Cortical and Subcortical Anatomy of the Parietal Lobe From the Neurosurgical Perspective

Topographic anatomy of the lateral surface of the parietal lobe and its relationship with white matter tracts

Aim of this study was to define sulcal and gyral variations of the lateral parietal cortex and underlying white matter tracts and emphasize the importance of relationship between topographic anatomy of parietal lobe and white matter tracts underlying it in approaches to deep parietal and atrial lesions. Twenty-eight formalin-fixed cerebral hemispheres of 14 adult cadavers were used. Ten hemispheres were dissected from lateral to medial by fiber dissection and all stages were photographed. Our anatomic findings were supported by MRI tractography. Postcentral sulcus and intraparietal sulcus were continuous in most of the cadavers (71% in right, 64% in left side). Intermediate sulcus of Jensen was in bayonet shape in 86 and 50 percent of cadavers at right and left side, respectively. The range of perpendicular distance between the meeting point and interhemispheric fissure was 2.5-4.9 cm in right and 2.8-4.2 cm in left hemisphere whereas the range of distance between meeting point and the sylvian fissure was 3-6 cm and 2.5-5.6 in left and right hemispheres, respectively. When the meeting point was located more laterally, the probability of damaging the arcuate fasciculus and superior longitudinal fasciculus II during dissection was increased. We also found that the intraparietal sulcus and intermediate sulcus of Jensen were associated with the superior longitudinal fasciculus II, middle longitudinal fasciculus, inferior frontooccipital fasciculus, tapetum, and optic radiation. These variations and their relation to subcortical tracts should be considered in atrium and deep parietal lobe surgeries.

SPECT/CT imaging of poor sleep quality in people with epilepsy

PURPOSE

To analyze the characteristics of cerebral blood flow changes of poor sleep quality in people with epilepsy(PWE).

METHODS

90 PWE treated in The General Hospital of Ningxia Medical University from December 2021 to September 2023 were divided into poor sleep quality group (PSQG) and good sleep quality group (GSQG) according to the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI), to compare the differences in cerebral perfusion between the two groups of patients, so as to summarize the characteristics of cerebral blood flow changes of poor sleep quality in PWE.

RESULTS

The positive rate of interictal single-photon emission computed tomography/computed tomography (SPECT/CT) was 76.7 %(69/90), which showed localized cerebral hypoperfusion. There was no statistical difference between the two groups of PSQG (N=29) and GSQG (N=61) in terms of the positive rate of SPECT/CT, the number of hypoperfusion foci, and the range of hypoperfusion foci. In PSQG and GSQG, 9 patients(31.0 %) and 6 patients(9.8 %) showed hypoperfusion in the right parietal lobe, respectively, and the difference between the two groups was statistically significant (P=0.017). There was no statistical difference the rate of the interictal epileptiform discharges (IEDs) and the brain area of IEDs in electroencephalography(EEG) between the two groups.

CONCLUSION

SPECT/CT of poor sleep quality in PWE demonstrated hypoperfusion in the right parietal lobe.

Glioma lateralization: Focus on the anatomical localization and the distribution of molecular alterations (Review)

It is well known how the precise localization of glioblastoma multiforme (GBM) predicts the direction of tumor spread in the surrounding neuronal structures. The aim of the present review is to reveal the lateralization of GBM by evaluating the anatomical regions where it is frequently located as well as the main molecular alterations observed in different brain regions. According to the literature, the precise or most frequent lateralization of GBM has yet to be determined. However, it can be said that GBM is more frequently observed in the frontal lobe. Tractus and fascicles involved in GBM appear to be focused on the corticospinal tract, superior longitudinal I, II and III fascicles, arcuate fascicle long segment, frontal strait tract, and inferior fronto‑occipital fasciculus. Considering the anatomical features of GBM and its brain involvement, it is logical that the main brain regions involved are the frontal‑temporal‑parietal‑occipital lobes, respectively. Although tumor volumes are higher in the right hemisphere, it has been determined that the prognosis of patients diagnosed with cancer in the left hemisphere is worse, probably reflecting the anatomical distribution of some detrimental alterations such as TP53 mutations, PTEN loss, EGFR amplification, and MGMT promoter methylation. There are theories stating that the right hemisphere is less exposed to external influences in its development as it is responsible for the functions necessary for survival while tumors in the left hemisphere may be more aggressive. To shed light on specific anatomical and molecular features of GBM in different brain regions, the present review article is aimed at describing the main lateralization pathways as well as gene mutations or epigenetic modifications associated with the development of brain tumors.

