Farhat Sahar, Melhem Jawad, Darwish Houssein, Bsat Shadi, Kawtharani Sarah, Fadlallah Hiba, Najjar Marwan, Beydoun Ahmad
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Neurosurgery, American University of Beirut Medical Center, Beirut, Lebanon.
Surg Neurol Int. 2024 Jul 12;15:242. doi: 10.25259/SNI_946_2023. eCollection 2024.
Simultaneous sampling of the cingulate gyri through a single depth electrode inserted underneath the falx cerebri is clinically useful in certain cases of drug-resistant epilepsy. However, the frequency at which each region of the cingulate gyri - namely, anterior, middle, and posterior - can be simultaneously sampled with a single electrode remains uncertain.
We assessed the anatomical relationship between the falx cerebri and the cingulate gyrus in 50 adults and children. Subsequently, we determined whether an arbitrary line, denoted as A (representing a 5 mm gap between the falx cerebri and corpus callosum necessary for depth electrode insertion), fell within the anterior, middle, or posterior cingulate gyrus.
The shape of the falx cerebri and its intersection point with the corpus callosum varied substantially across individuals, with a significant difference between children and adults ( = 0.02). The A line was located in the middle cingulate gyrus in 18 children (72%), while 3 (12%) and 4 (16%) had it located in the posterior and anterior cingulate gyrus, respectively. Among adults, 15 individuals (60%) had the A line in the middle cingulate gyrus, 10 (40%) in the posterior cingulate gyrus, and none in the anterior cingulate gyrus.
This study demonstrates the feasibility of simultaneous sampling of both the anterior and middle cingulate gyri in adults and children. Moreover, it represents the first investigation to document the wide interindividual variability in the morphology of the falx cerebri and its association with the cingulate gyrus.
在某些耐药性癫痫病例中，通过插入大脑镰下方的单个深度电极同时采集扣带回的样本在临床上是有用的。然而，使用单个电极同时采集扣带回每个区域（即前、中、后扣带回）样本的频率仍不确定。
我们评估了50名成人和儿童大脑镰与扣带回之间的解剖关系。随后，我们确定一条任意线（记为A，代表深度电极插入所需的大脑镰与胼胝体之间5毫米的间隙）是否落在前、中或后扣带回内。
大脑镰的形状及其与胼胝体的交点在个体间差异很大，儿童和成人之间存在显著差异（P = 0.·02）。在儿童中，A线位于中扣带回的有18名（72%），位于后扣带回的有3名（12%），位于前扣带回的有4名（16%）。在成人中，15名个体（60%）的A线位于中扣带回，10名（40%）位于后扣带回，前扣带回中没有。
本研究证明了在成人和儿童中同时采集前扣带回和中扣带回样本的可行性。此外，它是首次记录大脑镰形态的个体间广泛变异性及其与扣带回关联的研究。
