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Sadashiva N, Goyal-Honavar A, Nadeem M, Phaneendra GS, Konar S, Prabhuraj AR, Shukla D, Rao MB, Vazhayil V, Beniwal M, Arimappamagan A. Surgical outcomes of trigonal intraventricular meningiomas: a single-centre study. Neurosurg Rev 2024; 47:304. [PMID: 38965148 DOI: 10.1007/s10143-024-02542-6] [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: 01/05/2024] [Revised: 05/12/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
Trigonal meningiomas are rare intraventricular tumours that present a surgical challenge. There is no consensus on the optimal surgical approach to these lesions, though the transtemporal and transparietal approaches are most frequently employed. We aimed to examine the approach-related morbidity and surgical nuances in treating trigonal meningiomas. This retrospective review assimilated data from 64 trigonal meningiomas operated over 15 years. Details of clinicoradiological presentation, surgical approach and intraoperative impression, pathology and incidence of various postoperative deficits were recorded. In our study, Trigonal meningiomas most frequently presented with headache and visual deterioration. The median volume of tumours was 63.6cc. Thirty-one meningiomas each (48.4%) were WHO Grade 1 and WHO Grade 2, while 2 were WHO Grade 3. The most frequent approach employed was transtemporal (38 patients, 59.4%), followed by transparietal (22 patients, 34.4%). After surgery features of raised ICP and altered mental status resolved in all patients, while contralateral limb weakness resolved in 80%, aphasia in 60%, seizures in 70%, and vision loss in 46.2%. Eighteen patients (28.13%) developed transient postoperative neurological deficits, with one patient (1.5%) developing permanent morbidity. Surgery for IVMs results in rapid improvement of neurological status, though visual outcomes are poorer in patients with low vision prior to surgery, longer duration of complaints and optic atrophy. The new postoperative deficits in some patients tend to improve on follow up. Transtemporal and transparietal approaches may be employed, based on multiple factors like tumour extension, loculation of temporal horn, size of lesion with no significant difference in their safety profile.
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Affiliation(s)
- Nishanth Sadashiva
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India.
| | - Abhijit Goyal-Honavar
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Mohammed Nadeem
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Gugamsetti Sai Phaneendra
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Subhas Konar
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Andiperumal Raj Prabhuraj
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Malla Bhaskara Rao
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Vikas Vazhayil
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Manish Beniwal
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
| | - Arivazhagan Arimappamagan
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, 560029, Karnataka, India
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Qin T, Wang L, Xu H, Liu C, Shao Y, Li F, Wang Y, Jiang J, Lin H. rTMS concurrent with cognitive training rewires AD brain by enhancing GM-WM functional connectivity: a preliminary study. Cereb Cortex 2024; 34:bhad460. [PMID: 38037857 DOI: 10.1093/cercor/bhad460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and cognitive training for patients with Alzheimer's disease (AD) can change functional connectivity (FC) within gray matter (GM). However, the role of white matter (WM) and changes of GM-WM FC under these therapies are still unclear. To clarify this problem, we applied 40 Hz rTMS over angular gyrus (AG) concurrent with cognitive training to 15 mild-moderate AD patients and analyzed the resting-state functional magnetic resonance imaging before and after treatment. Through AG-based FC analysis, corona radiata and superior longitudinal fasciculus (SLF) were identified as activated WM tracts. Compared with the GM results with AG as seed, more GM regions were found with activated WM tracts as seeds. The averaged FC, fractional amplitude of low-frequency fluctuation (fALFF), and regional homogeneity (ReHo) of the above GM regions had stronger clinical correlations (r/P = 0.363/0.048 vs 0.299/0.108, 0.351/0.057 vs 0.267/0.153, 0.420/0.021 vs 0.408/0.025, for FC/fALFF/ReHo, respectively) and better classification performance to distinguish pre-/post-treatment groups (AUC = 0.91 vs 0.88, 0.65 vs 0.63, 0.87 vs 0.82, for FC/fALFF/ReHo, respectively). Our results indicated that rTMS concurrent with cognitive training could rewire brain network by enhancing GM-WM FC in AD, and corona radiata and SLF played an important role in this process.
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Affiliation(s)
- Tong Qin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Luyao Wang
- School of Life Science, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Yuxuan Shao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Fangjie Li
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai 201203, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Jiehui Jiang
- School of Life Science, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Hua Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
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Lakhani DA, Sabsevitz DS, Chaichana KL, Quiñones-Hinojosa A, Middlebrooks EH. Current State of Functional MRI in the Presurgical Planning of Brain Tumors. Radiol Imaging Cancer 2023; 5:e230078. [PMID: 37861422 DOI: 10.1148/rycan.230078] [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] [Indexed: 10/21/2023]
Abstract
Surgical resection of brain tumors is challenging because of the delicate balance between maximizing tumor removal and preserving vital brain functions. Functional MRI (fMRI) offers noninvasive preoperative mapping of widely distributed brain areas and is increasingly used in presurgical functional mapping. However, its impact on survival and functional outcomes is still not well-supported by evidence. Task-based fMRI (tb-fMRI) maps blood oxygen level-dependent (BOLD) signal changes during specific tasks, while resting-state fMRI (rs-fMRI) examines spontaneous brain activity. rs-fMRI may be useful for patients who cannot perform tasks, but its reliability is affected by tumor-induced changes, challenges in data processing, and noise. Validation studies comparing fMRI with direct cortical stimulation (DCS) show variable concordance, particularly for cognitive functions such as language; however, concordance for tb-fMRI is generally greater than that for rs-fMRI. Preoperative fMRI, in combination with MRI tractography and intraoperative DCS, may result in improved survival and extent of resection and reduced functional deficits. fMRI has the potential to guide surgical planning and help identify targets for intraoperative mapping, but there is currently limited prospective evidence of its impact on patient outcomes. This review describes the current state of fMRI for preoperative assessment in patients undergoing brain tumor resection. Keywords: MR-Functional Imaging, CNS, Brain/Brain Stem, Anatomy, Oncology, Functional MRI, Functional Anatomy, Task-based, Resting State, Surgical Planning, Brain Tumor © RSNA, 2023.
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Affiliation(s)
- Dhairya A Lakhani
- From the Department of Radiology, West Virginia University, Morgantown, WV (D.A.L.); and Departments of Psychiatry and Psychology (D.S.S.), Neurosurgery (K.L.C., A.Q.H., E.H.M.), and Radiology (E.H.M.), Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
| | - David S Sabsevitz
- From the Department of Radiology, West Virginia University, Morgantown, WV (D.A.L.); and Departments of Psychiatry and Psychology (D.S.S.), Neurosurgery (K.L.C., A.Q.H., E.H.M.), and Radiology (E.H.M.), Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
| | - Kaisorn L Chaichana
- From the Department of Radiology, West Virginia University, Morgantown, WV (D.A.L.); and Departments of Psychiatry and Psychology (D.S.S.), Neurosurgery (K.L.C., A.Q.H., E.H.M.), and Radiology (E.H.M.), Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
| | - Alfredo Quiñones-Hinojosa
- From the Department of Radiology, West Virginia University, Morgantown, WV (D.A.L.); and Departments of Psychiatry and Psychology (D.S.S.), Neurosurgery (K.L.C., A.Q.H., E.H.M.), and Radiology (E.H.M.), Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
| | - Erik H Middlebrooks
- From the Department of Radiology, West Virginia University, Morgantown, WV (D.A.L.); and Departments of Psychiatry and Psychology (D.S.S.), Neurosurgery (K.L.C., A.Q.H., E.H.M.), and Radiology (E.H.M.), Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
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Lee VK, Wallace J, Meyers B, Racki A, Shah A, Beluk NH, Cabral L, Beers S, Badaly D, Lo C, Panigrahy A, Ceschin R. Cerebral Spinal Fluid Volumetrics and Paralimbic Predictors of Executive Dysfunction in Congenital Heart Disease: A Machine Learning Approach Informing Mechanistic Insights. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.10.16.23297055. [PMID: 37905005 PMCID: PMC10615017 DOI: 10.1101/2023.10.16.23297055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
The relationship between increased cerebral spinal fluid (CSF) ventricular compartments, structural and microstructural dysmaturation, and executive function in patients with congenital heart disease (CHD) is unknown. Here, we leverage a novel machine-learning data-driven technique to delineate interrelationships between CSF ventricular volume, structural and microstructural alterations, clinical risk factors, and sub-domains of executive dysfunction in adolescent CHD patients. We trained random forest regression models to predict measures of executive function (EF) from the NIH Toolbox, the Delis-Kaplan Executive Function System (D-KEFS), and the Behavior Rating Inventory of Executive Function (BRIEF) and across three subdomains of EF - mental flexibility, working memory, and inhibition. We estimated the best parameters for the random forest algorithm via a randomized grid search of parameters using 10-fold cross-validation on the training set only. The best parameters were then used to fit the model on the full training set and validated on the test set. Algorithm performance was measured using root-mean squared-error (RMSE). As predictors, we included patient clinical variables, perioperative clinical measures, microstructural white matter (diffusion tensor imaging- DTI), and structural volumes (volumetric magnetic resonance imaging- MRI). Structural white matter was measured using along-tract diffusivity measures of 13 inter-hemispheric and cortico-association fibers. Structural volumes were measured using FreeSurfer and manual segmentation of key structures. Variable importance was measured by the average Gini-impurity of each feature across all decision trees in which that feature is present in the model, and functional ontology mapping (FOM) was used to measure the degree of overlap in feature importance for each EF subdomain and across subdomains. We found that CSF structural properties (including increased lateral ventricular volume and reduced choroid plexus volumes) in conjunction with proximate cortical projection and paralimbic-related association white matter tracts that straddle the lateral ventricles and distal paralimbic-related subcortical structures (basal ganglia, hippocampus, cerebellum) are predictive of two-specific subdomains of executive dysfunction in CHD patients: cognitive flexibility and inhibition. These findings in conjunction with combined RF models that incorporated clinical risk factors, highlighted important clinical risk factors, including the presence of microbleeds, altered vessel volume, and delayed PDA closure, suggesting that CSF-interstitial fluid clearance, vascular pulsatility, and glymphatic microfluid dynamics may be pathways that are impaired in CHD, providing mechanistic information about the relationship between CSF and executive dysfunction.
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Affiliation(s)
- Vince K. Lee
- Department of Radiology, University of Pittsburgh School of Medicine
- Department of Bioengineering, University of Pittsburgh School of Medicine
| | - Julia Wallace
- Department of Radiology, University of Pittsburgh School of Medicine
| | - Benjamin Meyers
- Department of Radiology, University of Pittsburgh School of Medicine
| | - Adriana Racki
- Department of Radiology, University of Pittsburgh School of Medicine
| | - Anushka Shah
- Department of Radiology, University of Pittsburgh School of Medicine
| | - Nancy H. Beluk
- Department of Radiology, University of Pittsburgh School of Medicine
| | - Laura Cabral
- Department of Radiology, University of Pittsburgh School of Medicine
- Department of Biomedical Informatics, University of Pittsburgh
| | - Sue Beers
- Department of Psychiatry, University of Pittsburgh Medical Center
- Department of Psychiatry, University of Pittsburgh School of Medicine
| | | | - Cecilia Lo
- Department of Developmental Biology, University of Pittsburgh School of Medicine
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh School of Medicine
- Department of Biomedical Informatics, University of Pittsburgh
| | - Rafael Ceschin
- Department of Radiology, University of Pittsburgh School of Medicine
- Department of Biomedical Informatics, University of Pittsburgh
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Valdes PA, Ng S, Bernstock JD, Duffau H. Development of an educational method to rethink and learn oncological brain surgery in an "a la carte" connectome-based perspective. Acta Neurochir (Wien) 2023; 165:2489-2500. [PMID: 37199758 DOI: 10.1007/s00701-023-05626-2] [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: 03/31/2023] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Understanding the structural connectivity of white matter tracts (WMT) and their related functions is a prerequisite to implementing an "a la carte" "connectomic approach" to glioma surgery. However, accessible resources facilitating such an approach are lacking. Here we present an educational method that is readily accessible, simple, and reproducible that enables the visualization of WMTs on individual patient images via an atlas-based approach. METHODS Our method uses the patient's own magnetic resonance imaging (MRI) images and consists of three main steps: data conversion, normalization, and visualization; these are accomplished using accessible software packages and WMT atlases. We implement our method on three common cases encountered in glioma surgery: a right supplementary motor area tumor, a left insular tumor, and a left temporal tumor. RESULTS Using patient-specific perioperative MRIs with open-sourced and co-registered atlas-derived WMTs, we highlight the critical subnetworks requiring specific surgical monitoring identified intraoperatively using direct electrostimulation mapping with cognitive monitoring. The aim of this didactic method is to provide the neurosurgical oncology community with an accessible and ready-to-use educational tool, enabling neurosurgeons to improve their knowledge of WMTs and to better learn their oncologic cases, especially in glioma surgery using awake mapping. CONCLUSIONS Taking no more than 3-5 min per patient and irrespective of their resource settings, we believe that this method will enable junior surgeons to develop an intuition, and a robust 3-dimensional imagery of WMT by regularly applying it to their cases both before and after surgery to develop an "a la carte" connectome-based perspective to glioma surgery.