Revealing the confusion of the evolution of the term sagittal stratum. Historical overview and systematic literature review

The fiber dissection technique is one of the earliest methods used to demonstrate the internal structures of the brain, but until the development of fiber tractography, most neuroanatomy studies were related to the cerebral cortex and less attention was given to the white matter. During the historical evolution of white matter dissection, debates have arisen about tissue preservation methods, dissection methodology, nomenclature, and efforts to adopt findings from primates to the human brain. Since its first description, the sagittal stratum has been one of the white matter structures subject to controversy and has not been sufficiently considered in the literature. With recent functional studies suggesting potential functions of the sagittal stratum, the importance of attaining a precise understanding of this structure and its constituent fiber tracts is further highlighted. This study revisits the historical background of white matter dissection, unveils the early synonymous descriptions of the sagittal stratum, and provides a systematic review of the current literature. Through evaluation of the historical statements about the sagittal stratum, we provide an understanding of the divergence and explain the reasons for the ambiguity. We believe that acquiring such an understanding will lead to further investigations on this subject, which has the potential to benefit in addressing various neuropsychiatric conditions, maintaining functional connectivity, and optimizing surgical outcomes.

Fixation and staining methods for macroscopical investigation of the brain

The proper preservation of human brain tissue is an indispensable requirement for post-mortem investigations. Neuroanatomical teaching, neuropathological examination, neurosurgical training, basic and clinical neuroscientific research are some of the possible downstream applications of brain specimens and, although much apart from one another, proper tissue fixation and preservation is a common denominator to all of them. In this review, the most relevant procedures to fixate brain tissue are described. In situ and immersion fixation approaches have been so far the most widespread ways to deliver the fixatives inside the skull. Although most of them rely on the use of formalin, alternative fixative solutions containing lower amounts of this compound mixed with other preservative agents, have been attempted. The combination of fixation and freezing paved the way for fiber dissection, particularly relevant for the neurosurgical practice and clinical neuroscience. Moreover, special techniques have been developed in neuropathology to tackle extraordinary problems, such as the examination of highly infective specimens, as in the case of the Creutzfeldt-Jakob encephalopathy, or fetal brains. Fixation is a fundamental prerequisite for further staining of brain specimens. Although several staining techniques have been developed for the microscopical investigation of the central nervous system, numerous approaches are also available for staining macroscopic brain specimens. They are mostly relevant for neuroanatomical and neuropathological teaching and can be divided in white and gray matter staining techniques. Altogether, brain fixation and staining techniques are rooted in the origins of neuroscience and continue to arouse interest in both preclinical and clinical neuroscientists also nowadays.

Sulcal morphology of posteromedial cortex substantially differs between humans and chimpanzees

Recent studies identify a surprising coupling between evolutionarily new sulci and the functional organization of human posteromedial cortex (PMC). Yet, no study has compared this modern PMC sulcal patterning between humans and non-human hominoids. To fill this gap in knowledge, we first manually defined over 2500 PMC sulci in 120 chimpanzee (Pan Troglodytes) hemispheres and 144 human hemispheres. We uncovered four new sulci, and quantitatively identified species differences in sulcal incidence, depth, and surface area. Interestingly, some sulci are more common in humans and others, in chimpanzees. Further, we found that the prominent marginal ramus of the cingulate sulcus differs significantly between species. Contrary to classic observations, the present results reveal that the surface anatomy of PMC substantially differs between humans and chimpanzees-findings which lay a foundation for better understanding the evolution of neuroanatomical-functional and neuroanatomical-behavioral relationships in this highly expanded region of the human cerebral cortex.

