Michele Rizzi, Ivana Sartori, Maria Del Vecchio, Luca Berta, Domenico Lizio, Maria Zauli Flavia, Alessandro De Benedictis, Silvio Sarubbo, Khalid Al-Orabi, Valeria Mariani, Pietro Avanzini
"C.Munari" Epilepsy Surgery Centre, ASST GOM Niguarda, Piazza Dell'Ospedale Maggiore, 20162, Milan, Italy.
Institute of Neuroscience, National Research Council of Italy, Parma, Italy.
Brain Struct Funct. 2022 May;227(4):1357-1370. doi: 10.1007/s00429-021-02430-5. Epub 2022 Mar 23.
The temporo-parietal junction (TPJ) is a cortical area contributing to a multiplicity of visual, language-related, and cognitive functions. In line with this functional richness, also the organization of the underlying white matter is highly complex and includes several bundles. The few studies tackling the outcome and neurological burdens of surgical operations addressing TPJ document the presence of language disturbances and visual field damages, with the latter hardly recovered in time. This observation advocates for identifying and functionally monitoring the optic radiation (OR) bundles that cross the white matter below the TPJ. In the present study, we adopted a multimodal approach to address the anatomo-functional correlates of the OR's dorsal loop. In particular, we combined cadavers' dissection with tractographic and electrophysiological data collected in drug-resistant epileptic patients explored by stereoelectroencephalography (SEEG). Cadaver dissection allowed us to appreciate the course and topography of the dorsal loop. More surprisingly, both tractographic and electrophysiological observations converged on a unitary picture highly coherent with the data obtained by neuroanatomical observation. The combination of diverse and multimodal observations allows overcoming the limitations intrinsic to single methodologies, defining a unitary picture which makes it possible to investigate the dorsal loop both presurgically and at the individual patient level, ultimately contributing to limit the postsurgical damages. Notwithstanding, such a combined approach could serve as a model of investigation for future neuroanatomical inquiries tackling white matter fibers anatomy and function through SEEG-derived neurophysiological data.
颞顶联合区(TPJ)是一个皮质区域,参与多种视觉、语言相关和认知功能。与这种功能丰富性相一致,其下方白质的组织结构也高度复杂,包括几条纤维束。少数针对涉及TPJ的外科手术结果和神经负担的研究记录了语言障碍和视野损害的存在,后者很难及时恢复。这一观察结果主张识别并功能监测穿过TPJ下方白质的视辐射(OR)纤维束。在本研究中,我们采用多模态方法来研究OR背侧环路的解剖功能相关性。具体而言,我们将尸体解剖与在耐药性癫痫患者中通过立体脑电图(SEEG)收集的纤维束成像和电生理数据相结合。尸体解剖使我们能够了解背侧环路的走行和形态。更令人惊讶的是,纤维束成像和电生理观察结果都汇聚成一幅与神经解剖学观察结果高度一致的统一图像。多种多模态观察结果的结合克服了单一方法固有的局限性,定义了一幅统一的图像,使得在手术前和个体患者层面研究背侧环路成为可能,最终有助于减少术后损伤。尽管如此,这种联合方法可以作为未来通过SEEG衍生的神经生理数据研究白质纤维解剖结构和功能的神经解剖学研究的调查模型。