1Department of Neurosurgery, Clinical Neuroscience Centre, University Hospital Zürich, University of Zürich, Switzerland.
2Department of Neurosurgery, Monza, University of Milan, Italy; and.
Neurosurg Focus. 2019 Sep 1;47(3):E13. doi: 10.3171/2019.6.FOCUS19331.
The authors report on and discuss the historical evolution of the 3 intellectual and scientific domains essential for the current understanding of the function of the human thalamus: 1) the identification of the thalamus as a distinct anatomical and functional entity, 2) the subdivision of thalamic gray matter into functionally homogeneous units (the thalamic nuclei) and relative disputes about nuclei nomenclature, and 3) experimental physiology and its limitations.Galen was allegedly the first to identify the thalamus. The etymology of the term remains unknown although it is hypothesized that Galen may have wanted to recall the thalamus of Odysseus. Burdach was the first to clearly and systematically define the thalamus and its macroscopic anatomy, which paved the way to understanding its internal microarchitecture. This structure in turn was studied in both nonhuman primates (Friedemann) and humans (Vogt and Vogt), leading to several discrepancies in the findings because of interspecies differences. As a consequence, two main nomenclatures developed, generating sometimes inconsistent (or nonreproducible) anatomo-functional correlations. Recently, considerable effort has been aimed at producing a unified nomenclature, based mainly on functional data, which is indispensable for future developments. The development of knowledge about macro- and microscopic anatomy has allowed a shift from the first galenic speculations about thalamic function (the "thalamus opticorum nervorum") to more detailed insights into the sensory and motor function of the thalamus in the 19th and 20th centuries. This progress is mostly the result of lesion and tracing studies. Direct evidence of the in vivo function of the human thalamus, however, originates from awake stereotactic procedures only.Our current knowledge about the function of the human thalamus is the result of a long process that occurred over several centuries and has been inextricably intermingled with the increasing accumulation of data about thalamic macro- and microscopic anatomy. Although the thalamic anatomy can currently be considered well understood, further studies are still needed to gain a deeper insight into the function of the human thalamus in vivo.
作者报告并讨论了当前理解人类丘脑功能所必需的 3 个知识和科学领域的历史演变：1）将丘脑确定为一个独特的解剖和功能实体，2）将丘脑灰质细分为功能均匀的单位（丘脑核）以及关于核命名的相对争议，3）实验生理学及其局限性。盖伦据称是第一个识别丘脑的人。该术语的词源仍然未知，尽管有人假设加伦可能想回忆奥德修斯的丘脑。布尔达赫是第一个清楚系统地定义丘脑及其宏观解剖结构的人，为理解其内部微观结构铺平了道路。该结构反过来在非人类灵长类动物（弗里德曼）和人类（沃格特和沃格特）中进行了研究，由于种间差异，导致发现结果存在差异。因此，出现了两种主要的命名法，有时会产生不一致（或不可复制）的解剖-功能相关性。最近，人们做出了相当大的努力，旨在根据主要的功能数据制定统一的命名法，这对于未来的发展是必不可少的。对宏观和微观解剖结构的认识的发展，使得人们从盖伦关于丘脑功能的最初推测（“视神经核”）转变为在 19 世纪和 20 世纪更详细地了解丘脑的感觉和运动功能。这一进展主要是损伤和追踪研究的结果。然而，人类丘脑活体功能的直接证据仅源自清醒立体定向程序。我们目前对人类丘脑功能的认识是一个历经数百年的漫长过程的结果，并且与对丘脑宏观和微观解剖学的不断积累的数据密不可分。尽管丘脑解剖学目前可以被认为已经很好地理解，但仍然需要进一步的研究来更深入地了解人类丘脑在活体中的功能。
