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In vivo probabilistic atlas of white matter tracts of the human subthalamic area combining track density imaging and optimized diffusion tractography. Brain Struct Funct 2022; 227:2647-2665. [PMID: 36114861 PMCID: PMC9618529 DOI: 10.1007/s00429-022-02561-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
The human subthalamic area is a region of high anatomical complexity, tightly packed with tiny fiber bundles. Some of them, including the pallidothalamic, cerebello-thalamic, and mammillothalamic tracts, are relevant targets in functional neurosurgery for various brain diseases. Diffusion-weighted imaging-based tractography has been suggested as a useful tool to map white matter pathways in the human brain in vivo and non-invasively, though the reconstruction of these specific fiber bundles is challenging due to their small dimensions and complex anatomy. To the best of our knowledge, a population-based, in vivo probabilistic atlas of subthalamic white matter tracts is still missing. In the present work, we devised an optimized tractography protocol for reproducible reconstruction of the tracts of subthalamic area in a large data sample from the Human Connectome Project repository. First, we leveraged the super-resolution properties and high anatomical detail provided by short tracks track-density imaging (stTDI) to identify the white matter bundles of the subthalamic area on a group-level template. Tracts identification on the stTDI template was also aided by visualization of histological sections of human specimens. Then, we employed this anatomical information to drive tractography at the subject-level, optimizing tracking parameters to maximize between-subject and within-subject similarities as well as anatomical accuracy. Finally, we gathered subject level tracts reconstructed with optimized tractography into a large-scale, normative population atlas. We suggest that this atlas could be useful in both clinical anatomy and functional neurosurgery settings, to improve our understanding of the complex morphology of this important brain region.
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You Y, Yoh Kim C, Yan G, Park JS. Surface models and true-color sectioned images of hypothalamic nuclei and its neighboring structures. Technol Health Care 2022; 30:27-36. [PMID: 35124581 PMCID: PMC9028663 DOI: 10.3233/thc-228003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Knowledge regarding the hypothalamic nuclei is essential for understanding neuroanatomy and has substantial clinical relevance. OBJECTIVE: The aim was to contribute to elucidate the complex hypothalamic architecture for research and provide an anatomical basis for clinical brain operation. METHODS: In this research, high-resolution and true-color sectioned images from Visible Korean were employed for hypothalamic nuclei and neighboring structures surface modeling, and a high-resolution three-dimensional atlas of the hypothalamus was created. RESULTS: Surface models of 26 structures including the hypothalamic nuclei and its neighboring structures were produced, which contained 5 anterior hypothalamic areas’ nuclei, 4 intermediate hypothalamic areas’ nuclei, 3 lateral hypothalamic areas’ nuclei, and 2 posterior hypothalamic areas’ nuclei, as well as 12 hypothalamic neighboring structures. CONCLUSIONS: The study evaluated the topographical anatomy of the hypothalamic nuclei and its neighboring structures based on true-color and highresolution sectioned images of Visible Korean.
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Affiliation(s)
- Yaqian You
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- Department of Anatomy, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Chung Yoh Kim
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, Korea
| | - Gen Yan
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
- Department of Radiology, Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Jin Seo Park
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, Korea
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Kwon DH, Paek SH, Kim YB, Lee H, Cho ZH. In vivo 3D Reconstruction of the Human Pallidothalamic and Nigrothalamic Pathways With Super-Resolution 7T MR Track Density Imaging and Fiber Tractography. Front Neuroanat 2021; 15:739576. [PMID: 34776880 PMCID: PMC8579044 DOI: 10.3389/fnana.2021.739576] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
The output network of the basal ganglia plays an important role in motor, associative, and limbic processing and is generally characterized by the pallidothalamic and nigrothalamic pathways. However, these connections in the human brain remain difficult to elucidate because of the resolution limit of current neuroimaging techniques. The present study aimed to investigate the mesoscopic nature of these connections between the thalamus, substantia nigra pars reticulata, and globus pallidus internal segment using 7 Tesla (7T) magnetic resonance imaging (MRI). In this study, track-density imaging (TDI) of the whole human brain was employed to overcome the limitations of observing the pallidothalamic and nigrothalamic tracts. Owing to the super-resolution of the TD images, the substructures of the SN, as well as the associated tracts, were identified. This study demonstrates that 7T MRI and MR tractography can be used to visualize anatomical details, as well as 3D reconstruction, of the output projections of the basal ganglia.