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Affiliation(s)
- Pablo A Valdes
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX, 77555, USA.
- Department of Neurosurgery, Hôpital Gui de Chauliac, CHU Montpellier, 80 Av Augustin Fliche, 34295, Montpellier, France.
| | - Sam Ng
- Department of Neurosurgery, Hôpital Gui de Chauliac, CHU Montpellier, 80 Av Augustin Fliche, 34295, Montpellier, France
- Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors", Institute of Functional Genomics, INSERM U1191, University of Montpellier, 141 Rue de la cardonille, 34091, Montpellier, France
| | - Joshua D Bernstock
- Department of Neurosurgery, Harvard Medical School/Brigham and Women's Hospital, Boston, MA, 02115, USA
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Hugues Duffau
- Department of Neurosurgery, Hôpital Gui de Chauliac, CHU Montpellier, 80 Av Augustin Fliche, 34295, Montpellier, France
- Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors", Institute of Functional Genomics, INSERM U1191, University of Montpellier, 141 Rue de la cardonille, 34091, Montpellier, France
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Vavassori L, Venturini M, Zigiotto L, Annicchiarico L, Corsini F, Avesani P, Petit L, De Benedictis A, Sarubbo S. The arcuate fasciculus: Combining structure and function into surgical considerations. Brain Behav 2023; 13:e3107. [PMID: 37280786 PMCID: PMC10454270 DOI: 10.1002/brb3.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/19/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Two Centuries from today, Karl Friedrich Burdach attributed the nomenclature "arcuate fasciculus" to a white matter (WM) pathway connecting the frontal to the temporal cortices by arching around the Sylvian fissure. Although this label remained essentially unvaried, the concepts related to it and the characterization of the structural properties of this bundle evolved along with the methodological progress of the past years. Concurrently, the functional relevance of the arcuate fasciculus (AF) classically restricted to the linguistic domain has extended to further cognitive abilities. These features make it a relevant structure to consider in a large variety of neurosurgical procedures. OBJECTIVE Herein, we build on our previous review uncovering the connectivity provided by the Superior Longitudinal System, including the AF, and provide a handy representation of the structural organization of the AF by considering the frequency of defined reports in the literature. By adopting the same approach, we implement an account of which functions are mediated by this WM bundle. We highlight how this information can be transferred to the neurosurgical field by presenting four surgical cases of glioma resection requiring the evaluation of the relationship between the AF and the nearby structures, and the safest approaches to adopt. CONCLUSIONS Our cumulative overview reports the most common wiring patterns and functional implications to be expected when approaching the study of the AF, while still considering seldom descriptions as an account of interindividual variability. Given its extension and the variety of cortical territories it reaches, the AF is a pivotal structure for different cognitive functions, and thorough understanding of its structural wiring and the functions it mediates is necessary for preserving the patient's cognitive abilities during glioma resection.
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Affiliation(s)
- Laura Vavassori
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
- Center for Mind and Brain Sciences (CIMeC)University of TrentoTrento Provincia Autonoma di TrentoItaly
| | - Martina Venturini
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Luca Zigiotto
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Luciano Annicchiarico
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Francesco Corsini
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
| | - Paolo Avesani
- Center for Mind and Brain Sciences (CIMeC)University of TrentoTrento Provincia Autonoma di TrentoItaly
- Neuroinfrmatics Laboratory (NiLab)Bruno Kessler FoundationPovo Provincia Autonoma di TrentoItaly
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives (GIN‐IMN), UMR5293, CNRS, CEAUniversity of BordeauxBordeauxFrance
| | | | - Silvio Sarubbo
- Department of NeurosurgeryAzienda Provinciale per i Servizi Sanitari (APSS), “S. Chiara” HospitalTrento Provincia Autonoma di TrentoItaly
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Zhong J, Zhang X, Xu H, Zheng X, Wang L, Jiang J, Li Y. Unlocking the enigma: unraveling multiple cognitive dysfunction linked to glymphatic impairment in early Alzheimer's disease. Front Neurosci 2023; 17:1222857. [PMID: 37547134 PMCID: PMC10400773 DOI: 10.3389/fnins.2023.1222857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 08/08/2023] Open
Abstract
Background Alzheimer's disease (AD) is one of the world's well-known neurodegenerative diseases, which is related to the balance mechanism of production and clearance of two proteins (amyloid-β and tau) regulated by the glymphatic system. Latest studies have found that AD patients exhibit impairments to their glymphatic system. However, the alterations in the AD disease continuum, especially in the early stages, remain unclear. Moreover, the relationship between the glymphatic system and cognitive dysfunction is still worth exploring. Methods A novel diffusion tensor image analysis method was applied to evaluate the activity of the glymphatic system by an index for diffusivity along the perivascular space (ALPS-index). Based on this method, the activity of the glymphatic system was noninvasively evaluated in 300 subjects, including 111 normal controls (NC), 120 subjects with mild cognitive impairment (MCI), and 69 subjects with AD. Partial correlation analysis was applied to explore the association between glymphatic system and cognitive impairment based on three domain-general scales and several domain-specific cognitive scales. Receiver operating characteristic curve analysis was used to evaluate the classification performance of ALPS-index along the AD continuum. Results ALPS-index was significantly different among NC, MCI and AD groups, and ALPS-index decreased with cognitive decline. In addition, ALPS-index was significantly correlated with the scores of the clinical scales (p<0.05, FDR corrected), especially in left hemisphere. Furthermore, combination of ALPS and fractional anisotropy (FA) values achieved better classification results (NC vs. MCI: AUC = 0.6610, NC vs. AD: AUC = 0.8214). Conclusion Here, we show that the glymphatic system is closely associated with multiple cognitive dysfunctions, and ALPS-index can be used as a biomarker for alterations along the AD continuum. This may provide new targets and strategies for the treatment of AD, and has the potential to assist clinical diagnosis.
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Affiliation(s)
- Jiayi Zhong
- School of Life Science, Shanghai University, Shanghai, China
| | - Xiaochen Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Xiaoran Zheng
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyao Wang
- School of Life Science, Shanghai University, Shanghai, China
| | - Jiehui Jiang
- Institute of Biomedical Engineering, Shanghai University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Beach TG, Sue LI, Scott S, Intorcia AJ, Walker JE, Arce RA, Glass MJ, Borja CI, Cline MP, Hemmingsen SJ, Qiji S, Stewart A, Martinez KN, Krupp A, McHattie R, Mariner M, Lorenzini I, Kuramoto A, Long KE, Tremblay C, Caselli RJ, Woodruff BK, Rapscak SZ, Belden CM, Goldfarb D, Choudhury P, Driver-Dunckley ED, Mehta SH, Sabbagh MN, Shill HA, Atri A, Adler CH, Serrano GE. Cerebral white matter rarefaction has both neurodegenerative and vascular causes and may primarily be a distal axonopathy. J Neuropathol Exp Neurol 2023; 82:457-466. [PMID: 37071794 PMCID: PMC10209646 DOI: 10.1093/jnen/nlad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
Cerebral white matter rarefaction (CWMR) was considered by Binswanger and Alzheimer to be due to cerebral arteriolosclerosis. Renewed attention came with CT and MR brain imaging, and neuropathological studies finding a high rate of CWMR in Alzheimer disease (AD). The relative contributions of cerebrovascular disease and AD to CWMR are still uncertain. In 1181 autopsies by the Arizona Study of Aging and Neurodegenerative Disorders (AZSAND), large-format brain sections were used to grade CWMR and determine its vascular and neurodegenerative correlates. Almost all neurodegenerative diseases had more severe CWMR than the normal control group. Multivariable logistic regression models indicated that Braak neurofibrillary stage was the strongest predictor of CWMR, with additional independently significant predictors including age, cortical and diencephalic lacunar and microinfarcts, body mass index, and female sex. It appears that while AD and cerebrovascular pathology may be additive in causing CWMR, both may be solely capable of this. The typical periventricular pattern suggests that CWMR is primarily a distal axonopathy caused by dysfunction of the cell bodies of long-association corticocortical projection neurons. A consequence of these findings is that CWMR should not be viewed simply as "small vessel disease" or as a pathognomonic indicator of vascular cognitive impairment or vascular dementia.
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Affiliation(s)
- Thomas G Beach
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Lucia I Sue
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Sarah Scott
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | - Richard A Arce
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Michael J Glass
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Madison P Cline
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Sanaria Qiji
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Analisa Stewart
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Addison Krupp
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Rylee McHattie
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Monica Mariner
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | - Angela Kuramoto
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Kathy E Long
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | | | | | | | | | | | | | | | | | - Shyamal H Mehta
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Holly A Shill
- Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
- Harvard Medical School & Brigham & Women’s Hospital, Boston, Massachusetts, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Geidy E Serrano
- Banner Sun Health Research Institute, Sun City, Arizona, USA
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Gurses ME, Hanalioglu S, Mignucci-Jiménez G, Gökalp E, Gonzalez-Romo NI, Gungor A, Cohen-Gadol AA, Türe U, Lawton MT, Preul MC. Three-Dimensional Modeling and Extended Reality Simulations of the Cross-Sectional Anatomy of the Cerebrum, Cerebellum, and Brainstem. Oper Neurosurg (Hagerstown) 2023:01787389-990000000-00693. [PMID: 37083688 DOI: 10.1227/ons.0000000000000703] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Understanding the anatomy of the human cerebrum, cerebellum, and brainstem and their 3-dimensional (3D) relationships is critical for neurosurgery. Although 3D photogrammetric models of cadaver brains and 2-dimensional images of postmortem brain slices are available, neurosurgeons lack free access to 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem that can be simulated in both augmented reality (AR) and virtual reality (VR). OBJECTIVE To create 3D models and AR/VR simulations from 2-dimensional images of cross-sectionally dissected cadaveric specimens of the cerebrum, cerebellum, and brainstem. METHODS The Klingler method was used to prepare 3 cadaveric specimens for dissection in the axial, sagittal, and coronal planes. A series of 3D models and AR/VR simulations were then created using 360° photogrammetry. RESULTS High-resolution 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem were obtained and used in creating AR/VR simulations. Eleven axial, 9 sagittal, and 7 coronal 3D models were created. The sections were planned to show important deep anatomic structures. These models can be freely rotated, projected onto any surface, viewed from all angles, and examined at various magnifications. CONCLUSION To our knowledge, this detailed study is the first to combine up-to-date technologies (photogrammetry, AR, and VR) for high-resolution 3D visualization of the cross-sectional anatomy of the entire human cerebrum, cerebellum, and brainstem. The resulting 3D images are freely available for use by medical professionals and students for better comprehension of the 3D relationship of the deep and superficial brain anatomy.
