics models, advancements in modern technology, role of neurosurgery in language mapping, and modern language mapping methods (including noninvasive neuroimaging techniques and invasive cortical electroencephalogram) are presented.
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15
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DE Benedictis A, Marras CE, Petit L, Sarubbo S. The inferior fronto-occipital fascicle: a century of controversies from anatomy theaters to operative neurosurgery. J Neurosurg Sci 2021; 65:605-615. [PMID: 33940782 DOI: 10.23736/s0390-5616.21.05360-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Since its first description in the early 19th century, the inferior frontooccipital fascicle (IFOF) and its anatomo-functional features were neglected in the neuroscientific literature for the last century. In the last decade, the rapid development of in vivo imaging for the reconstruction of white matter (WM) connectivity (i.e., tractography) and the consequent interest in more traditional ex vivo methods (postmortem dissection) have allowed a renewed debate about course, termination territories, anatomical relationships, and functional roles of this fascicle. EVIDENCE ACQUISITION We reviewed the main current knowledge concerning the structural and functional anatomy of the IFOF and possible implications in neurosurgical practice. EVIDENCE SYNTHESIS The IFOF connects the occipital cortex, the temporo-basal areas, the superior parietal lobule, and the pre-cuneus to the frontal lobe, passing through the ventral third of subinsular WM of the external capsule. This wide distribution of cortical terminations provides multimodal integration between several functional networks, including language, non-verbal semantic processing, object identification, visuo-spatial processing and planning, reading, facial expression recognition, memory and conceptualization, emotional and neuropsychological behavior. This anatomo-functional organization has important implication also in neurosurgical practice, especially when approaching the frontal, insular, temporo-parieto-occipital regions and the ventricular system. CONCLUSIONS The IFOF is the most extensive associative bundle of the human connectome. Its multi-layer organization reflects important implications in many aspects of brain functional processing. Accurate awareness of IFOF functional anatomy and integration between multimodal datasets coming from different sources has crucial implications for both neuroscientific knowledge and quality of neurosurgical treatments.
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Affiliation(s)
- Alessandro DE Benedictis
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy -
| | - Carlo E Marras
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut Des Maladies Neurodégénératives, UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Silvio Sarubbo
- Division of Neurosurgery, Structural and Functional Connectivity Lab, S. Chiara Hospital, Trento, Italy
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16
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Hodology of the superior longitudinal system of the human brain: a historical perspective, the current controversies, and a proposal. Brain Struct Funct 2021; 226:1363-1384. [PMID: 33881634 DOI: 10.1007/s00429-021-02265-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/23/2021] [Indexed: 02/07/2023]
Abstract
The description of human white matter pathways experienced a tremendous improvement, thanks to the advancement of neuroimaging and dissection techniques. The downside of this progress is the production of redundant and conflicting literature, bound by specific studies' methods and aims. The Superior Longitudinal System (SLS), encompassing the arcuate (AF) and the superior longitudinal fasciculi (SLF), becomes an illustrative example of this fundamental issue, being one of the most studied white matter association pathways of the brain. Herein, we provide a complete illustration of this white matter fiber system's current definition, from its early descriptions in the nineteenth century to its most recent characterizations. We propose a review of both in vivo diffusion magnetic resonance imaging-based tractography and anatomical dissection studies, enclosing all the information available up to date. Based on these findings, we reconstruct the wiring diagram of the SLS, highlighting a substantial variability in the description of its cortical sites of termination and the taxonomy and partonomy that characterize the system. We aim to level up discrepancies in the literature by proposing a parallel across the various nomenclature. Consistent with the topographical arrangement already documented for commissural and projection pathways, we suggest approaching the SLS organization as an orderly and continuous wiring diagram, respecting a medio-lateral palisading topography between the different frontal, parietal, occipital, and temporal gyri rather than in terms of individualized fascicles. A better and complete description of the fine organization of white matter association pathways' connectivity is fundamental for a better understanding of brain function and their clinical and neurosurgical applications.
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17
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Mato D, Velasquez C, Gómez E, Marco de Lucas E, Martino J. Predicting the Extent of Resection in Low-Grade Glioma by Using Intratumoral Tractography to Detect Eloquent Fascicles Within the Tumor. Neurosurgery 2021; 88:E190-E202. [PMID: 33313812 DOI: 10.1093/neuros/nyaa463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/12/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND An early maximal safe surgical resection is the current treatment paradigm for low-grade glioma (LGG). Nevertheless, there are no reliable methods to accurately predict the axonal intratumoral eloquent areas and, consequently, to predict the extent of resection. OBJECTIVE To describe the functional predictive value of eloquent white matter tracts within the tumor by using a pre- and postoperative intratumoral diffusion tensor imaging (DTI) tractography protocol in patients with LGG. METHODS A preoperative intratumoral DTI-based tractography protocol, using the tumor segmented volume as the only seed region, was used to assess the tracts within the tumor boundaries in 22 consecutive patients with LGG. The reconstructed tracts were correlated with intraoperative electrical stimulation (IES)-based language and motor subcortical mapping findings and the extent of resection was assessed by tumor volumetrics. RESULTS Identification of intratumoral language and motor tracts significantly predicted eloquent areas within the tumor during the IES mapping: the positive predictive value for the pyramidal tract, the inferior fronto-occipital fasciculus, the arcuate fasciculus and the inferior longitudinal fasciculus positive was 100%, 100%, 33%, and 80%, respectively, whereas negative predictive value was 100% for all of them. The reconstruction of at least one of these tracts within the tumor was significantly associated with a lower extent of resection (67%) as opposed to the extent of resection in the cases with a negative intratumoral tractography (100%) (P < .0001). CONCLUSION Intratumoral DTI-based tractography is a simple and reliable method, useful in assessing glioma resectability based on the analysis of intratumoral eloquent areas associated with motor and language tracts within the tumor.
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Affiliation(s)
- David Mato
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Valdecilla, Santander, Spain
| | - Carlos Velasquez
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Valdecilla, Santander, Spain
| | - Elsa Gómez
- Deparment of Psychiatry, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Valdecilla, Santander, Spain
| | - Enrique Marco de Lucas
- Deparment of Radiology, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Valdecilla, Santander, Spain
| | - Juan Martino
- Department of Neurological Surgery, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Valdecilla, Santander, Spain
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18
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Nakajima R, Kinoshita M, Shinohara H, Nakada M. The superior longitudinal fascicle: reconsidering the fronto-parietal neural network based on anatomy and function. Brain Imaging Behav 2021; 14:2817-2830. [PMID: 31468374 DOI: 10.1007/s11682-019-00187-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Due primarily to the extensive disposition of fibers and secondarily to the methodological preferences of researchers, the superior longitudinal fasciculus (SLF) subdivisions have multiple names, complicating SLF research. Here, we collected and reassessed existing knowledge regarding the SLF, which we used to propose a four-term classification of the SLF based mainly on function: dorsal SLF, ventral SLF, posterior SLF, and arcuate fasciculus (AF); these correspond to the traditional SLF II, SLF III or anterior AF, temporoparietal segment of the SLF or posterior AF, and AF or AF long segment, respectively. Each segment has a distinct functional role. The dorsal SLF is involved in visuospatial attention and motor control, while the ventral SLF is associated with language-related networks, auditory comprehension, and articulatory processing in the left hemisphere. The posterior SLF is involved in language-related processing, including auditory comprehension, reading, and lexical access, while the AF is associated with language-related activities, such as phonological processing; the right AF plays a role in social cognition and visuospatial attention. This simple proposed classification permits a better understanding of the SLF and may comprise a convenient classification for use in research and clinical practice relating to brain function.
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Affiliation(s)
- Riho Nakajima
- Department of Occupational therapy, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Masashi Kinoshita
- Department of Neurosurgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | | | - Mitsutoshi Nakada
- Department of Neurosurgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
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19
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Reisert M, Weiller C, Hosp JA. Displaying the autonomic processing network in humans - a global tractography approach. Neuroimage 2021; 231:117852. [PMID: 33582271 DOI: 10.1016/j.neuroimage.2021.117852] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/11/2021] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
Regulation of the internal homeostasis is modulated by the central autonomic system. So far, the view of this system is determined by animal and human research focusing on cortical and subcortical grey substance regions. To provide an overview based on white matter architecture, we used a global tractography approach to reconstruct a network of tracts interconnecting brain regions that are known to be involved in autonomic processing. Diffusion weighted imaging data were obtained from subjects of the human connectome project (HCP) database. Resulting tracts are in good agreement with previous studies assuming a division of the central autonomic system into a cortical (CAN) and a subcortical network (SAN): the CAN consist of three subsystems that encompass all cerebral lobes and overlap within the insular cortex: a parieto-anterior-temporal pathway (PATP), an occipito-posterior-temporo-frontal pathway (OPTFP) and a limbic pathway. The SAN on the other hand connects the hypothalamus to the periaqueductal grey and locus coeruleus, before it branches into a dorsal and a lateral part that target autonomic nuclei in the rostral medulla oblongata. Our approach furthermore reveals how the CAN and SAN are interconnected: the hypothalamus can be considered as the interface-structure of the SAN, whereas the insula is the central hub of the CAN. The hypothalamus receives input from prefrontal cortical fields but is also connected to the ventral apex of the insular cortex. Thus, a holistic view of the central autonomic system could be created that may promote the understanding of autonomic signaling under physiological and pathophysiological conditions.