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Affiliation(s)
- Dae-Hyuk Kwon
- Neuroscience Convergence Center, Green Manufacturing Research Center (GMRC), Korea University, Seoul, South Korea
| | - Sun Ha Paek
- Neurosurgery, Movement Disorder Center, Seoul National University College of Medicine, Advanced Institute of Convergence Technology (AICT), Seoul National University, Seoul, South Korea
| | - Young-Bo Kim
- Department of Neurosurgery, College of Medicine, Gachon University, Incheon, South Korea
| | - Haigun Lee
- Department of Materials Science and Engineering, Korea University, Seoul, South Korea
| | - Zang-Hee Cho
- Neuroscience Convergence Center, Green Manufacturing Research Center (GMRC), Korea University, Seoul, South Korea
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You Y, Kim CY, Kim SK, Chung BS, Har D, Choi J, Park JS. Advanced-sectioned images obtained by microsectioning of the entire male body. Clin Anat 2021; 35:79-86. [PMID: 34591338 DOI: 10.1002/ca.23795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/09/2022]
Abstract
Realistic two-dimensional (2D) and three-dimensional (3D) applications for anatomical studies are being developed from true-colored sectioned images. We generated advanced-sectioned images of the entire male body and verified that anatomical structures of both normal and abnormal shapes could be visualized in them. The cadaver was serially sectioned at constant intervals using a cryomacrotome. The sectioned surfaces were photographed using a digital camera to generate horizontal advanced-sectioned images in which normal and abnormal structures were classified. Advanced-sectioned images of the entire male body were generated. The image resolution was 3.3 × 3.3 fold better than that of the first sectioned images obtained in 2002. In the advanced-sectioned images, normal and abnormal structures ranging from microscopic (≥0.06 mm × 0.06 mm; pixel size) to macroscopic (≤473.1 mm × 202 mm; body size) could be identified. Furthermore, the real shapes and actual sites of lung cancer and lymph node enlargement were ascertained in them. Such images will be useful because of their true color and high resolution in digital 2D and 3D applications for gross anatomy and clinical anatomy. In future, we plan to generate new advanced-sectioned images of abnormal cadavers with different diseases for clinical anatomy studies.
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Affiliation(s)
- Yaqian You
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, South Korea
| | - Chung Yoh Kim
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, South Korea
| | - Seul Ki Kim
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, South Korea
| | - Beom Sun Chung
- Department of Anatomy, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Donghwan Har
- College of ICT Engineering, Chung Ang University, Seoul, South Korea
| | | | - Jin Seo Park
- Department of Anatomy, Dongguk University School of Medicine, Gyeongju, South Korea
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Li M, Ribas EC, Zhang Z, Wu X, Wang X, Liu X, Liang J, Chen G, Li M. Tractography of the ansa lenticularis in the human brain. Clin Anat 2021; 35:269-279. [PMID: 34535922 DOI: 10.1002/ca.23788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 12/31/2022]
Abstract
The aim of this study was to make a thorough investigation of the trajectory of the ansa lenticularis (AL) and its subcomponents using high-resolution fiber-tracking tractography. The subcomponents of the AL were reconstructed from one region of interest (ROI) in the area of the globus pallidus combined with another ROI in the red nucleus, substantia nigra, subthalamic nucleus, or thalamus. This fiber-tracking protocol was tested in an HCP-1065 template, 35 healthy subjects from Massachusetts General Hospital (MGH), and 20 healthy subjects from the human connectome project (HCP) using generalized q-sampling imaging (GQI)-based tractography. Quantitative anisotropy and fractional anisotropy were also computed for the AL subcomponents. The subcomponents of the AL could be reconstructed in the HCP-1065 template, 35 MGH healthy subjects, and 20 HCP healthy subjects. The AL descends from the globus pallidus and joins the ansa peduncularis for a short distance, subdividing later into fibers that continue separately to the red nucleus, substantia nigra, subthalamic nucleus, and thalamus. The study demonstrated the trajectory of the ansa lenticularis and its subcomponents using GQI-based tractography, improving our understanding of the anatomical connectivity between the globus pallidus and the thalamo-subthalamic region in the human brain. One Sentence Summary The investigation of the ansa lenticularis and its subcomponents using high-resolution diffusion images based tractography.
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Affiliation(s)
- Mengjun Li
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Eduardo Carvalhal Ribas
- Division of Neurosurgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Zhiping Zhang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaolong Wu
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xu Wang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaohai Liu
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Jiantao Liang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Ge Chen
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Mingchu Li
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
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Rocha MSG, de Freitas JL, Costa CDM, de Oliveira MO, Terzian PR, Queiroz JWM, Ferraz JB, Tatsch JFS, Soriano DC, Hamani C, Godinho F. Fields of Forel Brain Stimulation Improves Levodopa-Unresponsive Gait and Balance Disorders in Parkinson's Disease. Neurosurgery 2021; 89:450-459. [PMID: 34161592 DOI: 10.1093/neuros/nyab195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/03/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Gait and balance disturbance are challenging symptoms in advanced Parkinson's disease (PD). Anatomic and clinical data suggest that the fields of Forel may be a potential surgical target to treat these symptoms. OBJECTIVE To test whether bilateral stimulation centered at the fields of Forel improves levodopa unresponsive freezing of gait (FOG), balance problems, postural instability, and falls in PD. METHODS A total of 13 patients with levodopa-unresponsive gait disturbance (Hoehn and Yahr stage ≥3) were included. Patients were evaluated before (on-medication condition) and 1 yr after surgery (on-medication-on-stimulation condition). Motor symptoms and quality of life were assessed with the Unified Parkinson's Disease Rating scale (UPDRS III) and Quality of Life scale (PDQ-39). Clinical and instrumented analyses assessed gait, balance, postural instability, and falls. RESULTS Surgery improved balance by 43% (95% confidence interval [CI]: 21.2-36.4 to 35.2-47.1; P = .0012), reduced FOG by 35% (95% CI: 15.1-20.3 to 8.1-15.3; P = .0021), and the monthly number of falls by 82.2% (95% CI: 2.2-6.9 to -0.2-1.7; P = .0039). Anticipatory postural adjustments, velocity to turn, and postural sway measurements also improved 1 yr after deep brain stimulation (DBS). UPDRS III motor scores were reduced by 27.2% postoperatively (95% CI: 42.6-54.3 to 30.2-40.5; P < .0001). Quality of life improved 27.5% (95% CI: 34.6-48.8 to 22.4-37.9; P = .0100). CONCLUSION Our results suggest that DBS of the fields of Forel improved motor symptoms in PD, as well as the FOG, falls, balance, postural instability, and quality of life.
