Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, CNY 149-2301, 13th St. Charlestown, Boston, MA 02129, USA; Department of Radiology, Logan University, Chesterfield, MO, USA.
Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School, Hannover, Germany.
Neuroimage. 2018 Mar;168:412-426. doi: 10.1016/j.neuroimage.2017.02.052. Epub 2017 Feb 21.
The human brainstem plays a central role in connecting the cerebrum, the cerebellum and the spinal cord to one another, hosting relay nuclei for afferent and efferent signaling, and providing source nuclei for several neuromodulatory systems that impact central nervous system function. While the investigation of the brainstem with functional or structural magnetic resonance imaging has been hampered for years due to this brain structure's physiological and anatomical characteristics, the field has seen significant advances in recent years thanks to the broader adoption of ultrahigh-field (UHF) MRI scanning. In the present review, we focus on the advantages offered by UHF in the context of brainstem imaging, as well as the challenges posed by the investigation of this complex brain structure in terms of data acquisition and analysis. We also illustrate how UHF MRI can shed new light on the neuroanatomy and neurophysiology underlying different brainstem-based circuitries, such as the central autonomic network and neurotransmitter/neuromodulator systems, discuss existing and foreseeable clinical applications to better understand diseases such as chronic pain and Parkinson's disease, and explore promising future directions for further improvements in brainstem imaging using UHF MRI techniques.
人类脑干在连接大脑、小脑和脊髓方面起着核心作用,它是传入和传出信号的中继核,也是几个影响中枢神经系统功能的神经调质系统的源头核。由于脑干的生理和解剖学特征,多年来,利用功能或结构磁共振成像对脑干进行研究一直受到阻碍,但近年来,由于超高频(UHF)MRI 扫描的广泛应用,该领域取得了重大进展。在本综述中,我们重点介绍了 UHF 在脑干成像方面的优势,以及在采集和分析数据方面,研究这一复杂脑结构所带来的挑战。我们还举例说明了 UHF MRI 如何为不同基于脑干的回路的神经解剖学和神经生理学提供新的见解,如中枢自主网络和神经递质/神经调质系统,讨论现有的和可预见的临床应用,以更好地了解慢性疼痛和帕金森病等疾病,并探讨使用 UHF MRI 技术进一步改善脑干成像的有前景的未来方向。
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