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Affiliation(s)
- M Reisert
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Medical Physics, Freiburg University Medical Center, Freiburg, Germany
| | - C Weiller
- Clinic of Neurology and Neurophysiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - J A Hosp
- Clinic of Neurology and Neurophysiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
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20
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Wang YH, Wang ZM, Wei PH, Lu C, Fan XT, Ren LK, Shan YZ, Lu J, Zhao GG. Lateralizing the affected side of hippocampal sclerosis with quantitative high angular resolution diffusion scalars: a preliminary approach validated by diffusion spectrum imaging. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:297. [PMID: 33708924 PMCID: PMC7944293 DOI: 10.21037/atm-20-5719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Conflicts in regarding the lateralization of the seizure onset for mesial temporal lobe epilepsy (MTLE) are frequently encountered during presurgical evaluation. As a more elaborate, quantified protocol, indices of diffusion spectrum imaging (DSI) might be sensitive to evaluate the seizure involvement. However, the accuracy was less revealed. Herein, we determined the lateralizing value of the DSI indices among MTLE patients. Methods Eleven MTLE patients were enrolled together with 11 matched health contrasts. All the participants underwent a DSI scan and with reconstruction of the diffusion scalar, including quantitative anisotropy (QA), isotropic (ISO), and track density imaging (TDI) values. Statistics of these indices were applied to identify the differences between the healthy and ipsilateral sides, and those between the patients and the controls, with special attention to areas of the crura of fornix (FORX), the parahippocampal radiation of the cingulum (PHCR), the hippocampus (HP), parahippocampus (PHC), amygdala (AM) and entorhinal cortex (EC). Results Regarding lateralization, TDI of the FORX and the PHCR reached an AUC value of 0.95 and 0.93, respectively (P<0.05), and QA, ISO, TDI of the PHCR, as well as TDI of the FORX were statistically significant amongst the laterals of the patients (P<0.05). Also, the QA of the PHCR were statistically different in the patients' ipsilateral side relative to the contrasts (P<0.017). The diffusion level on different grey matter structures were significantly decreased including HP, AM and EC in GQI space (P<0.017). Conclusions The quantitative diffusion scalars of the DSI, especially TDI of the FORX and the PHCR, are sensitive indices to define the ipsilateral side for MTLE patients. For preliminary exploration, the use of quantitative DSI scalars may help to improve the seizure outcome by increasing the accuracy of localization and lateralization for MTLE.
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Affiliation(s)
- Yi-He Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhen-Ming Wang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peng-Hu Wei
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chao Lu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiao-Tong Fan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lian-Kun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yong-Zhi Shan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guo-Guang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorder, Beijing, China
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21
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Latini F, Trevisi G, Fahlström M, Jemstedt M, Alberius Munkhammar Å, Zetterling M, Hesselager G, Ryttlefors M. New Insights Into the Anatomy, Connectivity and Clinical Implications of the Middle Longitudinal Fasciculus. Front Neuroanat 2021; 14:610324. [PMID: 33584207 PMCID: PMC7878690 DOI: 10.3389/fnana.2020.610324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/30/2020] [Indexed: 12/01/2022] Open
Abstract
The middle longitudinal fascicle (MdLF) is a long, associative white matter tract connecting the superior temporal gyrus (STG) with the parietal and occipital lobe. Previous studies show different cortical terminations, and a possible segmentation pattern of the tract. In this study, we performed a post-mortem white matter dissection of 12 human hemispheres and an in vivo deterministic fiber tracking of 24 subjects acquired from the Human Connectome Project to establish whether a constant organization of fibers exists among the MdLF subcomponents and to acquire anatomical information on each subcomponent. Moreover, two clinical cases of brain tumors impinged on MdLF territories are reported to further discuss the anatomical results in light of previously published data on the functional involvement of this bundle. The main finding is that the MdLF is consistently organized into two layers: an antero-ventral segment (aMdLF) connecting the anterior STG (including temporal pole and planum polare) and the extrastriate lateral occipital cortex, and a posterior-dorsal segment (pMdLF) connecting the posterior STG, anterior transverse temporal gyrus and planum temporale with the superior parietal lobule and lateral occipital cortex. The anatomical connectivity pattern and quantitative differences between the MdLF subcomponents along with the clinical cases reported in this paper support the role of MdLF in high-order functions related to acoustic information. We suggest that pMdLF may contribute to the learning process associated with verbal-auditory stimuli, especially on left side, while aMdLF may play a role in processing/retrieving auditory information already consolidated within the temporal lobe.
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Affiliation(s)
- Francesco Latini
- Neurosurgical Unit, Department of Surgery, Ospedale Santo Spirito, Pescara, Italy
| | - Gianluca Trevisi
- Neurosurgical Unit, Department of Surgery, Ospedale Santo Spirito, Pescara, Italy
| | - Markus Fahlström
- Section of Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Malin Jemstedt
- Section of Speech-Language Pathology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | | | - Maria Zetterling
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Göran Hesselager
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Mats Ryttlefors
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden
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22
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Maldonado IL, Destrieux C, Ribas EC, Siqueira de Abreu Brito Guimarães B, Cruz PP, Duffau H. Composition and organization of the sagittal stratum in the human brain: a fiber dissection study. J Neurosurg 2021; 135:1214-1222. [PMID: 33418529 DOI: 10.3171/2020.7.jns192846] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 07/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The sagittal stratum is divided into two layers. In classic descriptions, the stratum sagittale internum corresponds to optic radiations (RADs), whereas the stratum sagittale externum corresponds to fibers of the inferior longitudinal fasciculus. Although advanced for the time it was proposed, this schematic organization seems simplistic considering the recent progress on the understanding of cerebral connectivity and needs to be updated. Therefore, the authors sought to investigate the composition of the sagittal stratum and to detail the anatomical relationships among the macroscopic fasciculi. METHODS The authors performed a layer-by-layer fiber dissection from the superolateral aspect to the ventricular cavity in 20 cadaveric human hemispheres. RESULTS Diverse bundles of white matter were observed to contribute to the sagittal stratum and their spatial arrangement was highly consistent from one individual to another. This was the case of the middle longitudinal fasciculus, the inferior fronto-occipital fasciculus, the RADs, and other posterior thalamic radiations directed to nonvisual areas of the cerebral cortex. In addition, small contributions to the sagittal stratum came from the anterior commissure anteriorly and the inferior longitudinal fasciculus inferiorly. CONCLUSIONS A general model of sagittal stratum organization in layers is possible, but the composition of the external layer is much more complex than is mentioned in classic descriptions. A small contribution of the inferior longitudinal fasciculus is the main difference between the present results and the classic descriptions in which this bundle was considered to entirely correspond to the stratum sagittale externum. This subject has important implications both for fundamental research and neurosurgery, as well as for the development of surgical approaches for the cerebral parenchyma and ventricular system.
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Affiliation(s)
- Igor Lima Maldonado
- 1UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,2CHRU de Tours, France.,3Le Studium Loire Valley Institute for Advanced Studies, Orléans, France
| | - Christophe Destrieux
- 1UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,2CHRU de Tours, France
| | - Eduardo Carvalhal Ribas
- 4Department of Neurology, Discipline of Neurosurgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | | | - Patrícia Pontes Cruz
- 6Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Brazil
| | - Hugues Duffau
- 7Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; and.,8INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, France
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23
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Pirone A, Graïc J, Grisan E, Cozzi B. The claustrum of the sheep and its connections to the visual cortex. J Anat 2021; 238:1-12. [PMID: 32885430 PMCID: PMC7755083 DOI: 10.1111/joa.13302] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 01/03/2023] Open
Abstract
The present study analyses the organization and selected neurochemical features of the claustrum and visual cortex of the sheep, based on the patterns of calcium-binding proteins expression. Connections of the claustrum with the visual cortex have been studied by tractography. Parvalbumin-immunoreactive (PV-ir) and Calbindin-immunoreactive (CB-ir) cell bodies increased along the rostro-caudal axis of the nucleus. Calretinin (CR)-labeled somata were few and evenly distributed along the rostro-caudal axis. PV and CB distribution in the visual cortex was characterized by larger round and multipolar cells for PV, and more bitufted neurons for CB. The staining pattern for PV was the opposite of that of CR, which showed densely stained but rare cell bodies. Tractography shows the existence of connections with the caudal visual cortex. However, we detected no contralateral projection in the visuo-claustral interconnections. Since sheep and goats have laterally placed eyes and a limited binocular vision, the absence of contralateral projections could be of prime importance if confirmed by other studies, to rule out the role of the claustrum in stereopsis.