Sulcal morphology of posteromedial cortex substantially differs between humans and chimpanzees

Recent studies identify a surprising coupling between evolutionarily new sulci and the functional organization of human posteromedial cortex (PMC). Yet, no study has compared this modern PMC sulcal patterning between humans and non-human hominoids. To fill this gap in knowledge, we first manually defined 918 sulci in 120 chimpanzee ( Pan Troglodytes ) hemispheres and 1619 sulci in 144 human hemispheres. We uncovered four new PMC sulci, and quantitatively identified species differences in incidence, depth, and surface area. Interestingly, some PMC sulci are more common in humans and others, in chimpanzees. Further, we found that the prominent marginal ramus of the cingulate sulcus differs significantly between species. Contrary to classic observations, the present results reveal that the surface anatomy of PMC substantially differs between humans and chimpanzees â€" findings which lay a foundation for better understanding the evolution of neuroanatomical-functional and neuroanatomical-behavioral relationships in this highly expanded region of the human cerebral cortex.

The Parietal Lobe in Alzheimer’s Disease and Blindness

The progressive aging of the population will notably increase the burden of those diseases which leads to a disabling situation, such as Alzheimer’s disease (AD) and ophthalmological diseases that cause a visual impairment (VI). Eye diseases that cause a VI raise neuroplastic processes in the parietal lobe. Meanwhile, the aforementioned lobe suffers a severe decline throughout AD. From this perspective, diving deeper into the particularities of the parietal lobe is of paramount importance. In this article, we discuss the functions of the parietal lobe, review the parietal anatomical and pathophysiological peculiarities in AD, and also describe some of the changes in the parietal region that occur after VI. Although the alterations in the hippocampus and the temporal lobe have been well documented in AD, the alterations of the parietal lobe have been less thoroughly explored. Recent neuroimaging studies have revealed that some metabolic and perfusion impairments along with a reduction of the white and grey matter could take place in the parietal lobe during AD. Conversely, it has been speculated that blinding ocular diseases induce a remodeling of the parietal region which is observable through the improvement of the integration of multimodal stimuli and in the increase of the volume of this cortical region. Based on current findings concerning the parietal lobe in both pathologies, we hypothesize that the increased activity of the parietal lobe in people with VI may diminish the neurodegeneration of this brain region in those who are visually impaired by oculardiseases.

Mild-to-Moderate Traumatic Brain Injury: A Review with Focus on the Visual System

Traumatic Brain Injury (TBI) is a major global public health problem. Neurological damage from TBI may be mild, moderate, or severe and occurs both immediately at the time of impact (primary injury) and continues to evolve afterwards (secondary injury). In mild (m)TBI, common symptoms are headaches, dizziness and fatigue. Visual impairment is especially prevalent. Insomnia, attentional deficits and memory problems often occur. Neuroimaging methods for the management of TBI include computed tomography and magnetic resonance imaging. The location and the extent of injuries determine the motor and/or sensory deficits that result. Parietal lobe damage can lead to deficits in sensorimotor function, memory, and attention span. The processing of visual information may be disrupted, with consequences such as poor hand-eye coordination and balance. TBI may cause lesions in the occipital or parietal lobe that leave the TBI patient with incomplete homonymous hemianopia. Overall, TBI can interfere with everyday life by compromising the ability to work, sleep, drive, read, communicate and perform numerous activities previously taken for granted. Treatment and rehabilitation options available to TBI sufferers are inadequate and there is a pressing need for new ways to help these patients to optimize their functioning and maintain productivity and participation in life activities, family and community.