Real-Time Ex-Vivo Magnetic Resonance Image-Guided Dissection of Human Brain White Matter: A Proof-of-Principle Study

Three-dimensional anatomy of the anterior commissure: A tractography and anatomical study

The anterior commissure (AC) is one of the main commissural fibers of the brain. Commissural fibers are involved in bilateral integration and coordination of any normal brain activity. The AC is an important interhemispheric structure which forms a bidirectional communication channel between the frontal, temporal, parietal and occipital lobes bilaterally. In this article, we focus on describing the morphology, relations, and distribution of the AC through diffusion spectrum imaging (DSI) DSI-based fiber tracking. Tractographies were compared with gross anatomical dissection of the anterior commissure of adult's brains. Our study suggests that the AC found by tracking methods is bigger in comparison to the one found by dissection. In summary, the tractography added extensions to the main AC structure.

The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications

The frontal aslant tract (FAT) is a recently identified white matter tract connecting the supplementary motor complex and lateral superior frontal gyrus to the inferior frontal gyrus. Advancements in neuroimaging and refinements to anatomical dissection techniques of the human brain white matter contributed to the recent description of the FAT anatomical and functional connectivity and its role in the pathogenesis of several neurological, psychiatric, and neurosurgical disorders. Through the application of diffusion tractography and intraoperative electrical brain stimulation, the FAT was shown to have a role in speech and language functions (verbal fluency, initiation and inhibition of speech, sentence production, and lexical decision), working memory, visual–motor activities, orofacial movements, social community tasks, attention, and music processing. Microstructural alterations of the FAT have also been associated with neurological disorders, such as primary progressive aphasia, post-stroke aphasia, stuttering, Foix–Chavany–Marie syndrome, social communication deficit in autism spectrum disorders, and attention–deficit hyperactivity disorder. We provide a systematic review of the current literature about the FAT anatomical connectivity and functional roles. Specifically, the aim of the present study relies on providing an overview for practical neurosurgical applications for the pre-operative, intra-operative, and post-operative assessment of patients with brain tumors located around and within the FAT. Moreover, some useful tests are suggested for the neurosurgical evaluation of FAT integrity to plan a safer surgery and to reduce post-operative deficits.