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Affiliation(s)
- Muhammet Enes Gurses
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Sahin Hanalioglu
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Giancarlo Mignucci-Jiménez
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Elif Gökalp
- Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nicolas I Gonzalez-Romo
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Abuzer Gungor
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Aaron A Cohen-Gadol
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
- The Neurosurgical Atlas, Carmel, Indiana, USA
| | - Uğur Türe
- Department of Neurosurgery, Yeditepe University Faculty of Medicine, Istanbul, Turkey
| | - Michael T Lawton
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Mark C Preul
- The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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10
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Saygi T, Avyasov R, Barut O, Daglar Z, Baran O, Hasimoglu O, Altinkaya A, Tanriover N. Microsurgical anatomy of the isthmic cingulum: a new white matter crossroad and neurosurgical implications in the posteromedial interhemispheric approaches and the glioma invasion patterns. Neurosurg Rev 2023; 46:82. [PMID: 37002437 DOI: 10.1007/s10143-023-01982-w] [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: 12/21/2022] [Revised: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 04/03/2023]
Abstract
The dichotomy of the cingulum bundle into the dorsal supracallosal and ventral parahippocampal parts is widely accepted; however, the retrosplenial component with its multiple alternative connections has not been revealed. The aim of this study was to delineate the microsurgical anatomy of a connectionally transition zone, the isthmic cingulum, in relation to the posteromedial interhemispheric access to the atrium and discuss the relevant patterns of glioma invasion on the basis of its fiber connections. White matter (WM) fibers were dissected layer by layer in a medial-to-lateral, lateral-to-medial, and posterior-to-anterior fashion. All related tracts and their connections were generated using deterministic tractography. The magnetic resonance imaging (MRI) tractography findings were correlated with those of fiber dissection. A medial parieto-occipital approach to reach the atrium was performed with special emphasis on the cingulate isthmus and underlying WM connections. The isthmic cingulum, introduced as a retrosplenial connectional crossroad for the first time, displayed multiple connections to the splenium and the superior thalamic radiations. Another new finding was the demonstration of lateral hemispheric extension of the isthmic cingulum fibers through the base of the posterior part of the precuneus at the base of the parieto-occipital sulcus. The laterally crossing cingulum fibers were interconnected with three distinct association tracts: the middle longitudinal (MdLF), the inferior frontooccipital fasciculi (IFOF), and the claustro-cortical fibers (CCF). In the process of entry to the atrium during posterior interhemispheric approaches, the splenial and thalamic connections, as well as the laterally crossing fibers of the isthmic cingulum, were all in jeopardy. The connectional anatomy of the retrosplenial area is much more complicated than previously known. The isthmic cingulum connections may explain the concept of interhemispheric and medial to lateral cerebral hemisphere invasion patterns in medial parieto-occipital and posteromesial temporal gliomas. The isthmic cingulum is of key importance in posteromedial interhemispheric approaches to both: the atrium and the posterior mesial temporal lobe.
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Affiliation(s)
- Tahsin Saygi
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Rashid Avyasov
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Ozan Barut
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Basaksehir Cam Sakura Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Daglar
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey
| | - Oguz Baran
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey
- Department of Neurosurgery, Koç University Hospital, Istanbul, Turkey
| | - Ozan Hasimoglu
- Department of Neurosurgery, Basaksehir Cam Sakura Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ayca Altinkaya
- Department of Neurology, Basaksehir Cam Sakura Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Necmettin Tanriover
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey.
- Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Cerrahpasa Street, No: 53, Fatih, Istanbul, Turkey.
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11
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Şahin MH, Akyüz ME, Karadağ MK, Yalçın A. Supramarginal Gyrus and Angular Gyrus Subcortical Connections: A Microanatomical and Tractographic Study for Neurosurgeons. Brain Sci 2023; 13:brainsci13030430. [PMID: 36979240 PMCID: PMC10046402 DOI: 10.3390/brainsci13030430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Background and Objectives: This article aims to investigate the subcortical microanatomy of the supramarginal gyrus (SMG) and angular gyrus (AnG) using a microfiber dissection technique and diffusion tensor imaging (DTI)/fiber tractography (FT). The cortical and subcortical structures of this region are highly functional, and their lesions often present clinically. For this reason, the possibility of post-surgical deficits is high. We focused on the supramarginal gyrus and the angular gyrus and reviewed their anatomy from a topographic, functional and surgical point of view, and aimed to raise awareness especially for neurosurgeons. Methods: Four previously frozen, formalin-fixed human brains were examined under the operating microscope using the fiber dissection technique. Four hemispheres were dissected from medial to lateral under the surgical microscope. Brain magnetic resonance imaging (MRI) of 20 healthy adults was examined. Pre-central and post-central gyrus were preserved to achieve topographic dominance in dissections of brain specimens. Each stage was photographed. Tractographic brain magnetic resonance imaging of 10 healthy adults was examined radiologically. Focusing on the supramarginal and angular gyrus, the white matter fibers passing under this region and their intersection areas were examined. These two methods were compared anatomically from the lateral view and radiologically from the sagittal view. Results: SMG and AnG were determined in brain specimens. The pre-central and post-central gyrus were topographically preserved. The superior and medial temporal gyrus, and inferior and superior parietal areas were decorticated from lateral to medial. U fibers, superior longitudinal fasciculus II (SLF II), superior longitudinal fasciculus III (SLF III), arcuat fasciculus (AF) and middle longitudinal fasciculus (MdLF) fiber groups were shown and subcortical fiber structures belonging to these regions were visualized by the DTI/FT method. The subcortical fiber groups under the SMG and the AnG were observed anatomically and radiologically to have a dense and complex structure. Conclusions: Due to the importance of the subcortical connections of SMG and AnG on speech function, tumoral lesions and surgeries of this region are of particular importance. The anatomical architecture of the complex subcortical structure, which is located on the projection of the SMG and AnG areas, was shown with a DTI/FT examination under a topographic dominance, preserving the pre-central and post-central gyrus. In this study, the importance of the anatomical localization, connections and functions of the supramarginal and angular gyrus was examined. More anatomical and radiological studies are needed to better understand this region and its connections.
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12
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Gungor A, Gurses ME, Dogan E, Varol E, Gökalp E, Etli MU, Ozoner B. Interhemispheric Transcingulate Sulcus Approach to Deep-Seated Medial Frontal and Parietal Lesions-Fiber Dissection Study With Illustrative Cases. Oper Neurosurg (Hagerstown) 2023; 24:e178-e186. [PMID: 36701601 DOI: 10.1227/ons.0000000000000499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Surgery for lesions located in the medial frontal and parietal lobes can be quite challenging for neurosurgeons because of morbidities that may arise from damage to critical midline structures or intact neural tissue that need to be crossed to reach the lesion. In our anatomic studies, the cingulate sulcus was observed as an alternative access route for lesions located in medial frontal and parietal lobes. OBJECTIVE To explain the microsurgical anatomy of the medial hemisphere and cingulate sulcus and to demonstrate the interhemispheric transcingulate sulcus approach (ITCSA) with 3 clinical cases. METHODS Five formalin-fixed brain specimens, which were frozen at -18 °C for at least 2 weeks and then thawed under tap water, were gradually dissected from medial to lateral. Diffusion fiber tracking performed using DSI Studio software in data was provided by the Human Connectome Project. Clinical data of 3 patients who underwent ITCSA were reviewed. RESULTS Cingulate sulcus is an effortlessly identifiable continuous sulcus on the medial surface of the brain. Our anatomic dissection study revealed that the lesions located in the deep medial frontal and parietal lobes can be reached through the cingulate sulcus with minor injury only to the cingulum and callosal fibers. Three patients were treated with ITCSA without any neurological morbidity. CONCLUSION Deep-seated lesions in the medial frontal lobe and parietal lobe medial to the corona radiata can be approached by using microsurgical techniques based on anatomic information. ITCSA offers an alternative route to these lesions besides the known lateral transcortical/transsulcal and interhemispheric transcingulate gyrus approaches.
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Affiliation(s)
- Abuzer Gungor
- Department of Neurosurgery, University of Health Sciences, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Neurology, Neurosurgery and Psychiatry, Istanbul, Turkey
- Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Muhammet Enes Gurses
- Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Yeditepe University School of Medicine, Istanbul, Turkey
- Department of Neurosurgery, Hacettepe University, Ankara, Turkey
| | - Eray Dogan
- Department of Neurosurgery, Microsurgical Neuroanatomy Laboratory, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Eyup Varol
- Department of Neurosurgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Elif Gökalp
- Department of Neurosurgery, Ankara University, Ankara, Turkey
| | - Mustafa Umut Etli
- Department of Neurosurgery, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Baris Ozoner
- Department of Neurosurgery, University of Health Sciences, Kartal Training and Research Hospital, Istanbul, Turkey
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13
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The connectivity-based parcellation of the angular gyrus: fiber dissection and MR tractography study. Brain Struct Funct 2023; 228:121-130. [PMID: 36056938 DOI: 10.1007/s00429-022-02555-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/14/2022] [Indexed: 01/07/2023]
Abstract
The angular gyrus (AG) wraps the posterior end of the superior temporal sulcus (STS), so it is considered a continuation of the superior temporal gyrus (STG)/ middle temporal gyrus (MTG) and forms the inferior parietal lobule (IPL) with the supramarginal gyrus (SMG). The AG was functionally divided in the literature, but there is no fiber dissection study in this context. This study divided AG into superior (sAG) and inferior (iAG) parts by focusing on STS. Red, blue silicone-injected eight and four non-silicone-injected human cadaveric cerebrums were dissected via the Klingler method focusing on the AG. White matter (WM) tracts identified during dissection were then reconstructed on the Human Connectome Project 1065 individual template for validation. According to this study, superior longitudinal fasciculus (SLF) II and middle longitudinal fasciculus (MdLF) are associated with sAG; the anterior commissure (AC), optic radiation (OR) with iAG; the arcuate fasciculus (AF), inferior frontooccipital fasciculus (IFOF), and tapetum (Tp) with both parts. In cortical parcellation of AG based on STS, sAG and iAG were associated with different fiber tracts. Although it has been shown in previous studies that there are functionally different subunits with AG parcellation, here, for the first time, other functions of the subunits have been revealed with cadaveric dissection and tractography images.
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14
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Gurses ME, Gungor A, Gökalp E, Hanalioglu S, Karatas Okumus SY, Tatar I, Berker M, Cohen-Gadol AA, Türe U. Three-Dimensional Modeling and Augmented and Virtual Reality Simulations of the White Matter Anatomy of the Cerebrum. Oper Neurosurg (Hagerstown) 2022; 23:355-366. [DOI: 10.1227/ons.0000000000000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022] Open
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15
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Gurses ME, Gungor A, Rahmanov S, Gökalp E, Hanalioglu S, Berker M, Cohen-Gadol AA, Türe U. Three-Dimensional Modeling and Augmented Reality and Virtual Reality Simulation of Fiber Dissection of the Cerebellum and Brainstem. Oper Neurosurg (Hagerstown) 2022; 23:345-354. [DOI: 10.1227/ons.0000000000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022] Open
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16
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Demirtaş OK, Güngör A, Çeltikçi P, Çeltikçi E, Munoz-Gualan AP, Doğulu FH, Türe U. Microsurgical anatomy and insular connectivity of the cerebral opercula. J Neurosurg 2022; 137:1509-1523. [PMID: 35303697 DOI: 10.3171/2021.12.jns212297] [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: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Radiological, anatomical, and electrophysiological studies have shown the insula and cerebral opercula to have extremely high functionality. Because of this complexity, interventions in this region cause higher morbidity compared to those in other areas of the brain. In most early studies of the insula and white matter pathways, insular dissection was begun after the opercula were removed. In this study, the authors examined the insula and deep white matter pathways to evaluate the insula as a whole with the surrounding opercula. METHODS Twenty formalin-fixed adult cerebral hemispheres were studied using fiber microdissection techniques and examination of sectional anatomy. Dissections were performed from lateral to medial, medial to lateral, inferior to superior, and superior to inferior. A silicone brain model was used to show the normal gyral anatomy. Sections and fibers found at every stage of dissection were photographed with a professional camera. MRI tractography studies were used to aid understanding of the dissections. RESULTS The relationships between the insula and cerebral opercula were investigated in detail through multiple dissections and sections. The relationship of the extreme and external capsules with the surrounding opercula and the fronto-occipital fasciculus with the fronto-orbital operculum was demonstrated. These findings were correlated with the tractography studies. Fibers of the extreme capsule connect the medial aspect of the opercula with the insula through the peri-insular sulcus. Medial to lateral dissections were followed with the removal of the central core structures, and in the last step, the medial surface of the cerebral opercula was evaluated in detail. CONCLUSIONS This anatomical study clarifies our understanding of the insula and cerebral opercula, which have complex anatomical and functional networks. This study also brings a new perspective to the connection of the insula and cerebral opercula via the extreme and external capsules.