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Affiliation(s)
- Andrea Pirone
- Department of Veterinary SciencesUniversity of PisaPisaItaly
| | - Jean‐Marie Graïc
- Department of Comparative Biomedicine and Food ScienceUniversity of PadovaLegnaroItaly
| | - Enrico Grisan
- Department of Information EngineeringUniversity of PadovaVicenzaItaly,School of EngineeringLondon South Bank UniversityLondonUK
| | - Bruno Cozzi
- Department of Comparative Biomedicine and Food ScienceUniversity of PadovaLegnaroItaly
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Tomasino B, Ius T, Skrap M, Luzzatti C. Phonological and surface dyslexia in individuals with brain tumors: Performance pre-, intra-, immediately post-surgery and at follow-up. Hum Brain Mapp 2020; 41:5015-5031. [PMID: 32857483 PMCID: PMC7643394 DOI: 10.1002/hbm.25176] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 11/29/2022] Open
Abstract
We address existing controversies regarding neuroanatomical substrates of reading-aloud processes according to the dual-route processing models, in this particular instance in a series of 49 individuals with brain tumors who performed several reading tasks of real-time neuropsychological testing during surgery (low- to high-grade cerebral neoplasms involving the left hemisphere). We explored how reading abilities in individuals with brain tumors evolve during and after surgery for a brain tumor, and we studied the reading performance in a sample of 33 individuals in a 4-month follow-up after surgery. Impaired reading performance was seen pre-surgery in 7 individuals with brain tumors, intra-surgery in 18 individuals, at immediate post-surgery testing in 26 individuals, and at follow-up in 5 individuals. We classified their reading disorders according to operational criteria for either phonological or surface dyslexia. Neuroimaging results are discussed within the theoretical framework of the dual-route model of reading. Lesion-mask subtraction analyses revealed that areas selectively related with phonological dyslexia were located-along with the left hemisphere dorsal stream-in the Rolandic operculum, the inferior frontal gyrus, the precentral gyrus, the supramarginal gyrus, the insula (and/or the underlying external capsule), and parts of the superior longitudinal fasciculus, whereas lesions related to surface dyslexia involved the ventral stream, that is, the left middle and inferior temporal gyrus and parts of the left inferior longitudinal fasciculus.
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Affiliation(s)
- Barbara Tomasino
- Scientific Institute, IRCCS "E. Medea,"San Vito al TagliamentoPordenoneItaly
| | - Tamara Ius
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della MisericordiaUdineItaly
| | - Miran Skrap
- Unità Operativa di Neurochirurgia, Azienda Sanitaria Universitaria Integrata S. Maria della MisericordiaUdineItaly
| | - Claudio Luzzatti
- Dipartimento di PsicologiaUniversità di Milano‐Bicocca and Milan Centre for NeuroscienceMilanItaly
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Baran O, Balak N, Baydin S, Aydin I, Kayhan A, Evran S, Kemerdere R, Tanriover N. Assessing the connectional anatomy of superior and lateral surgical approaches for medial temporal lobe epilepsy. J Clin Neurosci 2020; 81:378-389. [PMID: 33222947 DOI: 10.1016/j.jocn.2020.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/15/2020] [Accepted: 10/03/2020] [Indexed: 12/13/2022]
Abstract
The most common approaches in the treatment of epilepsy, the trans-sylvian selective amygdalohippocampectomy (SAH) and the anterior temporal lobe resection (ATLR) reach the medial temporal lobe through different surgical routes. Our aim was to delineate the white matter (WM) fiber tracts at risk in relation to trans-sylvian SAH and ATLR by defining each fascicle en route to medial temporal lobe during each approach. ATLR and trans-sylvian SAH were performedand related WM tracts en route to medial temporal region were presented in relation to the relevant approaches and surrounding neurovascular structures. The WM tracts most likely to be disrupted during trans-sylvian SAH along the roof of the temporal horn were the UF - and less commonly IFOF - at the layer of the external capsule, anterior commissure, anterior bend of optic radiations, and sublenticular internal capsule. Amygdaloid projections to the claustrum, putamen and globus pallidus, the tail of caudate and the peduncle of the lentiform nucleus were also in close proximity to the resection cavity. Fiber tracts most likely to be impaired during ATLR included the UF, ILF, IFOF, anterior commissure, optic radiations, and, less likely, the vertical ventral segment of the arcuate fascicle. Both ATLR and trans-sylvian SAH carry the risk of injury to WM pathways, which may result in unpredictable functional loss. A detailed 3-D knowledge of the related connectional anatomy will help subside neurocognitive, neuroophtalmologic, neurolinguistic complications of epilepsy surgery, providing an opportunity to tailor the surgery according to patient's unique connectional and functional anatomy.
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Affiliation(s)
- Oguz Baran
- Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey; Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey
| | - Naci Balak
- Istanbul Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Serhat Baydin
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey; Ondokuz Mayis University, Medical Faculty, Department of Neurosurgery, Samsun, Turkey
| | - Ilhan Aydin
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey; Medical Park Hospital, Neurosurgery Clinic, Istanbul, Turkey
| | - Ahmet Kayhan
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey; Haseki Research and Training Hospital, Neurosurgery Clinic, Istanbul, Turkey
| | - Sevket Evran
- Haseki Research and Training Hospital, Neurosurgery Clinic, Istanbul, Turkey
| | - Rahsan Kemerdere
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey
| | - Necmettin Tanriover
- Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Istanbul, Turkey; Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey.
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Luo C, Li M, Qin R, Chen H, Huang L, Yang D, Ye Q, Liu R, Xu Y, Zhao H, Bai F. Long Longitudinal Tract Lesion Contributes to the Progression of Alzheimer's Disease. Front Neurol 2020; 11:503235. [PMID: 33178095 PMCID: PMC7597387 DOI: 10.3389/fneur.2020.503235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The degenerative pattern of white matter (WM) microstructures during Alzheimer's disease (AD) and its relationship with cognitive function have not yet been clarified. The present research aimed to explore the alterations of the WM microstructure and its impact on amnestic mild cognitive (aMCI) and AD patients. Mechanical learning methods were used to explore the validity of WM microstructure lesions on the classification in AD spectrum disease. Methods: Neuropsychological data and diffusion tensor imaging (DTI) images were collected from 28 AD subjects, 31 aMCI subjects, and 27 normal controls (NC). Tract-based spatial statistics (TBSS) were used to extract diffusion parameters in WM tracts. We performed ANOVA analysis to compare diffusion parameters and clinical features among the three groups. Partial correlation analysis was used to explore the relationship between diffusion metrics and cognitive functions controlling for age, gender, and years of education. Additionally, we performed the support vector machine (SVM) classification to determine the discriminative ability of DTI metrics in the differentiation of aMCI and AD patients from controls. Results: As compared to controls or aMCI patients, AD patients displayed widespread WM lesions, including in the inferior longitudinal fasciculus, inferior fronto-occipital fasciculi, and superior longitudinal fasciculus. Significant correlations between fractional anisotropy (FA), mean diffusivity (MD), and radial diffusion (RD) of the long longitudinal tract and memory deficits were found in aMCI and AD groups, respectively. Furthermore, through SVM classification, we found DTI indicators generated by FA and MD parameters can effectively distinguish AD patients from the control group with accuracy rates of up to 89 and 85%, respectively. Conclusion: The WM microstructure is extensively disrupted in AD patients, and the WM integrity of the long longitudinal tract is closely related to memory, which would hold potential value for monitoring the progression of AD. The method of classification based on SVM and WM damage features may be objectively helpful to the classification of AD diseases.
