1Department of Neurosciences, Research Group Experimental Neurosurgery and Neuroanatomy, KU Leuven, and.
2Department of Imaging & Pathology, Translational MRI, KU Leuven, Leuven, Belgium.
J Neurosurg. 2019 Feb 22;132(2):615-623. doi: 10.3171/2018.11.JNS18679. Print 2020 Feb 1.
Connections between the insular cortex and the amygdaloid complex have been demonstrated using various techniques. Although functionally well connected, the precise anatomical substrate through which the amygdaloid complex and the insula are wired remains unknown. In 1960, Klingler briefly described the "fasciculus amygdaloinsularis," a white matter tract connecting the posterior insula with the amygdala. The existence of such a fasciculus seems likely but has not been firmly established, and the reported literature does not include a thorough description and documentation of its anatomy. In this fiber dissection study the authors sought to elucidate the pathway connecting the insular cortex and the mesial temporal lobe.
Fourteen brain specimens obtained at routine autopsy were dissected according to Klingler's fiber dissection technique. After fixation and freezing, anatomical dissections were performed in a stepwise progressive fashion.
The insula is connected with the opercula of the frontal, parietal, and temporal lobes through the extreme capsule, which represents a network of short association fibers. At the limen insulae, white matter fibers from the extreme capsule converge and loop around the uncinate fasciculus toward the temporal pole and the mesial temporal lobe, including the amygdaloid complex.
The insula and the mesial temporal lobe are directly connected through white matter fibers in the extreme capsule, resulting in the appearance of a single amygdaloinsular fasciculus. This apparent fasciculus is part of the broader network of short association fibers of the extreme capsule, which connects the entire insular cortex with the temporal pole and the amygdaloid complex. The authors propose the term "temporoinsular projection system" (TIPS) for this complex.
使用各种技术已经证明了脑岛皮质和杏仁核复合体之间的联系。尽管功能上连接良好，但确切的解剖结构仍然未知，通过该结构连接杏仁核复合体和脑岛。1960 年，Klingler 简要描述了“杏仁核脑岛束”，这是一条连接后脑岛和杏仁核的白质束。这样的束似乎存在，但尚未得到证实，并且报告的文献中没有对其解剖结构进行彻底的描述和记录。在这项纤维解剖研究中，作者试图阐明连接脑岛皮质和内侧颞叶的途径。
根据 Klingler 的纤维解剖技术，对 14 个在常规尸检中获得的脑标本进行解剖。在固定和冷冻后，以逐步渐进的方式进行解剖。
脑岛通过极囊与额、顶和颞叶的脑岛相连，极囊代表了一个短联络纤维网络。在脑岛的边缘，来自极囊的白质纤维汇聚并围绕钩束向颞极和内侧颞叶环绕，包括杏仁核复合体。
脑岛和内侧颞叶通过极囊中的白质纤维直接相连，形成单一的杏仁核脑岛束。这个明显的束是极囊短联络纤维网络的一部分，它将整个脑岛皮质与颞极和杏仁核复合体连接起来。作者提出了“颞脑岛投射系统”（TIPS）这个术语来描述这个复杂的系统。