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Affiliation(s)
- Oğuz Kağan Demirtaş
- 1Department of Neurosurgery, Gazi University Hospital, Ankara
- 2Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul
- 3Department of Neurosurgery, Sincan Nafiz Körfez State Hospital, Ankara
| | - Abuzer Güngör
- 2Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul
- 4Department of Neurosurgery, Bakirköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul
| | - Pınar Çeltikçi
- 5Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey; and
| | - Emrah Çeltikçi
- 1Department of Neurosurgery, Gazi University Hospital, Ankara
| | - Alberth Patricio Munoz-Gualan
- 2Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul
- 6Department of Nervous Disease and Neurosurgery, Peoples' Friendship University of Russia, Moscow, Russia
| | | | - Uğur Türe
- 2Department of Neurosurgery, Yeditepe University School of Medicine, Istanbul
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17
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Forkel SJ, Labache L, Nachev P, Thiebaut de Schotten M, Hesling I. Stroke disconnectome decodes reading networks. Brain Struct Funct 2022; 227:2897-2908. [PMID: 36192557 DOI: 10.1007/s00429-022-02575-x] [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: 03/11/2022] [Accepted: 09/19/2022] [Indexed: 12/31/2022]
Abstract
Cognitive functional neuroimaging has been around for over 30 years and has shed light on the brain areas relevant for reading. However, new methodological developments enable mapping the interaction between functional imaging and the underlying white matter networks. In this study, we used such a novel method, called the disconnectome, to decode the reading circuitry in the brain. We used the resulting disconnection patterns to predict a typical lesion that would lead to reading deficits after brain damage. Our results suggest that white matter connections critical for reading include fronto-parietal U-shaped fibres and the vertical occipital fasciculus (VOF). The lesion most predictive of a reading deficit would impinge on the left temporal, occipital, and inferior parietal gyri. This novel framework can systematically be applied to bridge the gap between the neuropathology of language and cognitive neuroscience.
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Affiliation(s)
- Stephanie J Forkel
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France. .,Donders Centre for Cognition, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, The Netherlands. .,Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Department of Neurosurgery, Technical University of Munich School of Medicine, Munich, Germany.
| | - Loïc Labache
- Department of Psychology, Yale University, New Haven, CT, 06511, USA
| | - Parashkev Nachev
- UCL Queen Square Institute of Neurology, University College London, Queen Square, London, WC1N 3GB, UK
| | - Michel Thiebaut de Schotten
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Isabelle Hesling
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
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18
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Preservation of frontal white matter tracts in ventricular surgery: favoring an anterior interhemispheric transcallosal approach vs a transcortical transfrontal transventricular approach. Neurosurg Rev 2022; 45:3349-3359. [PMID: 35933549 DOI: 10.1007/s10143-022-01841-0] [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: 04/28/2022] [Revised: 06/29/2022] [Accepted: 07/27/2022] [Indexed: 10/15/2022]
Abstract
Secondary to the creation of a surgical corridor and retraction, white matter tracts degenerate, causing long-term scarring with potential neurological consequences. Third and lateral ventricle tumors require surgery that may lead to cognitive impairment. Our objective is to compare the long-term consequences of a transcortical transfrontal approach and an interhemispheric transcallosal approach on corpus callosum and frontal white matter tracts degeneration. Surgical patients with ventricular tumor accessible through both approaches were included and clinico-radiological data were retrospectively analyzed. The primary endpoint was the callosotomy length at 3-month post-operative T1 MRI, corrected by the extension of the tumor and the use of neuronavigation. Secondary outcomes included perioperative criteria such as bleeding, use of retractors and duration, FLAIR hypersignal on 3-month MRI, and re-do surgeries. To assess white matter tract interruption, 3-month FLAIR hypersignal was superposed to a tractography atlas. Seventy patients were included, 57 (81%) in the transfrontal group and 13 (19%) in the interhemispheric group. There was no difference in the mean callosotomy length on 3-month MRI (12.3 mm ± 5.60 transfrontal vs 11.7 mm ± 3.92 interhemispheric, p = 0.79) on univariate and multivariate analyses. The callosotomy length was inferior by - 3.13 mm for tumors located exclusively in the third ventricle (p = 0.016), independent of the approach. Retractors were used more often in transfrontal approaches (60% vs 33%, p < 0.001). The extent of frontal FLAIR hypersignal was higher after transfrontal approach (14.1 mm vs 0.525 mm, p < 0.001), correlated to the use of retractors (p < 0.05). After the interhemispheric approach, no tract other than corpus callosum was interrupted, whereas, after the transfrontal approach, frontal arcuate fibers and projections from the thalamus were interrupted in all patients, the cingulum in 19 (33%), the superior fronto-occipital fasciculus in 15 (26%), and the superior longitudinal fasciculus in 2 (3%). Transfrontal and interhemispheric approaches to the third and lateral ventricles both lead to the same long-term damage to the corpus callosum, but the transfrontal approach interrupts several white matter tracts essential to cognitive tasks such as attention and planning, even in the non-dominant hemisphere. These results encourage all neurosurgeons to be familiar with both approaches and favor the interhemispheric approach when both can give access to the tumor with a comparable risk. Neuropsychological studies are necessary to correlate these anatomical findings to cognitive outcomes.
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19
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Akeret K, Forkel SJ, Buzzi RM, Vasella F, Amrein I, Colacicco G, Serra C, Krayenbühl N. Multimodal anatomy of the human forniceal commissure. Commun Biol 2022; 5:742. [PMID: 35879431 PMCID: PMC9314404 DOI: 10.1038/s42003-022-03692-3] [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] [Received: 12/21/2021] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
Ambiguity surrounds the existence and morphology of the human forniceal commissure. We combine advanced in-vivo tractography, multidirectional ex-vivo fiber dissection, and multiplanar histological analysis to characterize this structure’s anatomy. Across all 178 subjects, in-vivo fiber dissection based on the Human Connectome Project 7 T MRI data identifies no interhemispheric connections between the crura fornicis. Multidirectional ex-vivo fiber dissection under the operating microscope demonstrates the psalterium as a thin soft-tissue membrane spanning between the right and left crus fornicis, but exposes no commissural fibers. Multiplanar histological analysis with myelin and Bielchowsky silver staining, however, visualizes delicate cruciform fibers extending between the crura fornicis, enclosed by connective tissue, the psalterium. The human forniceal commissure is therefore much more delicate than previously described and presented in anatomical textbooks. This finding is consistent with the observed phylogenetic trend of a reduction of the forniceal commissure in non-human primates compared to non-primate eutherian mammals. Anatomical dissection and tractography elucidate the delicate nature of the human forniceal commissure, an interhemispheric white matter circuit.
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Affiliation(s)
- Kevin Akeret
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Stephanie J Forkel
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France.,Donders Centre for Cognition, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, the Netherlands.,Centre for Neuroimaging Sciences, Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Departments of Neurosurgery, Technical University of Munich School of Medicine, Munich, Germany
| | - Raphael M Buzzi
- Division of Internal Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Flavio Vasella
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Irmgard Amrein
- Institute of Anatomy, University of Zurich, Zurich, Switzerland.,Department of Health Sciences and Technology, ETH, Zurich, Switzerland
| | | | - Carlo Serra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Niklaus Krayenbühl
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich and University of Zurich, Zurich, Switzerland. .,Division of Pediatric Neurosurgery, University Children's Hospital, Zurich, Switzerland.
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20
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Gu Y, Zhao P, Feng W, Xia X, Tian X, Yan Y, Wang X, Gao D, Du Y, Li X. Structural brain network measures in elderly patients with cerebral small vessel disease and depressive symptoms. BMC Geriatr 2022; 22:568. [PMID: 35810313 PMCID: PMC9270825 DOI: 10.1186/s12877-022-03245-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/27/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives To investigate the relationship between diffusion tensor imaging (DTI) indicators and cerebral small vessel disease (CSVD) with depressive states, and to explore the underlying mechanisms of white matter damage in CSVD with depression. Method A total of 115 elderly subjects were consecutively recruited from the neurology clinic, including 36 CSVD patients with depressive state (CSVD+D), 34 CSVD patients without depressive state (CSVD-D), and 45 controls. A detailed neuropsychological assessment and multimodal magnetic resonance imaging (MRI) were performed. Based on tract-based spatial statistics (TBSS) analysis and structural network analysis, differences between groups were compared, including white matter fiber indicators (fractional anisotropy and mean diffusivity) and structural brain network indicators (global efficiency, local efficiency and network strength), in order to explore the differences and correlations of DTI parameters among the three groups. Results There were no significant differences in terms of CSVD burden scores and conventional imaging findings between the CSVD-D and CSVD+D groups. Group differences were found in DTI indicators (p < 0.05), after adjusting for age, gender, education level, and vascular risk factors (VRF), there were significant correlations between TBSS analysis indicators and depression, including: fractional anisotropy (FA) (r = − 0.291, p < 0.05), mean diffusivity (MD) (r = 0.297, p < 0.05), at the same time, between structural network indicators and depression also show significant correlations, including: local efficiency (ELocal) (r = − 0.278, p < 0.01) and network strength (r = − 0.403, p < 0.001). Conclusions Changes in FA, MD values and structural network indicators in DTI parameters can predict the depressive state of CSVD to a certain extent, providing a more direct structural basis for the hypothesis of abnormal neural circuits in the pathogenesis of vascular-related depression. In addition, abnormal white matter alterations in subcortical neural circuits probably affect the microstructural function of brain connections, which may be a mechanism for the concomitant depressive symptoms in CSVD patients.
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Affiliation(s)
- Yumeng Gu
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Ping Zhao
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Wenjun Feng
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Xiaoshuang Xia
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Xiaolin Tian
- Department of Rehabilitation, Second Hospital of Tianjin Medical University, Tianjin, 300211, China
| | - Yu Yan
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Xiaowen Wang
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Decheng Gao
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Yanfen Du
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China
| | - Xin Li
- Department of Neurology, Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin, 300211, China.
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21
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García-Feijoo P, Reghin-Neto M, Holanda V, Rassi MS, Saceda-Gutierrez JM, Carceller-Benito FE, De Oliveira E. 3-Step didactic white matter dissection of human cerebellum: Micro-neuroanatomical training. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:61-70. [PMID: 35248300 DOI: 10.1016/j.neucie.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/06/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVES A thorough understanding of cerebellum anatomy is essential in 4th ventricle approaches (more frequent in pediatric neurosurgery), avoiding relevant complications such as cerebellar mutism. The aim of the present work is to show the feasibility of a didactic dissection of human cerebellum focusing on cerebellar peduncles and dentate nucleus (DN), which are structures at high risk during these surgical procedures. MATERIAL AND METHODS The cerebellum was dissected according to the Klingler method for white matter, using standard and specific microsurgery tools. Surgical microscope magnification (×6-×40) provided by a D.F. Vasconcellos M900 was required. A Canon EOS T7 18-55 mm digital camera was used and Adobe Lightroom Classic CC and Keynote were selected as photo enhancing software. Special methods such as LED light endoscopic transillumination were used for photographical reasons. RESULTS DN dissection was successfully achieved and the relations between these nucleus and the cerebellar peduncles, inferior vermis and medullary velums were described. Through this three steps dissection guide (1. tentorial surface; 2. suboccipital surface; 3. 4th ventricle structures), the most relevant anatomical structures were shown and its implications in different 4th ventricle approaches were characterised. CONCLUSION 3 D perspective provided by real specimen anatomical dissection is critical for learning neuroanatomy. LED transillumination was shown as a useful technique for the 4th ventricle structures photographic documentation which improves spatial recognition. This benefit can be applied for the study of the relations between the medullary velums and the rhomboid fossa foramina, which are permeable to light. The proposed three-steps dissection guide helps to a better understanding of human cerebellum and to gain self-confidence, allowing safer practice for neurosurgeons in all stages of their career.