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Affiliation(s)
- Caimei Luo
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Mengchun Li
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Ruomeng Qin
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Haifeng Chen
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Lili Huang
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Dan Yang
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Qing Ye
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Renyuan Liu
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yun Xu
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Hui Zhao
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Feng Bai
- The State Key Laboratory of Pharmaceutical Biotechnology, Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Institute of Brain Science, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
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Vanacôr CN, Isolan GR, Yu YH, Telles JPM, Oberman DZ, Rabelo NN, Figueiredo EG. Microsurgical anatomy of language. Clin Anat 2020; 34:154-168. [PMID: 32918507 DOI: 10.1002/ca.23681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/21/2020] [Accepted: 09/05/2020] [Indexed: 11/09/2022]
Abstract
The localizationist model, which focused on classical cortical areas such as Broca's and Wernicke's, can no longer explain how language processing works. Over recent years, several studies have revealed new language-related cortical and subcortical areas, resulting in a transition from localizationist concepts to a hodotopical model. These studies have described language processing as an extensive and complex network of multiple interconnected cortical areas and subcortical pathways, differing from the classical circuit described by the localizationist perspective. The hodotopical model was made possible by a paradigm shift in the treatment of cerebral tumors, especially low-grade gliomas: total or subtotal tumor resections with cortical and subcortical mapping on awake patients have become the gold standard treatment for lesions located in the dominant hemisphere. In this article, we review current understating of the microsurgical anatomy of language.
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Affiliation(s)
- Clarissa Nunes Vanacôr
- Postgraduate Program in Medicine - Surgical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,CEANNE (Centro Avançado de Neurologia e Neurocirurgia), Porto Alegre, Brazil.,Moinhos De Vento Hospital, Porto Alegre, Brazil
| | - Gustavo Rassier Isolan
- Postgraduate Program in Medicine - Surgical Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,CEANNE (Centro Avançado de Neurologia e Neurocirurgia), Porto Alegre, Brazil
| | - Yang Han Yu
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - João Paulo Mota Telles
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Nícollas Nunes Rabelo
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Eberval Gadelha Figueiredo
- Division of Neurosurgery, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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The ansa peduncularis in the human brain: A tractography and fiber dissection study. Brain Res 2020; 1746:146978. [PMID: 32535175 DOI: 10.1016/j.brainres.2020.146978] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The ansa peduncularis is a composite of white matter fiber bundles closely packed together that sweeps around the cerebral peduncle. The exact components of the ansa peduncularis and their anatomical trajectories are still not established firmly in the literature. OBJECTIVE The aim of this study was to examine the topographical anatomy of the ansa peduncularis and its subcomponents using the fiber dissection and tractography techniques. METHODS Ten formalin-fixed brains were prepared according to Klingler's method and dissected by the fiber dissection technique from the lateral, medial and inferior surfaces. The ansa peduncularis was also traced using high definition fiber tracking (HDFT) from the MRI data of twenty healthy adults and a 1021-subject template from the Human Connectome Project. RESULTS The ventral amygdalofugal pathway system includes white matter fiber bundles with a topographically close relation as they sweep around the cerebral peduncle and contribute to form the ansa peduncularis: amygdaloseptal fibers connect the amygdala and anterior temporal cortex to the septal region and amygdalohypothalamic fibers project from the amygdala to the hypothalamus. Additionally, from the amygdala and anterior temporal cortex, amygdalothalamic fibers project to the medial thalamic region. The ansa lenticularis, which connects the globus pallidus to the thalamus, was not shown in our study. CONCLUSION The study demonstrated the trajectory of the ansa peduncularis and its subcomponents, based on fiber dissection and tractography, improving our understanding of human brain anatomical connectivity.
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Maldonado IL, Parente de Matos V, Castro Cuesta TA, Herbet G, Destrieux C. The human cingulum: From the limbic tract to the connectionist paradigm. Neuropsychologia 2020; 144:107487. [PMID: 32470344 DOI: 10.1016/j.neuropsychologia.2020.107487] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/22/2020] [Accepted: 05/04/2020] [Indexed: 12/21/2022]
Abstract
The cingulum is a core component of the limbic lobe and part of the circuit that was described by Papez where environmental experiences become endowed with emotional awareness. Recent techniques for the study of cerebral connectivity have updated this fasciculus' morphology and led to the acknowledgment that its involvement in superior functions goes far beyond emotion processing. Long and robust, the cingulum is a long association fasciculus with terminations in all cerebral lobes. These observations plead for a pivotal rethinking of its role in the human brain and lead to the conclusion that to merely consider it as the main fasciculus of the limbic system was actually a reductionism. This paper summarizes the key facts regarding why the cingulum is now perceived as a primary interconnecting apparatus in the medial aspect of the cerebral hemisphere.
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Affiliation(s)
- Igor Lima Maldonado
- UMR Inserm U1253, IBrain, Université de Tours, Tours, France; Le Studium Loire Valley Institute for Advanced Studies, Orleans, France; CHRU de Tours, Tours, France; Departamento de Biomorfologia - Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; Programa de Pós-Graduação Em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil.
| | | | - Taryn Ariadna Castro Cuesta
- Programa de Pós-Graduação Em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; University of Montpellier, Institute of Functional Genomics, INSERM, 1191, Montpellier, France
| | - Christophe Destrieux
- UMR Inserm U1253, IBrain, Université de Tours, Tours, France; CHRU de Tours, Tours, France; Laboratory of Anatomy, Faculté de Médecine, 10 Bd Tonnellé, 37032, Tours, France
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Dauleac C, Frindel C, Mertens P, Jacquesson T, Cotton F. Overcoming challenges of the human spinal cord tractography for routine clinical use: a review. Neuroradiology 2020; 62:1079-1094. [DOI: 10.1007/s00234-020-02442-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/16/2020] [Indexed: 02/06/2023]
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31
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Vanderweyen DC, Theaud G, Sidhu J, Rheault F, Sarubbo S, Descoteaux M, Fortin D. The role of diffusion tractography in refining glial tumor resection. Brain Struct Funct 2020; 225:1413-1436. [PMID: 32180019 DOI: 10.1007/s00429-020-02056-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/28/2020] [Indexed: 12/14/2022]
Abstract
Primary brain tumors are notoriously hard to resect surgically. Due to their infiltrative nature, finding the optimal resection boundary without damaging healthy tissue can be challenging. One potential tool to help make this decision is diffusion-weighted magnetic resonance imaging (dMRI) tractography. dMRI exploits the diffusion of water molecule along axons to generate a 3D modelization of the white matter bundles in the brain. This feature is particularly useful to visualize how a tumor affects its surrounding white matter and plan a surgical path. This paper reviews the different ways in which dMRI can be used to improve brain tumor resection, its benefits and also its limitations. We expose surgical tools that can be paired with dMRI to improve its impact on surgical outcome, such as loading the 3D tractography in the neuronavigation system and direct electrical stimulation to validate the position of the white matter bundles of interest. We also review articles validating dMRI findings using other anatomical investigation techniques, such as postmortem dissections, manganese-enhanced MRI, electrophysiological stimulations, and phantom studies with known ground truth. We will be discussing the areas of the brain where dMRI performs well and where the future challenges are. We will conclude this review with suggestions and take home messages for neurosurgeons, tractographers, and vendors for advancing the field and on how to benefit from tractography's use in clinical practice.
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Affiliation(s)
- Davy Charles Vanderweyen
- Department of Surgery, Division of Neurosurgery, Faculty of Medicine, University of Sherbrooke, 3001 12 Ave N, Sherbrooke, QC, J1H 5H3, Canada.
| | - Guillaume Theaud
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, University of Sherbrooke, 2500 Boulevard Université, Sherbrooke, QC, J1K2R1, Canada
| | - Jasmeen Sidhu
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, University of Sherbrooke, 2500 Boulevard Université, Sherbrooke, QC, J1K2R1, Canada
| | - François Rheault
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, University of Sherbrooke, 2500 Boulevard Université, Sherbrooke, QC, J1K2R1, Canada
| | - Silvio Sarubbo
- Division of Neurosurgery, Emergency Area, Structural and Functional Connectivity Lab Project, "S. Chiara" Hospital, Azienda Provinciale Per I Servizi Sanitari (APSS), Trento, Italy
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab (SCIL), Computer Science Department, University of Sherbrooke, 2500 Boulevard Université, Sherbrooke, QC, J1K2R1, Canada
| | - David Fortin
- Department of Surgery, Division of Neurosurgery, Faculty of Medicine, University of Sherbrooke, 3001 12 Ave N, Sherbrooke, QC, J1H 5H3, Canada
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Latini F, Ryttlefors M. Teaching Anatomy to Neuroscientific Health-Care Professionals: Are They Receiving the Best Anatomical Education? MEDICAL SCIENCE EDUCATOR 2020; 30:41-45. [PMID: 34457634 PMCID: PMC8368751 DOI: 10.1007/s40670-019-00838-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
University neuroanatomical courses seldom teach the anatomical-functional connectivity of the brain. White matter dissection improves understanding of brain connectivity, but until now has been restricted to neurosurgeons and in some cases to medical students, never to health-care non-medical professionals. Our aim was to teach white matter anatomy to medical and non-medical students to evaluate this technique in groups with different education. A standardized lab demonstration of white matter anatomy was performed with high appreciation rate in both groups, suggesting a suboptimal neuroanatomical education provided by basic course. We encourage to include this technique of teaching brain anatomy into basic neuroanatomical courses to improve the level of comprehension and competence in all health-care staff within the field of neuroscience.
