Department of Neurosurgery, University of Southern California, Los Angeles, California, USA.
Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
World Neurosurg. 2021 Jun;150:e520-e529. doi: 10.1016/j.wneu.2021.03.045. Epub 2021 Mar 17.
BACKGROUND: The middle frontal gyrus (MFG) is involved in attention, working memory, and language-related processing. A detailed understanding of the subcortical white matter tracts connected within the MFG can facilitate improved navigation of white matter lesions in and around this gyrus and explain the postoperative morbidity after surgery. We aimed to characterize the fiber tracts within the MFG according to their connection to neuroanatomic structures through the use of diffusion spectrum imaging-based fiber tractography and validate the findings by gross anatomic dissection for qualitative visual agreement. METHODS: Tractography analysis was completed using diffusion imaging data from 10 healthy, adult subjects enrolled in the Human Connectome Project. We assessed the MFG as a whole component according to its fiber connectivity with other neural regions. Mapping was completed on all tracts within both hemispheres, with the resultant tract volumes used to calculate a lateralization index. A modified Klingler technique was used on 10 postmortem dissections to demonstrate the location and orientation of the major tracts. RESULTS: Two major connections of the MFG were identified: the superior longitudinal fasciculus, which connects the MFG to parts of the inferior parietal lobule, posterior temporal lobe, and lateral occipital cortex; and the inferior fronto-occipital fasciculus, which connected the MFG to the lingual gyrus and cuneus. Intra- and intergyral short association, U-shaped fibers were also identified. CONCLUSIONS: Subcortical white matter pathways integrated within the MFG include the superior longitudinal fasciculus and inferior fronto-occipital fasciculus. The MFG is implicated in a variety of tasks involving attention and memory, making it an important cortical region. The postoperative neurologic outcomes related to surgery in and around the MFG could be clarified in the context of the anatomy of the fiber bundles highlighted in the present study.
背景:额中回(MFG)参与注意力、工作记忆和语言相关处理。详细了解与 MFG 内连接的皮质下白质束可以促进对该回和周围白质病变的更好导航,并解释手术后的发病率。我们旨在通过基于扩散谱成像的纤维束追踪技术,根据其与神经解剖结构的连接来描述 MFG 内的纤维束,并通过大体解剖学切割进行定性视觉一致性验证来验证发现。
方法:使用人类连接组计划中招募的 10 名健康成年受试者的扩散成像数据完成了纤维束追踪分析。我们根据其与其他神经区域的纤维连接,将 MFG 整体组件进行了评估。对两个半球内的所有束进行了映射,使用所得束体积计算侧化指数。对 10 个尸体解剖进行了改良的 Klingler 技术,以显示主要束的位置和方向。
结果:确定了 MFG 的两个主要连接:上纵束,将 MFG 连接到下顶叶、后颞叶和外侧枕叶的部分;以及下额枕束,将 MFG 连接到舌回和楔叶。还确定了 intra- 和 intergyral 短连接、U 形纤维。
结论:整合在 MFG 内的皮质下白质通路包括上纵束和下额枕束。MFG 涉及多种涉及注意力和记忆的任务,使其成为一个重要的皮质区域。在本研究中强调的纤维束解剖学背景下,可以阐明与 MFG 内和周围手术相关的术后神经结果。
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