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Affiliation(s)
- Maria Sheila Guimarães Rocha
- Hospital Santa Marcelina, Neurology and Functional Neurosurgery Department, São Paulo, Brazil.,Faculdade Santa Marcelina, Internal Medicine Division, São Paulo, Brazil
| | | | | | - Maira Okada de Oliveira
- Hospital Santa Marcelina, Neurology and Functional Neurosurgery Department, São Paulo, Brazil.,Global Brain Health Institute, University of California-San Francisco, San Francisco, California, USA
| | - Paulo Roberto Terzian
- Hospital Santa Marcelina, Neurology and Functional Neurosurgery Department, São Paulo, Brazil
| | | | - Jamana Barbosa Ferraz
- Hospital Santa Marcelina, Neurology and Functional Neurosurgery Department, São Paulo, Brazil.,Faculdade Santa Marcelina, Internal Medicine Division, São Paulo, Brazil
| | | | - Diogo Coutinho Soriano
- Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Clement Hamani
- Sunnybrook Health Sciences Centre, Harquail Centre for Neuromodulation, Division of Neurosurgery, University of Toronto, Toronto, Canada
| | - Fabio Godinho
- Hospital Santa Marcelina, Neurology and Functional Neurosurgery Department, São Paulo, Brazil.,Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo, Brazil.,Institute of Psychiatry, Hospital das Clínicas, Functional Neurosurgery Division, University of São Paulo, São Paulo, Brazil
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Horisawa S, Fukui A, Yamahata H, Tanaka Y, Kuwano A, Momosaki O, Iijima M, Nanke M, Kawamata T, Taira T. Unilateral pallidothalamic tractotomy for akinetic-rigid Parkinson's disease: a prospective open-label study. J Neurosurg 2021; 135:799-805. [PMID: 33450738 DOI: 10.3171/2020.7.jns201547] [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: 04/29/2020] [Accepted: 07/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neurosurgical ablation is an effective treatment for medically refractory motor symptoms of Parkinson's disease (PD). A limited number of studies have reported the effect of ablation of the pallidothalamic tract for PD. In this study, the authors evaluated the safety and efficacy of unilateral pallidothalamic tractotomy for akinetic-rigid (AR)-PD. METHODS Fourteen AR-PD patients, who were enrolled in this prospective open-label study, underwent unilateral pallidothalamic tractotomy. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III and Part IV (dyskinesia and dystonia) scores and levodopa equivalent daily dose (LEDD) were evaluated at baseline and at 3 and 12 months postoperatively. RESULTS Of the 14 patients enrolled in the study, 4 were lost to follow-up and 10 were analyzed. The total MDS-UPDRS Part III score significantly improved from 45 ± 4.6 at baseline to 32.9 ± 4.8 at 12 months postoperatively (p = 0.005). Contralateral side rigidity and bradykinesia significantly improved from 4.4 ± 0.5 and 10.4 ± 1.5 at baseline to 1.7 ± 0.4 (p = 0.005) and 5.2 ± 1.4 (p = 0.011) at 12 months, respectively. While posture significantly improved with a 20% reduction in scores (p = 0.038), no significant improvement was found in gait (p = 0.066). Dyskinesia and dystonia were improved with a 79.2% (p = 0.0012) and 91.7% (p = 0.041) reduction in scores, respectively. No significant change was found in the LEDD. Hypophonia was noted in 2 patients, eyelid apraxia was noted in 1 patient, and a reduced response to levodopa, which resulted in an increase in the daily dose of levodopa, was noted in 3 patients. No serious permanent neurological deficits were observed. CONCLUSIONS Unilateral pallidothalamic tractotomy improved contralateral side rigidity and bradykinesia, dyskinesia, and dystonia in patients with AR-PD. Clinical trial registration no.: UMIN000031138 (umin.ac.jp).
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Affiliation(s)
| | | | | | | | | | | | | | - Magi Nanke
- 3School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Bordes S, Werner C, Mathkour M, McCormack E, Iwanaga J, Loukas M, Lammle M, Dumont AS, Tubbs RS. Arterial Supply of the Thalamus: A Comprehensive Review. World Neurosurg 2020; 137:310-318. [DOI: 10.1016/j.wneu.2020.01.237] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 01/28/2020] [Accepted: 01/29/2020] [Indexed: 12/14/2022]
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