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Affiliation(s)
- Francesco Latini
- Department of Neuroscience, Neurosurgery, Uppsala University, S-751 85 Uppsala, Sweden
| | - Mats Ryttlefors
- Department of Neuroscience, Neurosurgery, Uppsala University, S-751 85 Uppsala, Sweden
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Zhang F, Noh T, Juvekar P, Frisken SF, Rigolo L, Norton I, Kapur T, Pujol S, Wells W, Yarmarkovich A, Kindlmann G, Wassermann D, San Jose Estepar R, Rathi Y, Kikinis R, Johnson HJ, Westin CF, Pieper S, Golby AJ, O’Donnell LJ. SlicerDMRI: Diffusion MRI and Tractography Research Software for Brain Cancer Surgery Planning and Visualization. JCO Clin Cancer Inform 2020; 4:299-309. [PMID: 32216636 PMCID: PMC7113081 DOI: 10.1200/cci.19.00141] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/27/2022] Open
Abstract
PURPOSE We present SlicerDMRI, an open-source software suite that enables research using diffusion magnetic resonance imaging (dMRI), the only modality that can map the white matter connections of the living human brain. SlicerDMRI enables analysis and visualization of dMRI data and is aimed at the needs of clinical research users. SlicerDMRI is built upon and deeply integrated with 3D Slicer, a National Institutes of Health-supported open-source platform for medical image informatics, image processing, and three-dimensional visualization. Integration with 3D Slicer provides many features of interest to cancer researchers, such as real-time integration with neuronavigation equipment, intraoperative imaging modalities, and multimodal data fusion. One key application of SlicerDMRI is in neurosurgery research, where brain mapping using dMRI can provide patient-specific maps of critical brain connections as well as insight into the tissue microstructure that surrounds brain tumors. PATIENTS AND METHODS In this article, we focus on a demonstration of SlicerDMRI as an informatics tool to enable end-to-end dMRI analyses in two retrospective imaging data sets from patients with high-grade glioma. Analyses demonstrated here include conventional diffusion tensor analysis, advanced multifiber tractography, automated identification of critical fiber tracts, and integration of multimodal imagery with dMRI. RESULTS We illustrate the ability of SlicerDMRI to perform both conventional and advanced dMRI analyses as well as to enable multimodal image analysis and visualization. We provide an overview of the clinical rationale for each analysis along with pointers to the SlicerDMRI tools used in each. CONCLUSION SlicerDMRI provides open-source and clinician-accessible research software tools for dMRI analysis. SlicerDMRI is available for easy automated installation through the 3D Slicer Extension Manager.
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Affiliation(s)
- Fan Zhang
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Thomas Noh
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | - Sarah F. Frisken
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Laura Rigolo
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Isaiah Norton
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Tina Kapur
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Sonia Pujol
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - William Wells
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- Massachusetts Institute of Technology, Boston, MA
| | | | | | - Demian Wassermann
- Parietal, Inria Saclay-lle de France, Neurospin CEA, Université Paris-Saclay, Palaiseau, France
| | | | - Yogesh Rathi
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Ron Kikinis
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- University of Bremen and Fraunhofer MEVIS, Bremen, Germany
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Zhang Y, Vakhtin AA, Jennings JS, Massaband P, Wintermark M, Craig PL, Ashford JW, Clark JD, Furst AJ. Diffusion tensor tractography of brainstem fibers and its application in pain. PLoS One 2020; 15:e0213952. [PMID: 32069284 PMCID: PMC7028272 DOI: 10.1371/journal.pone.0213952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/02/2020] [Indexed: 12/13/2022] Open
Abstract
Evaluation of brainstem pathways with diffusion tensor imaging (DTI) and tractography may provide insights into pathophysiologies associated with dysfunction of key brainstem circuits. However, identification of these tracts has been elusive, with relatively few in vivo human studies to date. In this paper we proposed an automated approach for reconstructing nine brainstem fiber trajectories of pathways that might be involved in pain modulation. We first performed native-space manual tractography of these fiber tracts in a small normative cohort of participants and confirmed the anatomical precision of the results using existing anatomical literature. Second, region-of-interest pairs were manually defined at each extracted fiber’s termini and nonlinearly warped to a standard anatomical brain template to create an atlas of the region-of-interest pairs. The resulting atlas was then transformed non-linearly into the native space of 17 veteran patients’ brains for automated brainstem tractography. Lastly, we assessed the relationships between the integrity levels of the obtained fiber bundles and pain severity levels. Fractional anisotropy (FA) measures derived using automated tractography reflected the respective tracts’ FA levels obtained via manual tractography. A significant inverse relationship between FA and pain levels was detected within the automatically derived dorsal and medial longitudinal fasciculi of the brainstem. This study demonstrates the feasibility of DTI in exploring brainstem circuitries involved in pain processing. In this context, the described automated approach is a viable alternative to the time-consuming manual tractography. The physiological and functional relevance of the measures derived from automated tractography is evidenced by their relationships with individual pain severities.
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Affiliation(s)
- Yu Zhang
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- * E-mail:
| | - Andrei A. Vakhtin
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - Jennifer S. Jennings
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Payam Massaband
- Radiology, VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - Max Wintermark
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
- Neuroradiology at Stanford University, Stanford, California, United States of America
| | - Patricia L. Craig
- Radiology, VA Palo Alto Health Care System, Palo Alto, California, United States of America
| | - J. Wesson Ashford
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
| | - J. David Clark
- Pain Clinic, VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, United States of America
| | - Ansgar J. Furst
- War Related Illness and Injury Study Center (WRIISC), VA Palo Alto Health Care System, Palo Alto, California, United States of America
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, United States of America
- Neurology and Neurological Sciences, Stanford University, Stanford, California, United States of America
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Pescatori L, Tropeano MP, Ciappetta P. The ipsilateral interhemispheric transprecuneal approach: microsurgical anatomy, indications, and neurosurgical applications. Neurosurg Rev 2020; 44:529-541. [PMID: 32036503 DOI: 10.1007/s10143-020-01244-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/17/2019] [Accepted: 01/15/2020] [Indexed: 11/25/2022]
Abstract
Surgical treatment of intraventricular lesions is challenging because of their deep location, vascularization, and their complex relationships with white matter fibers. The authors undertook this study to describe the microsurgical anatomy of the white matter fibers covering the lateral wall of the atrium and temporal horn and to demonstrate how the ipsilateral interhemispheric transprecuneal approach can be safely used to remove lesions of this region sparing the anatomo-functional integrity of the fibers themselves. A detailed description of the approach including operative measurements is also given. The Klingler' technique with progressive identification of white matter fibers covering the lateral wall of the atrium and temporal horn was performed on ten formalin-fixed human hemispheres. Then, ten fresh, non-formalin-fixed non-silicon-injected adult cadaveric heads were analyzed for the simulation of the ipsilateral interhemispheric transprecuneal approach. Three illustrative cases are presented. The simulation of the interhemispheric transprecuneal approach on ten fresh non-formalin-fixed specimens showed that a 10 to 20 mm corticotomy perpendicular to the parieto-occipital sulcus at the junction with the cingulum allows a wide corridor for the exposure of the entire atrial cavity and the posterior third of the temporal horn. The ipsilateral interhemispheric transprecuneus approach represents a safe and effective option for tumors involving the atrium and the posterior third of the temporal horn.
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Affiliation(s)
- Lorenzo Pescatori
- Ca'Foncello Hospital, Treviso, Veneto, Italy.,La Sapienza University of Rome, Rome, Italy
| | - Maria Pia Tropeano
- Humanitas Clinical and Research Hospital & Humanitas University, Viale Alessandro Manzoni, 56, Rozzano, Milan, Italy.
