Abstract
The human brainstem is critical for the control of many life-sustaining functions, such as consciousness, respiration, sleep, and transfer of sensory and motor information between the brain and the spinal cord. Most of our knowledge about structure and organization of white and gray matter within the brainstem is derived from ex vivo dissection and histology studies. However, these methods cannot be applied to study structural architecture in live human participants. Tractography from diffusion-weighted magnetic resonance imaging (MRI) may provide valuable insights about white matter organization within the brainstem in vivo. However, this method presents technical challenges in vivo due to susceptibility artifacts, functionally dense anatomy, as well as pulsatile and respiratory motion. To investigate the limits of MR tractography, we present results from high angular resolution diffusion imaging of an intact excised human brainstem performed at 11.1 T using isotropic resolution of 0.333, 1, and 2 mm, with the latter reflecting resolution currently used clinically. At the highest resolution, the dense fiber architecture of the brainstem is evident, but the definition of structures degrades as resolution decreases. In particular, the inferred corticopontine/corticospinal tracts (CPT/CST), superior (SCP) and middle cerebellar peduncle (MCP), and medial lemniscus (ML) pathways are clearly discernable and follow known anatomical trajectories at the highest spatial resolution. At lower resolutions, the CST/CPT, SCP, and MCP pathways are artificially enlarged due to inclusion of collinear and crossing fibers not inherent to these three pathways. The inferred ML pathways appear smaller at lower resolutions, indicating insufficient spatial information to successfully resolve smaller fiber pathways. Our results suggest that white matter tractography maps derived from the excised brainstem can be used to guide the study of the brainstem architecture using diffusion MRI in vivo.
Highlights
The brainstem is a complex neural structure crucial for sustaining survival functions
We note that tract volumes and edge weight values of the fiber bundles increase in magnitude as acquisition resolution is decreased from 0.333 to 2 mm
The present study aimed to address some of these technical challenges by acquiring high-resolution ex vivo data using high field strength MR scanner
Summary
The brainstem is a complex neural structure crucial for sustaining survival functions. The brainstem is quite dense functionally with many nuclei and small cortical and spinal white matter projections. These structures can be difficult to visualize on standard clinical MRI scans as there is not sufficient tissue-specific contrast. DWI tractography can be used to infer white matter pathways based on the properties of water diffusion within underlying tissue This method provides many valuable insights into white matter organization within the brain and has been applied to visualize brainstem neural architecture (Nagae-Poetscher et al, 2004; Behrens et al, 2007; Habas and Cabanis, 2007; Catani and Thiebaut de Schotten, 2008; Rilling et al, 2008)
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