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Affiliation(s)
| | - Mateus Reghin-Neto
- Hospital o do Servidor Público do Estado de São Paulo (HSPE), São Paulo, Brazil
| | - Vanesa Holanda
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | - Marcio S Rassi
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | | | | | - Evandro De Oliveira
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
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22
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Garcia-Bonilla M, Castaneyra-Ruiz L, Zwick S, Talcott M, Otun A, Isaacs AM, Morales DM, Limbrick DD, McAllister JP. Acquired hydrocephalus is associated with neuroinflammation, progenitor loss, and cellular changes in the subventricular zone and periventricular white matter. Fluids Barriers CNS 2022; 19:17. [PMID: 35193620 PMCID: PMC8864805 DOI: 10.1186/s12987-022-00313-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/06/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Hydrocephalus is a neurological disease with an incidence of 80-125 per 100,000 births in the United States. Neuropathology comprises ventriculomegaly, periventricular white matter (PVWM) alterations, inflammation, and gliosis. We hypothesized that hydrocephalus in a pig model is associated with subventricular and PVWM cellular alterations and neuroinflammation that could mimic the neuropathology described in hydrocephalic infants. METHODS Hydrocephalus was induced by intracisternal kaolin injections in 35-day old female pigs (n = 7 for tissue analysis, n = 10 for CSF analysis). Age-matched sham controls received saline injections (n = 6). After 19-40 days, MRI scanning was performed to measure the ventricular volume. Stem cell proliferation was studied in the Subventricular Zone (SVZ), and cell death and oligodendrocytes were examined in the PVWM. The neuroinflammatory reaction was studied by quantifying astrocytes and microglial cells in the PVWM, and inflammatory cytokines in the CSF. RESULTS The expansion of the ventricles was especially pronounced in the body of the lateral ventricle, where ependymal disruption occurred. PVWM showed a 44% increase in cell death and a 67% reduction of oligodendrocytes. In the SVZ, the number of proliferative cells and oligodendrocyte decreased by 75% and 57% respectively. The decrease of the SVZ area correlated significantly with ventricular volume increase. Neuroinflammation occurred in the hydrocephalic pigs with a significant increase of astrocytes and microglia in the PVWM, and high levels of inflammatory interleukins IL-6 and IL-8 in the CSF. CONCLUSION The induction of acquired hydrocephalus produced alterations in the PVWM, reduced cell proliferation in the SVZ, and neuroinflammation.
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Affiliation(s)
- Maria Garcia-Bonilla
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA.
| | - Leandro Castaneyra-Ruiz
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Sarah Zwick
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Michael Talcott
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA.,Division of Comparative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Ayodamola Otun
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - Albert M Isaacs
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Alberta, T2N 2T9, Canada
| | - Diego M Morales
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - David D Limbrick
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
| | - James P McAllister
- Department of Neurosurgery, Washington University in St. Louis School of Medicine, St. Louis, MO, 63110, USA
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23
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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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24
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Clarke MA, Archer D, Yoon K, Oguz I, Smith SA, Xu J, Cutter G, Bagnato F. White matter tracts that overlap with the thalamus and the putamen are protected against multiple sclerosis pathology. Mult Scler Relat Disord 2022; 57:103430. [PMID: 34922252 PMCID: PMC10703593 DOI: 10.1016/j.msard.2021.103430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/12/2021] [Accepted: 11/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The thalamus and the putamen are highly connected hubs implicated in multiple sclerosis (MS) pathology. It remains unclear if white matter (WM) tracts, which pass through them, have a different susceptibility to MS pathology, and if so, if their impact on disability predominates over that exerted by disease in other WM tracts. We hypothesized that WM tracts connected to and passing through these hubs (subsequently termed hub+ tracts) would be more susceptible to MS-related pathology than tracts that do not pass through them (hub- tracts) due to retrograde and anterograde distant degeneration. Thus, we compared the lesion load and neurite orientation dispersion and density imaging (NODDI) derived metrics between hub+ and hub- tracts and assessed the relationship between these MRI metrics and those of physical impairment. METHODS Eighteen patients (mean age of 45.5 years, 12 females) had 3 Tesla MRI consisting of T1-weighted and T2-weighted Fluid Attenuated Inversion Recovery (FLAIR), and NODDI from which the orientation dispersion index (ODI), neurite density index (NDI), and isotropic volume fraction (IVF) were derived. Forty-nine WM tracts, i.e., 12 hub+ and 37 hub- tracts, were segmented out. Exploratory analyses of the differences in lesion burden, whole tract and normal appearing WM (NAWM) NODDI metrics were carried out between the two types of tracts using a Mann-Whitney U test. Correlations with physical impairment, quantified using the expanded disability status scale (EDSS) and timed 25-foot walk (T25FW) test were assessed using Spearman correlation analyses. RESULTS Hub- tracts had larger T1- (p<0.001) and T2-lesion (p<0.001) volumes; lower ODI (p<0.001), NDI (p<0.001) and higher IVF (p = 0.020) in comparison to hub+ tracts. Measures of tissue injury in hub+ tracts correlated with those of clinical disability, though less strongly than in hub- tracts. CONCLUSIONS Contrary to our hypothesis, our exploratory pilot study results suggest that WM tracts that overlap with the thalamus and the putamen have a lower degree of lesional and non-lesional tissue injury, suggesting a protective role of the hubs against MS pathology or a higher degree of vulnerability of those not passing through hub stations. We also show a weaker association between disability impairment and hub+ pathology, compared to that in hub- tracts. Our findings point to a potential role of disease location in relation to hubs as guidance for treatment personalization in MS.
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Affiliation(s)
- M A Clarke
- Neuroimaging Unit, Neuro-immunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville TN, USA.
| | - D Archer
- Vanderbilt Memory & Alzheimer's Center, Vanderbilt University Medical Center, USA
| | - K Yoon
- School of Medicine, Vanderbilt University, Nashville TN, USA
| | - I Oguz
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville TN, USA
| | - S A Smith
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville TN, USA; Vanderbilt University Institute of Imaging Sciences, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville TN, USA
| | - J Xu
- Vanderbilt University Institute of Imaging Sciences, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville TN, USA
| | - G Cutter
- Department of Biostatistics, University of Alabama, Birmingham, AL, USA
| | - F Bagnato
- Neuroimaging Unit, Neuro-immunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville TN, USA; Department of Neurology, VA Medical Center, TN Valley Healthcare System (TVHS) Nashville TN, USA
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25
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The posterior interhemispheric transparieto-occipital fissure approach to the atrium of the lateral ventricle: a fiber microdissection study with case series. Neurosurg Rev 2021; 45:1663-1674. [PMID: 34822014 DOI: 10.1007/s10143-021-01693-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/21/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
The surgical approach to the atrium of the lateral ventricle remains a challenge because of its deep location and close relationship to important neurovascular structures. We present an alternative and safer approach to lesions of the atrium using a natural pathway through the parieto-occipital fissure. We demonstrate this approach through cadaveric anatomical microdissection and a case series. Five formalin-fixed brain specimens (10 hemispheres) were dissected with the Klingler technique. Transillumination was used to show the trajectory of the approach in cadaveric specimens. Clinical data from five patients who underwent this approach were reviewed. This data included intraoperative ultrasound images, operative images, pre- and postoperative magnetic resonance imaging, MR tractography, and visual field examination. The parieto-occipital fissure is a constant, uninterrupted fissure that can be easily identified in cadavers. Our anatomical dissection study revealed that the atrium of the lateral ventricle can be approached through the parieto-occipital fissure with minor damage to the short association fibers between the precuneus and cuneus, and a few fibers of the forceps major. In our series, five patients underwent total resection of their atrial lesions via the posterior interhemispheric transparieto-occipital fissure. No morbidity or mortality was observed, and the disruption of white matter was minimal, as indicated on postoperative tractography. The postoperative visual fields were normal. The posterior interhemispheric transparieto-occipital fissure approach is an alternative to remove lesions in the atrium of the lateral ventricle, causing the least damage to white matter tracts and preserving visual cortex and optic radiation.
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26
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Cuellar-Hernandez JJ, Lopez-Gonzalez MA, Olivas-Campos JR, Tabera-Tarello PM, Seañez-Prieto C, Eastin TM, Song M. The use of exoscope combined with tubular retractor system for minimally invasive transsulcal resection of an ventricular atrium atypical choroid plexus papilloma: Three-dimensional operative video. Surg Neurol Int 2021; 12:444. [PMID: 34754526 PMCID: PMC8571091 DOI: 10.25259/sni_642_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/20/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Choroid plexus papilloma represents 1–4% of pediatric brain tumors, mostly located in the ventricular atrium.[1] Intraventricular tumors represent a challenge due to the poor visualization of the surgical field and damage to surrounding structures.[2] Use of tubular retraction reduces cerebrovascular trauma to the surrounding parenchyma by distributing pressure uniformly, allowing less invasive corticotomy, and more stability on surgical corridors that allow the surgeon to use both hands and external visualization devices.[2-5] Case Description: We present the case of a 3-year-old boy with progressive headache, vomiting, and loss of control in the left hand for 3 months, with a history of ventricular shunt placement for acute obstructive hydrocephalus. The MRI revealed large lobulated lesion, which was hypointense on T1, hyperintense on T2, marked enhancement on T1 C+ (Gd) within the atrium of the right lateral ventricle, and spectroscopy with a peak of choline. Written consent for the use of photos and videos on this work was obtained from the patient’s mother. A high-definition two-dimensional exoscope (VITOM® Karl Storz, Tuttlingen) was used during the surgical approach and throughout tumor removal, which was aided by ViewSite Brain Access System (VBAS®; Vycor Medical Inc.).[3] We performed a transparietal minimally invasive transsulcal parafascicular approach through the Frazier point for direct access to the ventricular atrium. Histological examination confirmed atypical choroid plexus papilloma. Postoperative imaging shows no residual tumor. The postoperative course was satisfactory with improvement of the headache and control of the left hand, leading to discharge home 1 week after surgery. Conclusion: The tubular transparietal minimally invasive approach obviates the need for traditional approaches to the atrium. This technique is safe and effective for the treatment of intraventricular and periventricular lesions, thus making this challenging target in more accessible to neurosurgeons, avoiding structure damage and any associated morbidity or mortality.