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Chen HF, Huang LL, Li HY, Qian Y, Yang D, Qing Z, Luo CM, Li MC, Zhang B, Xu Y. Microstructural disruption of the right inferior fronto-occipital and inferior longitudinal fasciculus contributes to WMH-related cognitive impairment. CNS Neurosci Ther 2020; 26:576-588. [PMID: 31901155 PMCID: PMC7163793 DOI: 10.1111/cns.13283] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/07/2019] [Accepted: 12/12/2019] [Indexed: 01/03/2023] Open
Abstract
Aims White matter hyperintensity (WMH) is the most common neuroimaging manifestation of cerebral small vessel disease and is related to cognitive dysfunction or dementia. This study aimed to investigate the mechanism and effective indicators to predict WMH‐related cognitive impairment. Methods We recruited 22 healthy controls (HC), 25 cases of WMH with normal cognition (WMH‐NC), and 23 cases of WMH with mild cognitive impairment (WMH‐MCI). All individuals underwent diffusion tensor imaging (DTI) and a standardized neuropsychological assessment. Automated Fiber Quantification was used to extract altered DTI metrics between groups, and partial correlation was performed to assess the associations between WM integrity and cognitive performance. Furthermore, machine learning analyses were performed to determine underlying imaging markers of WMH‐related cognitive impairment. Results Our study found that mean diffusivity (MD) values of several fiber bundles including the bilateral anterior thalamic radiation (ATR), the left inferior fronto‐occipital fasciculus (IFOF), the right inferior longitudinal fasciculus (ILF), and the right superior longitudinal fasciculus (SLF) were negatively correlated with memory function, while that of the anterior component of the right IFOF and the posterior and intermediate component of the right ILF showed significant negative correlation with MMSE and episodic memory, respectively. Furthermore, machine learning analyses showed that the accuracy of recognizing WMH‐MCI patients from the WMH populations was up to 80.5% and the intermediate and posterior components of the right ILF and the anterior component of the right IFOF contribute the most. Conclusions Changes in the properties of DTI may be the potential mechanism of WMH‐related MCI, especially the right IFOF and the right ILF, which may become imaging markers for predicting WMH‐related cognitive dysfunction.
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Affiliation(s)
- Hai-Feng Chen
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Li-Li Huang
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Hui-Ya Li
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Yi Qian
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Dan Yang
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Zhao Qing
- Department of Radiology, Afliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Cai-Mei Luo
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Meng-Chun Li
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
| | - Bing Zhang
- Department of Radiology, Afliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Xu
- Department of Neurology, Medical School and The State Key Laboratory of Pharmaceutical Biotechnology, Institute of Brain Science, Drum Tower Hospital, Nanjing University, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Medical School of Nanjing University, Nanjing, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Clinic Medical Center for Neurology, Nanjing, China
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Welton T, Indja BE, Maller JJ, Fanning JP, Vallely MP, Grieve SM. Replicable brain signatures of emotional bias and memory based on diffusion kurtosis imaging of white matter tracts. Hum Brain Mapp 2019; 41:1274-1285. [PMID: 31773802 PMCID: PMC7268065 DOI: 10.1002/hbm.24874] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 12/31/2022] Open
Abstract
Diffusion MRI (dMRI) is sensitive to anisotropic diffusion within bundles of nerve axons and can be used to make objective measurements of brain networks. Many brain disorders are now recognised as being caused by network dysfunction or are secondarily associated with changes in networks. There is therefore great potential in using dMRI measures that reflect network integrity as a future clinical tool to help manage these conditions. Here, we used dMRI to identify replicable, robust and objective markers that meaningfully reflect cognitive and emotional performance. Using diffusion kurtosis analysis and a battery of cognitive and emotional tests, we demonstrated strong relationships between white matter structure across networks of anatomically and functionally specific brain regions with both emotional bias and emotional memory performance in a large healthy cohort. When the connectivity of these regions was examined using diffusion tractography, the terminations of the identified tracts overlapped precisely with cortical loci relating to these domains, drawn from an independent spatial meta‐analysis of available functional neuroimaging literature. The association with emotional bias was then replicated using an independently acquired healthy cohort drawn from the Human Connectome Project. These results demonstrate that, even in healthy individuals, white matter dMRI structural features underpin important cognitive and emotional functions. Our robust cross‐correlation and replication supports the potential of structural brain biomarkers from diffusion kurtosis MRI to characterise early neurological changes and risk in individuals with a reduced threshold for cognitive dysfunction, with further testing required to demonstrate clinical utility.
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Affiliation(s)
- Thomas Welton
- Sydney Translational Imaging Laboratory, Heart Research Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ben E Indja
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Jerome J Maller
- Sydney Translational Imaging Laboratory, Heart Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.,GE Healthcare, Richmond, Victoria, Australia
| | - Jonathon P Fanning
- Faculty of Medicine, The University of Queensland, Brisbane, New South Wales, Australia.,The Critical Care Research Group, The Prince Charles Hospital, Brisbane, New South Wales, Australia
| | - Michael P Vallely
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia.,Department of Cardiothoracic Surgery, The Northern Beaches Hospital, Sydney, New South Wales, Australia
| | - Stuart M Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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38
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Matsushima T, Matsushima K, Kobayashi S, Lister JR, Morcos JJ. The microneurosurgical anatomy legacy of Albert L. Rhoton Jr., MD: an analysis of transition and evolution over 50 years. J Neurosurg 2019; 129:1331-1341. [PMID: 29393756 DOI: 10.3171/2017.7.jns17517] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 07/13/2017] [Indexed: 11/06/2022]
Abstract
The authors chronologically categorized the 160 original articles written by Dr. Rhoton and his fellows to show why they selected their themes and how they carried out their projects. The authors note that as neurosurgery progresses and new techniques and approaches are developed, accurate and safe treatment will depend upon continued clarification of microsurgical anatomy.
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Affiliation(s)
- Toshio Matsushima
- 1International University of Health and Welfare.,2Neuroscience Center, Fukuoka Sanno Hospital, Fukuoka
| | - Ken Matsushima
- 3Department of Neurosurgery, Tokyo Medical University, Tokyo
| | - Shigeaki Kobayashi
- 4Medical Research and Education Center, Aizawa Hospital, Matsumoto, Japan
| | - J Richard Lister
- 5Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville; and
| | - Jacques J Morcos
- 6Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Alterations in the Structural and Functional Connectivity of the Visuomotor Network of Children With Periventricular Leukomalacia. Semin Pediatr Neurol 2019; 31:48-56. [PMID: 31548024 PMCID: PMC6761984 DOI: 10.1016/j.spen.2019.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Children born preterm with periventricular leukomalacia (PVL) demonstrate increased difficulties with tasks requiring visuomotor integration. The visuomotor integration network encompasses brain regions within frontal, parietal, and occipital cortices. Because of their proximity to the lateral ventricle the underlying white matter pathways are at a high risk of damage following PVL-related hypoxic-ischemic white matter injury. This study provides an exploratory analysis of the structural and functional connections within the visuomotor integration network, along with an a priori evaluation of the superior longitudinal fasciculus, inferior fronto-occipital fasciculus, and frontal aslant tract. For each pathway, tracts within both hemispheres revealed decreased volume and number of reconstructed fibers and an increase in quantitative anisotropy and generalized fractional anisotropy. The connectivity results also indicate that there may be changes to both the structural integrity and functional integration of neural networks involved with visuomotor integration functions in children with PVL.
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40
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Associative white matter connecting the dorsal and ventral posterior human cortex. Brain Struct Funct 2019; 224:2631-2660. [DOI: 10.1007/s00429-019-01907-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 06/07/2019] [Indexed: 02/05/2023]
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41
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Ansado J, Blunt A, Chen JK, Koski L, Ptito A. Impact of non-invasive brain stimulation on transcallosal modulation in mild traumatic brain injury: a multimodal pilot investigation. Brain Inj 2019; 33:1021-1031. [DOI: 10.1080/02699052.2019.1605620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jennyfer Ansado
- Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Aaron Blunt
- Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Jen-Kai Chen
- Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Lisa Koski
- Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Alain Ptito
- Cognitive Neuroscience Unit, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Department of Psychology, McGill University Health Centre, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
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Jin Z, Bao Y, Wang Y, Li Z, Zheng X, Long S, Wang Y. Differences between generalized Q-sampling imaging and diffusion tensor imaging in visualization of crossing neural fibers in the brain. Surg Radiol Anat 2019; 41:1019-1028. [PMID: 31144009 PMCID: PMC6694094 DOI: 10.1007/s00276-019-02264-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 05/22/2019] [Indexed: 12/03/2022]
Abstract
Purpose The aim of this study was to discuss the advantages of GQI reconstruction in the imaging of nerve fibers at crossing regions. Compared with DTI, the paper also discussed the advantages of GQI in imaging principles. Methods 3-T MRI data from five normal participants were reconstructed using GQI and DTI. After adjusting the parameters, we compared the differences in reconstructed nerve fibers at the crossing regions between the two methods. To complete this study, we chose four obvious examples (the optic nerve, the Superior cerebellar peduncles, the intersection of the pyramidal tract, the corpus callosum and the arcuate fibers and the intersection of the supplementary motor area (SMA) and the anterior part of arcuate fasciculus) to illustrate. Results By reconstructing nerve fibers in three regions, we can find that crossing-area images of nerve fibers significantly differed between DTI and GQI reconstruction. Although crossing fibers could be clearly and completely visualized after GQI reconstruction, they showed artifacts, incompleteness, deletions, and fractures after DTI reconstruction. After GQI reconstruction, we can find that there were two or more nerve fibers in each voxel. However, only one nerve fiber was present in each voxel after DTI reconstruction. Conclusion The imaging of crossing fibers is more complete, consistent, and accurate when they are reconstructed by GQI than when they are reconstructed by DTI.