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Affiliation(s)
| | | | - J Ramon Olivas-Campos
- Department of Neurosurgery, Northeast National Medical Center, Monterrey, Nuevo Leon, Mexico
| | - Paulo M Tabera-Tarello
- Department of Neurosurgery, Northeast National Medical Center, Monterrey, Nuevo Leon, Mexico
| | - Carlos Seañez-Prieto
- Department of Neurosurgery, Northeast National Medical Center, Monterrey, Nuevo Leon, Mexico
| | - Timothy Marc Eastin
- Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, California, United States
| | - Minwoo Song
- Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, California, United States
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27
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White matter variability, cognition, and disorders: a systematic review. Brain Struct Funct 2021; 227:529-544. [PMID: 34731328 PMCID: PMC8844174 DOI: 10.1007/s00429-021-02382-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
Abstract
Inter-individual differences can inform treatment procedures and—if accounted for—have the potential to significantly improve patient outcomes. However, when studying brain anatomy, these inter-individual variations are commonly unaccounted for, despite reports of differences in gross anatomical features, cross-sectional, and connectional anatomy. Brain connections are essential to facilitate functional organization and, when severed, cause impairments or complete loss of function. Hence, the study of cerebral white matter may be an ideal compromise to capture inter-individual variability in structure and function. We reviewed the wealth of studies that associate cognitive functions and clinical symptoms with individual tracts using diffusion tractography. Our systematic review indicates that tractography has proven to be a sensitive method in neurology, psychiatry, and healthy populations to identify variability and its functional correlates. However, the literature may be biased, as the most commonly studied tracts are not necessarily those with the highest sensitivity to cognitive functions and pathologies. Additionally, the hemisphere of the studied tract is often unreported, thus neglecting functional laterality and asymmetries. Finally, we demonstrate that tracts, as we define them, are not correlated with one, but multiple cognitive domains or pathologies. While our systematic review identified some methodological caveats, it also suggests that tract–function correlations might still be a promising tool in identifying biomarkers for precision medicine. They can characterize variations in brain anatomy, differences in functional organization, and predicts resilience and recovery in patients.
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28
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Bernard F, Haemmerli J, Zegarek G, Kiss-Bodolay D, Schaller K, Bijlenga P. Augmented reality-assisted roadmaps during periventricular brain surgery. Neurosurg Focus 2021; 51:E4. [PMID: 34333465 DOI: 10.3171/2021.5.focus21220] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/18/2021] [Indexed: 11/06/2022]
Abstract
Visualizing major periventricular anatomical landmarks intraoperatively during brain tumor removal is a decisive measure toward preserving such structures and thus the patient's postoperative quality of life. The aim of this study was to describe potential standardized preoperative planning using standard landmarks and procedures and to demonstrate the feasibility of using augmented reality (AR) to assist in performing surgery according to these "roadmaps." The authors have depicted stepwise AR surgical roadmaps applied to periventricular brain surgery with the aim of preserving major cognitive function. In addition to the technological aspects, this study highlights the importance of using emerging technologies as potential tools to integrate information and to identify and visualize landmarks to be used during tumor removal.
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Affiliation(s)
- Florian Bernard
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland.,2Division of Neurosurgery, Angers University Hospitals.,3Laboratory of Anatomy, University of Angers; and.,4CRCINA, UMR 1232 INSERM/CNRS and EA7315 team, Angers, France
| | - Julien Haemmerli
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Gregory Zegarek
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Daniel Kiss-Bodolay
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Karl Schaller
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Philippe Bijlenga
- 1Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
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29
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Porto de Oliveira JVM, Raquelo-Menegassio AF, Maldonado IL. What's your name again? A review of the superior longitudinal and arcuate fasciculus evolving nomenclature. Clin Anat 2021; 34:1101-1110. [PMID: 34218465 DOI: 10.1002/ca.23764] [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: 01/11/2021] [Revised: 05/25/2021] [Accepted: 06/18/2021] [Indexed: 11/11/2022]
Abstract
Studies of the superior longitudinal fasciculus (SLF) have multiplied in recent decades owing to methodological advances, but the absence of a convention for nomenclature remains a source of confusion. Here, we have reviewed existing nomenclatures in the context of the research studies that generated them and we have identified their agreements and disagreements. A literature search was conducted using PubMed/MEDLINE, Web-of-Science, Embase, and a review of seminal publications, without restrictions regarding publication date. Our search revealed that diffusion imaging, autoradiography, and fiber dissection have been the main methods contributing to tract designation. The first two have been particularly influential in systematizing the horizontal elements distant from the lateral sulcus. Twelve approaches to naming were identified, eight of them differing considerably from each other. The terms SLF and arcuate fasciculus (AF) were often used as synonyms until the second half of the 20th century. During the last 15 years, this has ceased to be the case in a growing number of publications. The term AF has been used to refer to the assembly of three different segments, or exclusively to long frontotemporal fibers. Similarly, the term SLF has been employed to denote the whole superior longitudinal associative system, or only the horizontal frontoparietal parts. As only partial correspondence can be identified among the available nomenclatures, and in the absence of an official designation of all anatomical structures that can be encountered in clinical practice, a high level of vigilance regarding the effectiveness of every oral or written act of communication is mandatory.
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Affiliation(s)
| | | | - Igor Lima Maldonado
- UMR Inserm U1253, iBrain, Université de Tours, Tours, 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
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30
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Egemen E, Celtikci P, Dogruel Y, Yakar F, Sahinoglu D, Farouk M, Adiguzel E, Ugur HC, Coskun E, Güngör A. Microsurgical and Tractographic Anatomical Study of Transtemporal-Transchoroidal Fissure Approaches to the Ambient Cistern. Oper Neurosurg (Hagerstown) 2021; 20:189-197. [PMID: 33313862 DOI: 10.1093/ons/opaa272] [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: 04/07/2020] [Accepted: 06/28/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Approaching ambient cistern lesions is still a challenge because of deep location and related white matter tracts (WMTs) and neural structures. OBJECTIVE To investigate the white matter anatomy in the course of 3 types of transtemporal-transchoroidal fissure approaches (TTcFA) to ambient cistern by using fiber dissection technique with translumination and magnetic resonance imaging fiber tractography. METHODS Eight formalin-fixed cerebral hemispheres were dissected on surgical corridor from the temporal cortex to the ambient cistern by using Klingler's method. The trans-middle temporal gyrus, trans-inferior temporal sulcus (TITS), and trans-inferior temporal gyrus (TITG) approaches were evaluated. WMTs that were identified during dissection were then reconstructed on the Human Connectome Project 1021 individual template for validation. RESULTS The trans-middle gyrus approach interrupted the U fibers, arcuate fasciculus (AF), the ventral segment of inferior frontoocipital fasciculus (IFOF), the temporal extensions of the anterior commissure (AC) posterior crura, the tapetum (Tp) fibers, and the anterior loop of the optic radiation (OR). The TITS approach interrupted U fibers, inferior longitudinal fasciculus (ILF), IFOF, and OR. The TITG approach interrupted the U fibers, ILF, and OR. The middle longitudinal fasciculus, ILF, and uncinate fasciculus (UF) were not interrupted in the trans-middle gyrus approach and the AF, UF, AC, and Tp fibers were not interrupted in the TITS/gyrus approaches. CONCLUSION Surgical planning of the ambient cistern lesions requires detailed knowledge about WMTs. Fiber dissection and tractography techniques improve the orientation during surgery and may help decrease surgical complications.
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Affiliation(s)
- Emrah Egemen
- Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Pinar Celtikci
- Department of Radiology, Baskent University, Ankara, Turkey
| | - Yücel Dogruel
- Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Fatih Yakar
- Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Defne Sahinoglu
- Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Mohamed Farouk
- Department of Neurosurgery, Mansoura University, Mansoura, Egypt
| | - Esat Adiguzel
- Department of Anatomy, Pamukkale University School of Medicine, Denizli, Turkey
| | - Hasan Caglar Ugur
- Department of Neurosurgery, Ankara University School of Medicine, Ibni Sina Hospital, Ankara, Turkey
| | - Erdal Coskun
- Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey
| | - Abuzer Güngör
- Department of Neurosurgery, Neurosurgery Laboratory, Yeditepe University School of Medicine, Istanbul, Turkey
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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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32
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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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Vergani F, Ghimire P, Rajashekar D, Dell'acqua F, Lavrador JP. Superior longitudinal fasciculus (SLF) I and II: an anatomical and functional review. J Neurosurg Sci 2021; 65:560-565. [PMID: 33940781 DOI: 10.23736/s0390-5616.21.05327-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this review, we summarise the current knowledge regarding the Superior Longitudinal Fasciculus (SLF) I and II. These fibres represent a longitudinal association tract between the parietal and frontal lobes of the brain. We highlight the anatomical representation of the SLF I and II in the primate and in the human brain. The fibres of the SLF I extend from the superior parietal lobule and precuneus, running anteriorly to reach the superior frontal gyrus and the supplementary motor area. The anatomy of the SLF I is debated in the literature, with some Authors questioning the existence of the SLF I as an individual tract. The SLF II is located inferiorly and laterally compared to the SLF I. The fibres of the SLF II extend from the inferior parietal lobule to the middle frontal gyrus. The putative functions of these tracts are reviewed, with particular regards to intraoperative findings and their relevance in applied neurosurgery. Considered together, the two tracts link associative parietal areas with premotor and supplementary motor frontal areas. The two tracts seem therefore involved in supporting the integration of sensory information and motor planning, finalised to visuospatial attention and complex motor behaviour. Finally, we discuss future directions for further study of these fibre tracts, highlighting the need for more detailed anatomical study of the SLF I and additional intraoperative tests that have been suggested to explore the function of these tracts during surgery.
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Affiliation(s)
- Francesco Vergani
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK -
| | - Prajwal Ghimire
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Devika Rajashekar
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK
| | - Flavio Dell'acqua
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King's College London, London, UK
| | - Jose P Lavrador
- Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London, UK
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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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35
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Bugain M, Dimech Y, Torzhenskaya N, Thiebaut de Schotten M, Caspers S, Muscat R, Bajada CJ. Occipital Intralobar fasciculi: a description, through tractography, of three forgotten tracts. Commun Biol 2021; 4:433. [PMID: 33785859 PMCID: PMC8010026 DOI: 10.1038/s42003-021-01935-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/03/2021] [Indexed: 02/01/2023] Open
Abstract
Diffusion MRI paired with tractography has facilitated a non-invasive exploration of many association, projection, and commissural fiber tracts. However, there is still a scarcity of research studies related to intralobar association fibers. The Dejerines' (two of the most notable neurologists of 19th century France) gave an in-depth description of the intralobar fibers of the occipital lobe. Unfortunately, their exquisite work has since been sparsely cited in the modern literature. This work gives a modern description of many of the occipital intralobar lobe fibers described by the Dejerines. We perform a virtual dissection and reconstruct the tracts using diffusion MRI tractography. The dissection is guided by the Dejerines' treatise, Anatomie des Centres Nerveux. As an accompaniment to this article, we provided a French-to-English translation of the treatise portion concerning five intra-occipital tracts, namely: the stratum calcarinum, the stratum proprium cunei, the vertical occipital fasciculus of Wernicke, the transverse fasciculus of the cuneus and the transverse fasciculus of the lingual lobule of Vialet. It was possible to reconstruct all but one of these tracts. For completeness, the recently described sledge runner fasciculus, although not one of the Dejerines' tracts, was identified and successfully reconstructed.
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Affiliation(s)
- Maeva Bugain
- grid.4462.40000 0001 2176 9482Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, The University of Malta, Msida, Malta
| | - Yana Dimech
- grid.4462.40000 0001 2176 9482Department of Cognitive Sciences, Faculty of Media and Knowledge Sciences, The University of Malta, Msida, Malta
| | - Natalia Torzhenskaya
- grid.4462.40000 0001 2176 9482Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, The University of Malta, Msida, Malta
| | - Michel Thiebaut de Schotten
- grid.462844.80000 0001 2308 1657Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, Paris, France ,grid.4444.00000 0001 2112 9282Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives -UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Svenja Caspers
- grid.8385.60000 0001 2297 375XInstitute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany ,grid.411327.20000 0001 2176 9917Institute for Anatomy I, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Richard Muscat
- grid.4462.40000 0001 2176 9482Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, The University of Malta, Msida, Malta
| | - Claude J. Bajada
- grid.4462.40000 0001 2176 9482Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, The University of Malta, Msida, Malta ,grid.8385.60000 0001 2297 375XInstitute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
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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: 85] [Impact Index Per Article: 28.3] [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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García-Feijoo P, Reghin-Neto M, Holanda V, Rassi MS, Saceda-Gutierrez JM, Carceller-Benito FE, De Oliveira E. 3-Step didactic white matter dissection of human cerebellum: Micro-neuroanatomical training. Neurocirugia (Astur) 2021; 33:S1130-1473(20)30137-8. [PMID: 33549481 DOI: 10.1016/j.neucir.2020.11.006] [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: 04/22/2020] [Revised: 08/25/2020] [Accepted: 11/06/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES A thorough understanding of cerebellum anatomy is essential in 4th ventricle approaches (more frequent in pediatric neurosurgery), avoiding relevant complications such as cerebellar mutism. The aim of the present work is to show the feasibility of a didactic dissection of human cerebellum focusing on cerebellar peduncles and dentate nucleus (DN), which are structures at high risk during these surgical procedures. MATERIAL AND METHODS The cerebellum was dissected according to the Klingler method for white matter, using standard and specific microsurgery tools. Surgical microscope magnification (x6-x40) provided by a D.F. Vasconcellos M900 was required. A Canon EOS T7 18-55 mm digital camera was used and Adobe Lightroom Classic CC and Keynote were selected as photo enhancing software. Special methods such as LED light endoscopic transillumination were used for photographical reasons. RESULTS DN dissection was successfully achieved and the relations between these nucleus and the cerebellar peduncles, inferior vermis and medullary velums were described. Through this three steps dissection guide (1. tentorial surface; 2. suboccipital surface; 3. 4th ventricle structures), the most relevant anatomical structures were shown and its implications in different 4th ventricle approaches were characterised. CONCLUSION 3 D perspective provided by real specimen anatomical dissection is critical for learning neuroanatomy. LED transillumination was shown as a useful technique for the 4th ventricle structures photographic documentation which improves spatial recognition. This benefit can be applied for the study of the relations between the medullary velums and the rhomboid fossa foramina, which are permeable to light. The proposed three-steps dissection guide helps to a better understanding of human cerebellum and to gain self-confidence, allowing safer practice for neurosurgeons in all stages of their career.
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Affiliation(s)
| | - Mateus Reghin-Neto
- Hospital o do Servidor Público do Estado de São Paulo (HSPE), São Paulo, Brazil
| | - Vanesa Holanda
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | - Marcio S Rassi
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
| | | | | | - Evandro De Oliveira
- Laboratório de Microcirurgia, A Beneficência Portuguesa (BP) de São Paulo, Instituto de Ciências Neurológicas (ICNE), São Paulo, Brazil
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38
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Weiss A, Di Carlo DT, Di Russo P, Weiss F, Castagna M, Cosottini M, Perrini P. Microsurgical anatomy of the amygdaloid body and its connections. Brain Struct Funct 2021; 226:861-874. [PMID: 33528620 DOI: 10.1007/s00429-020-02214-3] [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: 05/19/2020] [Accepted: 12/30/2020] [Indexed: 12/14/2022]
Abstract
The amygdaloid body is a limbic nuclear complex characterized by connections with the thalamus, the brainstem and the neocortex. The recent advances in functional neurosurgery regarding the treatment of refractory epilepsy and several neuropsychiatric disorders renewed the interest in the study of its functional Neuroanatomy. In this scenario, we felt that a morphological study focused on the amygdaloid body and its connections could improve the understanding of the possible implications in functional neurosurgery. With this purpose we performed a morfological study using nine formalin-fixed human hemispheres dissected under microscopic magnification by using the fiber dissection technique originally described by Klingler. In our results the amygdaloid body presents two divergent projection systems named dorsal and ventral amygdalofugal pathways connecting the nuclear complex with the septum and the hypothalamus. Furthermore, the amygdaloid body is connected with the hippocampus through the amygdalo-hippocampal bundle, with the anterolateral temporal cortex through the amygdalo-temporalis fascicle, the anterior commissure and the temporo-pulvinar bundle of Arnold, with the insular cortex through the lateral olfactory stria, with the ambiens gyrus, the para-hippocampal gyrus and the basal forebrain through the cingulum, and with the frontal cortex through the uncinate fascicle. Finally, the amygdaloid body is connected with the brainstem through the medial forebrain bundle. Our description of the topographic anatomy of the amygdaloid body and its connections, hopefully represents a useful tool for clinicians and scientists, both in the scope of application and speculation.
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Affiliation(s)
- Alessandro Weiss
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy. .,, Pisa, Italy.
| | - Davide Tiziano Di Carlo
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paolo Di Russo
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Francesco Weiss
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Maura Castagna
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Mirco Cosottini
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Paolo Perrini
- Department of Translational Research On New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Pitskhelauri DI, Ishkinin RE, Bykanov AE, Sanikidze AZ, Buklina SB, Abramyan AA, Pronin IN. [Anterior transperiinsular approach to the head of the caudate nucleus and mediobasal frontal lobe]. ZHURNAL VOPROSY NEIROKHIRURGII IMENI N. N. BURDENKO 2021; 85:54-60. [PMID: 34951760 DOI: 10.17116/neiro20218506154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The head of the caudate nucleus and adjacent mediobasal frontal lobe are deeply localized and have complex anatomical and topographic relationships with surrounding functionally significant cerebral structures. These aspects determine difficult surgical treatment of pathology in this zone. OBJECTIVE To propose a new anterior transperiinsular approach for optimizing surgical access to the head of the caudate nucleus and mediobasal frontal lobe. MATERIAL AND METHODS Two patients with cavernoma of the head of the caudate nucleus and oligodendroglioma of the head of the caudate nucleus and mediobasal frontal lobe underwent resection via transsylvian anterior transperiinsular approach in 2018. In both cases, tumors were localized in dominant hemisphere. Standard MRI was performed before and after surgery. Luria's neurological and neuropsychological examination was carried out before surgery, in 7 days after surgery and then every 3 months. RESULTS Surgical access was performed via stage-by-stage proximal dissection of Sylvian fissure with visualization of anterior and superior periinsular grooves. After that, periinsular groove was dissected at the base of anterior short gyrus. Then, we moved apart white matter using microinstruments and approached the area of interest. In case of this trajectory, surgical approach was performed at the level of the upper parts of inferior frontooccipital fascicle under the arcuate fascicle. Both patients underwent total resection of tumors that was confirmed by MRI. No pre- and postoperative neurological or neuropsychological abnormalities were observed. CONCLUSION Anterior transperiinsular approach provides minimally invasive access to the head of the caudate nucleus and mediobasal frontal lobe. It can be used on dominant hemisphere without significant risk of speech or other cognitive impairments. The advantages of this approach are minimal damage to associative pathways and small distance between periinsular groove and zone of interest. Dissection of commissural fibers of the corpus callosum is not required compared to conventional transcallosal approach.
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Affiliation(s)
| | | | - A E Bykanov
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - S B Buklina
- Burdenko Neurosurgical Center, Moscow, Russia
| | | | - I N Pronin
- Burdenko Neurosurgical Center, Moscow, Russia
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40
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Castle-Kirszbaum M, Goldschlager T. Pyramidal weakness: Is it time to retire the term? Clin Anat 2020; 34:478-482. [PMID: 33347647 DOI: 10.1002/ca.23715] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/02/2020] [Accepted: 12/15/2020] [Indexed: 11/06/2022]
Abstract
Pyramidal weakness, that is, the weakness that preferentially spares the antigravity muscles, is considered an integral part of the upper motor neuron syndrome. Despite its name, pyramidal weakness has very little to do with the pyramidal tract, and preeminent texts on neurology, neuroanatomy, and clinical examination differ considerably in their descriptions and localization of this enigmatic finding. Evidence from human and nonhuman primate studies demonstrates that lesions confined only to the corticospinal (pyramidal) tract cause significant deficits in fine motor control of the hand, but do not cause posturing or patterned weakness of the extremities. Lesioning of the corticofugal fibers, particularly the corticoreticular and corticopontine tracts, leads to dysbalanced output from reticulospinal, and vestibulospinal systems, which along with changes in rubrospinal tract output balance, probably accounts for the pyramidal weakness pattern. Importantly, this would delineate that pyramidal weakness could only be incited by lesions above the brainstem. It has also been suggested that the inherently greater strength of the antigravity musculature is the substrate for pyramidal weakness, independent of any preferential motor innervation. These hypotheses require further testing in myometric studies with carefully selected participants.
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Affiliation(s)
| | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Melbourne, Australia.,Department of Surgery, Monash University, Melbourne, Australia
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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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Holanda VM, Okun MS, Middlebrooks EH, Gungor A, Barry ME, Forder J, Foote KD. Postmortem Dissections of Common Targets for Lesion and Deep Brain Stimulation Surgeries. Neurosurgery 2020; 86:860-872. [PMID: 31504849 DOI: 10.1093/neuros/nyz318] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 05/09/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The subthalamic nucleus (STN), globus pallidus internus (GPi), and pedunculopontine nucleus (PPN) are effective targets for deep brain stimulation (DBS) in many pathological conditions. Previous literature has focused on appropriate stimulation targets and their relationships with functional neuroanatomic pathways; however, comprehensive anatomic dissections illustrating these nuclei and their connections are lacking. This information will provide insight into the anatomic basis of stimulation-induced DBS benefits and side effects. OBJECTIVE To combine advanced cadaveric dissection techniques and ultrahigh field magnetic resonance imaging (MRI) to explore the anatomy of the STN, GPi, and PPN with their associated fiber pathways. METHODS A total of 10 cadaveric human brains and 2 hemispheres of a cadaveric head were examined using fiber dissection techniques. The anatomic dissections were compared with 11.1 Tesla (T) structural MRI and 4.7 T MRI fiber tractography. RESULTS The extensive connections of the STN (caudate nucleus, putamen, medial frontal cortex, substantia innominata, substantia nigra, PPN, globus pallidus externus (GPe), GPi, olfactory tubercle, hypothalamus, and mammillary body) were demonstrated. The connections of GPi to the thalamus, substantia nigra, STN, amygdala, putamen, PPN, and GPe were also illustrated. The PPN was shown to connect to the STN and GPi anteriorly, to the cerebellum inferiorly, and to the substantia nigra anteriorly and superiorly. CONCLUSION This study demonstrates connections using combined anatomic microdissections, ultrahigh field MRI, and MRI tractography. The anatomic findings are analyzed in relation to various stimulation-induced clinical effects. Precise knowledge of neuroanatomy, anatomic relationships, and fiber connections of the STN, GPi, PPN will likely enable more effective targeting and improved DBS outcomes.
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Affiliation(s)
- Vanessa M Holanda
- Fixel Institute for Neurological Diseases, Department of Neurosurgery, University of Florida, Gainesville, Florida.,Center of Neurology and Neurosurgery Associates (NeuroCENNA), BP - A Beneficência Portuguesa de São Paulo, São Paulo SP, Brazil.,Department of Neurosurgery, Mayo Clinic College of Medicine, Jacksonville, Florida
| | - Michael S Okun
- Fixel Institute for Neurological Diseases, Department of Neurology, University of Florida, Gainesville, Florida
| | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic College of Medicine, Jacksonville, Florida
| | - Abuzer Gungor
- Department of Neurosurgery, Acιbadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Margaret E Barry
- Fixel Institute for Neurological Diseases, Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - John Forder
- Department of Radiology, University of Florida, Gainesville, Florida
| | - Kelly D Foote
- Fixel Institute for Neurological Diseases, Department of Neurosurgery, University of Florida, Gainesville, Florida
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Comparison of the keyhole trans-middle temporal gyrus approach and transsylvian approach for selective amygdalohippocampectomy: A single-center experience. J Clin Neurosci 2020; 81:390-396. [PMID: 33222948 DOI: 10.1016/j.jocn.2020.10.019] [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: 06/09/2020] [Revised: 09/19/2020] [Accepted: 10/03/2020] [Indexed: 01/19/2023]
Abstract
Several approach routes exist for selective amygdalohippocampectomy (SAH); however, previous reports regarding a comparison of these routes are limited. Here, we compared trans-middle temporal gyrus (T2) SAH and transsylvian (TS) SAH in terms of seizure outcome, visual-field defect, memory function, and operation time in our institution. This retrospective study examined the data of 16 patients with medically intractable mesial temporal lobe epilepsy. Six patients underwent trans-T2 SAH and 10 patients underwent TS SAH between July 2014 and February 2019 in Osaka City University Hospital. In trans-T2 SAH, we performed a keyhole temporal craniotomy and a small corticotomy on T2. In TS SAH, we performed a 1.5 cm corticotomy along the inferior periinsular sulcus after opening the sylvian fissure. Amygdalohippocampectomy after reaching the inferior horn of the lateral ventricle was performed in the same manner in both procedures. The seizure outcome, visual-field defect, memory function, and operation time were retrospectively compared between the procedures. Seizure-free outcomes were achieved for six patients in the trans-T2 SAH and eight patients in the TS SAH group. There were no significant differences in the seizure outcome, visual-field defect, and memory function. The operation time was significantly shorter for trans-T2 SAH than TS SAH. The postoperative scar was less conspicuous for trans-T2 SAH. Trans-T2 SAH and TS SAH were comparable in terms of the seizure outcome, visual-field defect, and memory function. The operation time and length of the skin incision were shorter for trans-T2 SAH, suggesting that it may be preferable for general epilepsy surgeons.