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Affiliation(s)
- Zhuoru Jin
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China
| | - Yue Bao
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China
| | - Yong Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China
| | - Zhipeng Li
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China
| | - Xiaomeng Zheng
- Department of Neurosurgery, University of Birmingham, Edgbaston Street, Birmingham, UK
| | - Shengrong Long
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China
| | - Yibao Wang
- Department of Neurosurgery, The First Affiliated Hospital of China Medical University, No. 155, North Nanjing Street, Heping District, Shenyang, 110001, Liaoning, P. R. China.
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Bernard F, Zemmoura I, Ter Minassian A, Lemée JM, Menei P. Anatomical variability of the arcuate fasciculus: a systematical review. Surg Radiol Anat 2019; 41:889-900. [PMID: 31028450 DOI: 10.1007/s00276-019-02244-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/17/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE The arcuate fasciculus (AF) is a white matter fibers tract that links the lateral temporal with the frontal cortex. The AF can be divided into three components: two superficial indirect short tracts (anterior and posterior) and one deep direct long tract. Both DTI and white matter dissections studies find differences regarding the anatomy of the AF, especially its cortical connections. This paper aims at providing a comprehensive anatomical classification of the AF, using the terminologia anatomica. METHODS Articles (n = 478) were obtained from a systematical PRISMA review. Studies which focused on primates, unhealthy subjects, as well as studies without cortical termination description and review articles were excluded from the analysis. One hundred and ten articles were retained for full-text examination, of which 19 finally fulfilled our criteria to be included in this review. RESULTS We classified main descriptions and variations of each segment of the AF according to fiber orientation and cortical connections. Three types of connections were depicted for each segment of the AF. Concerning the anterior segment, most of the frontal fibers (59.35%) ran from the ventral portion of the precentral gyrus and the posterior part of the pars opercularis, to the supramarginal gyrus (85.0%). Main fibers of the posterior segment of the AF ran from the posterior portion of the middle temporal gyrus (100%) to the angular gyrus (92.0%). In main descriptions of the long segment of the AF, fibers ran from both the ventral portion of the precentral gyrus and posterior part of the pars opercularis (63.9%) to the middle and inferior temporal gyrus (60.3%). Minor subtypes were described in detail in the article. CONCLUSION We provide a comprehensive classification of the anatomy of the AF, regarding the orientation and cortical connections of its fibers. Although fiber orientation is very consistent, cortical endings of the AF may be different from one study to another, or from one individual to another which is a key element to understand the anatomical basis of current models of language or to guide intraoperative stimulation during awake surgery.
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Affiliation(s)
- Florian Bernard
- , Department of Neurosurgery, Teaching Hospital, 49100, Angers, France. .,Laboratory of Anatomy, Medical Faculty, 28 rue Roger Amsler, 49100, Angers, France.
| | - Ilyess Zemmoura
- Department of Neurosurgery, CHRU de Tours, Tours, France.,UMR1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Aram Ter Minassian
- Department of Reanimation, Teaching Hospital, 49100, Angers, France.,INSERM, 1066 Department and EA7315 Team, Angers, France
| | - Jean-Michel Lemée
- , Department of Neurosurgery, Teaching Hospital, 49100, Angers, France.,CRCINA, UMR 1232 INSERM/CNRS and EA7315 Team, Angers, France
| | - Philippe Menei
- , Department of Neurosurgery, Teaching Hospital, 49100, Angers, France.,CRCINA, UMR 1232 INSERM/CNRS and EA7315 Team, Angers, France
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Jacquesson T, Yeh FC, Panesar S, Barrios J, Attyé A, Frindel C, Cotton F, Gardner P, Jouanneau E, Fernandez-Miranda JC. Full tractography for detecting the position of cranial nerves in preoperative planning for skull base surgery: technical note. J Neurosurg 2019; 132:1642-1652. [PMID: 31003214 DOI: 10.3171/2019.1.jns182638] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/28/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Diffusion imaging tractography has allowed the in vivo description of brain white matter. One of its applications is preoperative planning for brain tumor resection. Due to a limited spatial and angular resolution, it is difficult for fiber tracking to delineate fiber crossing areas and small-scale structures, in particular brainstem tracts and cranial nerves. New methods are being developed but these involve extensive multistep tractography pipelines including the patient-specific design of multiple regions of interest (ROIs). The authors propose a new practical full tractography method that could be implemented in routine presurgical planning for skull base surgery. METHODS A Philips MRI machine provided diffusion-weighted and anatomical sequences for 2 healthy volunteers and 2 skull base tumor patients. Tractography of the full brainstem, the cerebellum, and cranial nerves was performed using the software DSI Studio, generalized-q-sampling reconstruction, orientation distribution function (ODF) of fibers, and a quantitative anisotropy-based generalized deterministic algorithm. No ROI or extensive manual filtering of spurious fibers was used. Tractography rendering was displayed in a tridimensional space with directional color code. This approach was also tested on diffusion data from the Human Connectome Project (HCP) database. RESULTS The brainstem, the cerebellum, and the cisternal segments of most cranial nerves were depicted in all participants. In cases of skull base tumors, the tridimensional rendering permitted the visualization of the whole anatomical environment and cranial nerve displacement, thus helping the surgical strategy. CONCLUSIONS As opposed to classical ROI-based methods, this novel full tractography approach could enable routine enhanced surgical planning or brain imaging for skull base tumors.
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Affiliation(s)
- Timothee Jacquesson
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.,2Skull Base Multi-Disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon.,3CREATIS Laboratory CNRS UMR5220, Inserm U1206, INSA-Lyon, University of Lyon 1
| | - Fang-Chang Yeh
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sandip Panesar
- 4Department of Neurosurgery, Stanford University Medical Center, Stanford, California
| | - Jessica Barrios
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Arnaud Attyé
- 5Department of Neuroradiology and MRI, Grenoble University Hospital, Grenoble, France; and
| | - Carole Frindel
- 3CREATIS Laboratory CNRS UMR5220, Inserm U1206, INSA-Lyon, University of Lyon 1
| | - Francois Cotton
- 3CREATIS Laboratory CNRS UMR5220, Inserm U1206, INSA-Lyon, University of Lyon 1.,6Department of Radiology, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon
| | - Paul Gardner
- 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Emmanuel Jouanneau
- 2Skull Base Multi-Disciplinary Unit, Department of Neurosurgery B, Neurological Hospital Pierre Wertheimer, Hospices Civils de Lyon
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45
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Sledge runner fasciculus: anatomic architecture and tractographic morphology. Brain Struct Funct 2019; 224:1051-1066. [DOI: 10.1007/s00429-018-01822-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022]
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Structure, asymmetry, and connectivity of the human temporo-parietal aslant and vertical occipital fasciculi. Brain Struct Funct 2018; 224:907-923. [PMID: 30542766 DOI: 10.1007/s00429-018-1812-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
We previously proposed a bipartite 'dorsal-ventral' model of human arcuate fasciculus (AF) morphology. This model does not, however, account for the 'vertical,' temporo-parietal subdivision of the AF described in earlier dissection and tractographic studies. In an effort to address the absence of the vertical AF (VAF) within 'dorsal-ventral' nomenclature, we conducted a dedicated tractographic and white-matter dissection study of this tract and another short, vertical, posterior-hemispheric fascicle: the vertical occipital fasciculus (VOF). We conducted atlas-based, non-tensor, deterministic tractography in 30 single subjects from the Human Connectome Project database and verified our results using an average diffusion atlas compiled from 842 separate normal subjects. We also performed white-matter dissection in four post-mortem specimens. Our tractography results demonstrate that the VAF is, in fact, a bipartite system connecting the ventral parietal and temporal regions, with variable connective, and no volumetric lateralization. The VOF is a non-lateralized, non-segmented system connecting lateral occipital areas with basal-temporal regions. Importantly, the VOF was spatially dissociated from the VAF. As the VAF demonstrates no overall connective or volumetric lateralization, we postulate its distinction from the AF system and propose its re-naming to the 'temporo-parietal aslant tract,' (TPAT), with unique dorsal and ventral subdivisions. Our tractography results were supported by diffusion atlas and white-matter dissection findings.
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Tokida H, Takeshima S, Takeshita J, Shimoe Y, Yamori S, Kuriyama M. [A case of various illusion, and hallucination caused by occipital lobe infarction]. Rinsho Shinkeigaku 2018; 58:556-559. [PMID: 30175805 DOI: 10.5692/clinicalneurol.cn-001081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 70-year-old right-handed man noticed that the right side of the screen on his television displayed a time lag compared to the other side. For five days before admission, he had characteristic polyopia, visual photopia, and complex hallucination. Upon neurological examination, he showed no abnormal findings except for right homonymous hemianopia. MRI showed acute infarction of the occipital gyri and part of the lingual gyrus in the left occipital lobe. After admission, he experienced various visual hallucinations and visual illusions, including metamorphopsia and micropia, many times. They gradually disappeared after 2 months. Various hallucination was caused by the release of visual information, and illusion was thought to be due to integration failure of visual information. The appearance of complex hallucination in the blind visual field is known due to the damage of the region on the left occipital gyrus. However, the cases with various symptoms such as visual photopia and micropsia are rare.
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Affiliation(s)
- Haruki Tokida
- Department of Rehabilitation, Brain Attack Center, Ota Memorial Hospital.,Present address: Department of Sensory Sciences, Kawasaki University of Medical Welfare
| | - Shinichi Takeshima
- Department of Neurology, Brain Attack Center, Ota Memorial Hospital.,Present address: Department of Rehabilitation Medicine, Showa University School of Medicine
| | - Jun Takeshita
- Department of Neurology, Brain Attack Center, Ota Memorial Hospital
| | - Yutaka Shimoe
- Department of Neurology, Brain Attack Center, Ota Memorial Hospital
| | - Shigeru Yamori
- Department of Rehabilitation, Brain Attack Center, Ota Memorial Hospital
| | - Masaru Kuriyama
- Department of Neurology, Brain Attack Center, Ota Memorial Hospital
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Herbet G, Zemmoura I, Duffau H. Functional Anatomy of the Inferior Longitudinal Fasciculus: From Historical Reports to Current Hypotheses. Front Neuroanat 2018; 12:77. [PMID: 30283306 PMCID: PMC6156142 DOI: 10.3389/fnana.2018.00077] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
The inferior longitudinal fasciculus (ILF) is a long-range, associative white matter pathway that connects the occipital and temporal-occipital areas of the brain to the anterior temporal areas. In view of the ILF's anatomic connections, it has been suggested that this pathway has a major role in a relatively large array of brain functions. Until recently, however, the literature data on these potential functions were scarce. Here, we review the key findings of recent anatomic, neuromodulation, and neuropsychological studies. We also summarize reports on how this tract is disrupted in a wide range of brain disorders, including psychopathologic, neurodevelopmental, and neurologic diseases. Our review reveals that the ILF is a multilayered, bidirectional tract involved in processing and modulating visual cues and thus in visually guided decisions and behaviors. Accordingly, sudden disruption of the ILF by neurologic insult is mainly associated with neuropsychological impairments of visual cognition (e.g., visual agnosia, prosopagnosia, and alexia). Furthermore, disruption of the ILF may constitute the pathophysiologic basis for visual hallucinations and socio-emotional impairments in schizophrenia, as well as emotional difficulties in autism spectrum disorder. Degeneration of the ILF in neurodegenerative diseases affecting the temporal lobe may explain (at least in part) the gradual onset of semantic and lexical access difficulties. Although some of the functions mediated by the ILF appear to be relatively lateralized, observations from neurosurgery suggest that disruption of the tract's anterior portion can be dynamically compensated for by the contralateral portion. This might explain why bilateral disruption of the ILF in either acute or progressive disease is highly detrimental in neuropsychological terms.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
| | - Ilyess Zemmoura
- Department of Neurosurgery, Tours University Medical Center, Tours, France
- UMR 1253, iBrain, INSERM, University of Tours, Tours, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- INSERM-1051, Team 4, Saint-Eloi Hospital, Institute for Neurosciences of Montpellier, Montpellier, France
- University of Montpellier, Montpellier, France
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Stereoscopic visual area connectivity: a diffusion tensor imaging study. Surg Radiol Anat 2018; 40:1197-1208. [PMID: 30088052 DOI: 10.1007/s00276-018-2076-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To study the white matter tracts connecting the different stereoscopic visual areas of the brain by diffusion tensor imaging. METHODS In a previous study, we identified the cortical activations to a visual 3D stimulation in 12 subjects using functional MRI (fMRI). These areas of cortical activations [V5, V6, lateral occipital complex (LOC) and intra parietal sulcus areas (IPS)] in addition to the lateral geniculate nucleus (LGN) and the primary visual area V1 were chosen as regions of interest (ROIs). We studied by deterministic tractography the connections existing between these ROIs. RESULTS Found connections were divided into three groups. The first group entails the geniculo-extrastriate connections. LGN was connected to V5, V6, IPS and LOC. These fibers course in the inferior longitudinal fascicule. The second group comprises the associative fibers. V1 was connected to V5 and LOC through the transverse occipital fascicule on one hand, and, to V6 and IPS through the stratum proprium cuni on the other hand. Connections between V5 and LOC, and V6 and IPS course within the vertical occipital fascicule. The third group contains commissural fibers. Forceps major entailed the connections between both V1, both V6, both IPS and IPS and contralateral V6. LGN was connected to contralateral LGN, V1, V6, IPS and LOC. CONCLUSIONS We have elucidated numerous connections between the visual areas and the LGN. Generalization of these results to the remainder of the population must remain prudent due to the limited number of subjects in this study.
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Matsuo S, Baydin S, Güngör A, Middlebrooks EH, Komune N, Iihara K, Rhoton AL. Prevention of postoperative visual field defect after the occipital transtentorial approach: anatomical study. J Neurosurg 2018; 129:188-197. [DOI: 10.3171/2017.4.jns162805] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEA postoperative visual field defect resulting from damage to the occipital lobe during surgery is a unique complication of the occipital transtentorial approach. Though the association between patient position and this complication is well investigated, preventing the complication remains a challenge. To define the area of the occipital lobe in which retraction is least harmful, the surface anatomy of the brain, course of the optic radiations, and microsurgical anatomy of the occipital transtentorial approach were examined.METHODSTwelve formalin-fixed cadaveric adult heads were examined with the aid of a surgical microscope and 0° and 45° endoscopes. The optic radiations were examined by fiber dissection and MR tractography techniques.RESULTSThe arterial and venous relationships of the lateral, medial, and inferior surfaces of the occipital lobe were defined anatomically. The full course of the optic radiations was displayed via both fiber dissection and MR tractography. Although the stems of the optic radiations as exposed by both techniques are similar, the terminations of the fibers are slightly different. The occipital transtentorial approach provides access for the removal of lesions involving the splenium, pineal gland, collicular plate, cerebellomesencephalic fissure, and anterosuperior part of the cerebellum. An angled endoscope can aid in exposing the superior medullary velum and superior cerebellar peduncles.CONCLUSIONSAnatomical findings suggest that retracting the inferior surface of the occipital lobe may avoid direct damage and perfusion deficiency around the calcarine cortex and optic radiations near their termination. An accurate understanding of the course of the optic radiations and vascular relationships around the occipital lobe and careful retraction of the inferior surface of the occipital lobe may reduce the incidence of postoperative visual field defect.
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Affiliation(s)
- Satoshi Matsuo
- 1Department of Neurosurgery, Kyushu Central Hospital
- 2Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and
| | - Serhat Baydin
- 2Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and
| | - Abuzer Güngör
- 2Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and
| | - Erik H. Middlebrooks
- 3Department of Radiology, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama
| | | | - Koji Iihara
- 5Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Albert L. Rhoton
- 2Department of Neurosurgery, University of Florida, College of Medicine, Gainesville, Florida; and
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