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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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Monroy-Sosa A, Chakravarthi SS, Fukui MB, Kura B, Jennings JE, Celix JM, Nash KC, Kassam M, Rovin RA, Kassam AB. White Matter-Governed Superior Frontal Sulcus Surgical Paradigm: A Radioanatomic Microsurgical Study—Part I. Oper Neurosurg (Hagerstown) 2020; 19:E343-E356. [DOI: 10.1093/ons/opaa065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 01/13/2020] [Indexed: 12/27/2022] Open
Abstract
Abstract
BACKGROUND
Frontal subcortical and intraventricular pathologies are traditionally accessed via transcortical or interhemispheric-transcallosal corridors.
OBJECTIVE
To describe the microsurgical subcortical anatomy of the superior frontal sulcus (SFS) corridor.
METHODS
Cadaveric dissections were undertaken and correlated with magnetic resonance imaging/diffusion-tensor imaging-Tractography. Surgical cases demonstrated clinical applicability.
RESULTS
SFS was divided into the following divisions: proximal, precentral sulcus to coronal suture; middle, 3-cm anterior to coronal suture; and distal, middle division to the orbital crest. Anatomy was organized as layered circumferential rings projecting radially towards the ventricles: (1) outer ring: at the level of the SFS, the following lengths were measured: (A) precentral sulcus to coronal suture = 2.29 cm, (B) frontal bone projection of superior sagittal sinus (SSS) to SFS = 2.37 cm, (C) superior temporal line to SFS = 3.0 cm, and (D) orbital crest to distal part of SFS = 2.32 cm; and (2) inner ring: (a) medial to SFS, U-fibers, frontal aslant tract (FAT), superior longitudinal fasciculus I (SLF-I), and cingulum bundle, (b) lateral to SFS, U-fibers, (SLF-II), claustrocortical fibers (CCF), and inferior fronto-occipital fasciculus, and (c) intervening fibers, FAT, corona radiata, and CCF. The preferred SFS parafascicular entry point (SFSP-EP) also referred to as the Kassam-Monroy entry point (KM-EP) bisects the distance between the midpupillary line and the SSS and has the following coordinates: x = 2.3 cm (lateral to SSS), y ≥ 3.5 cm (anterior to CS), and z = parallel corona radiata and anterior limb of the internal capsule.
CONCLUSION
SFS corridor can be divided into lateral, medial, and intervening white matter tract segments. Based on morphometric assessment, the optimal SFSP-EP is y ≥ 3.5 cm, x = 2.3 cm, and z = parallel to corona radiata and anterior limb of the internal capsule.
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Affiliation(s)
- Alejandro Monroy-Sosa
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Srikant S Chakravarthi
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Melanie B Fukui
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Bhavani Kura
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Jonathan E Jennings
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Juanita M Celix
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Kenneth C Nash
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Mikaeel Kassam
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
- Neeka Health, Milwaukee, Wisconsin
| | - Richard A Rovin
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
| | - Amin B Kassam
- Department of Neurosurgery, Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin
- Neeka Health, Milwaukee, Wisconsin
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Kalyvas A, Koutsarnakis C, Komaitis S, Karavasilis E, Christidi F, Skandalakis GP, Liouta E, Papakonstantinou O, Kelekis N, Duffau H, Stranjalis G. Mapping the human middle longitudinal fasciculus through a focused anatomo-imaging study: shifting the paradigm of its segmentation and connectivity pattern. Brain Struct Funct 2019; 225:85-119. [PMID: 31773331 DOI: 10.1007/s00429-019-01987-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022]
Abstract
Τhe middle longitudinal fasciculus (MdLF) was initially identified in humans as a discrete subcortical pathway connecting the superior temporal gyrus (STG) to the angular gyrus (AG). Further anatomo-imaging studies, however, proposed more sophisticated but conflicting connectivity patterns and have created a vague perception on its functional anatomy. Our aim was, therefore, to investigate the ambiguous structural architecture of this tract through focused cadaveric dissections augmented by a tailored DTI protocol in healthy participants from the Human Connectome dataset. Three segments and connectivity patterns were consistently recorded: the MdLF-I, connecting the dorsolateral Temporal Pole (TP) and STG to the Superior Parietal Lobule/Precuneus, through the Heschl's gyrus; the MdLF-II, connecting the dorsolateral TP and the STG with the Parieto-occipital area through the posterior transverse gyri and the MdLF-III connecting the most anterior part of the TP to the posterior border of the occipital lobe through the AG. The lack of an established termination pattern to the AG and the fact that no significant leftward asymmetry is disclosed tend to shift the paradigm away from language function. Conversely, the theory of "where" and "what" auditory pathways, the essential relationship of the MdLF with the auditory cortex and the functional role of the cortical areas implicated in its connectivity tend to shift the paradigm towards auditory function. Allegedly, the MdLF-I and MdLF-II segments could underpin the perception of auditory representations; whereas, the MdLF-III could potentially subserve the integration of auditory and visual information.
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Affiliation(s)
- Aristotelis 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
| | - Christos Koutsarnakis
- 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.
| | - 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
| | - Efstratios Karavasilis
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios P Skandalakis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Liouta
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Hellenic Center for Neurosurgical Research, "PetrosKokkalis", Athens, Greece
| | - Olympia Papakonstantinou
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Hugues Duffau
- Department of Neurosurgery, Montpellier University Medical Center, Gui de Chauliac Hospital, Montpellier, France
| | - 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, "PetrosKokkalis", Athens, Greece
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Briggs RG, Conner AK, Sali G, Rahimi M, Baker CM, Burks JD, Glenn CA, Battiste JD, Sughrue ME. A Connectomic Atlas of the Human Cerebrum-Chapter 16: Tractographic Description of the Vertical Occipital Fasciculus. Oper Neurosurg (Hagerstown) 2019; 15:S456-S461. [PMID: 30260427 DOI: 10.1093/ons/opy270] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022] Open
Abstract
In this supplement, we show a comprehensive anatomic atlas of the human cerebrum demonstrating all 180 distinct regions comprising the cerebral cortex. The location, functional connectivity, and structural connectivity of these regions are outlined, and where possible a discussion is included of the functional significance of these areas. In this chapter, we specifically address regions integrating to form the vertical occipital fasciculus.
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Affiliation(s)
- Robert G Briggs
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andrew K Conner
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Goksel Sali
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Meherzad Rahimi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Cordell M Baker
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Joshua D Burks
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Chad A Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - James D Battiste
- Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Michael E Sughrue
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.,Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia
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Holanda VM, Gungor A, Baydin S, Middlebrooks EH, Danish SF. Anatomic Investigation of the Trajectory for Stereotactic Laser Amygdalohippocampectomy. Oper Neurosurg (Hagerstown) 2019; 15:194-206. [PMID: 29140463 DOI: 10.1093/ons/opx218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 09/16/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) has emerged as a promising treatment for mesial temporal lobe epilepsy. Surgeons must understand the relevant anatomy that is traversed by the catheter and affected by ablation. OBJECTIVE To study the anatomic structures crossed by the LITT catheter until it reaches the amygdala. METHODS Three human cadaveric heads were implanted with catheters using a frameless stereotactic technique. The Visualase® system (Medtronic, Dublin, Ireland) was utilized to ablate along the trajectory. Coronal and oblique axial slices were created. Fiber tract dissections were performed in a lateral-medial and inferior-superior scheme. Magnetic resonance tractography was acquired to illustrate the tracts dissected. RESULTS Entry points occurred within 4 cm of the transverse and sagittal sinus, inferior to the lambdoid suture. The cortex of the inferior occipital gyrus was crossed in the region of the transverse occipital sulcus. The vertical occipital fasciculus was crossed en route to passing through the optic radiations. The catheter crossed through or inferior to the optic radiations before piercing the parahippocampal gyrus at about 4 cm from the skull. The catheter entered the hippocampus as it pierced the superior margin of the parahippocampus at 6 cm. The catheter entered the head of the hippocampus to lie inferolateral to the amygdala in the last centimeter of the trajectory. CONCLUSION Understanding the anatomic principles of LITT catheter trajectories will improve the ability to perform this procedure. The current study is the first to examine the anatomy of this trajectory and will serve as the basis for future studies.
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Affiliation(s)
- Vanessa M Holanda
- Center of Neurology and Neurosurgery Associates (NeuroCENNA), Beneficência Portuguesa of São Paulo Hospital, São Paulo-SP, Brazil
| | - Abuzer Gungor
- Department of Neurosurgery, Bakirkoy Research and Training Hospital for Neurology, Neurosurgery, and Psychiatry, Istanbul, Turkey
| | - Serhat Baydin
- Department of Neurosurgery, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Erik H Middlebrooks
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Shabbar F Danish
- Division of Neurosurgery, Rutgers-RWJ Medical School, New Brunswick, New Jersey
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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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50
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Takemura H, Pestilli F, Weiner KS. Comparative neuroanatomy: Integrating classic and modern methods to understand association fibers connecting dorsal and ventral visual cortex. Neurosci Res 2019; 146:1-12. [PMID: 30389574 PMCID: PMC6491271 DOI: 10.1016/j.neures.2018.10.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/19/2018] [Accepted: 10/25/2018] [Indexed: 12/13/2022]
Abstract
Comparative neuroanatomy studies improve understanding of brain structure and function and provide insight regarding brain development, evolution, and also what features of the brain are uniquely human. With modern methods such as diffusion MRI (dMRI) and quantitative MRI (qMRI), we are able to measure structural features of the brain with the same methods across human and non-human primates. In this review article, we discuss how recent dMRI measurements of vertical occipital connections in humans and macaques can be compared with previous findings from invasive anatomical studies that examined connectivity, including relatively forgotten classic strychnine neuronography studies. We then review recent progress in understanding the neuroanatomy of vertical connections within the occipitotemporal cortex by combining modern quantitative MRI and classical histological measurements in human and macaque. Finally, we a) discuss current limitations of dMRI and tractography and b) consider potential paths for future investigations using dMRI and tractography for comparative neuroanatomical studies of white matter tracts between species. While we focus on vertical association connections in visual cortex in the present paper, this same approach can be applied to other white matter tracts. Similar efforts are likely to continue to advance our understanding of the neuroanatomical features of the brain that are shared across species, as well as to distinguish the features that are uniquely human.
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Affiliation(s)
- Hiromasa Takemura
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, and Osaka University, Suita, Japan; Graduate School of Frontier Biosciences, Osaka University, Suita, Japan.
| | - Franco Pestilli
- Departments of Psychological and Brain Sciences, Computer Science and Intelligent Systems Engineering, Programs in Neuroscience and Cognitive Science, School of Optometry, Indiana University, Bloomington, IN, USA
| | - Kevin S Weiner
- Department of Psychology, University of California, Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
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