Neuroanatomical Terms Research Articles

Petroclival Clinoidal Folds and Relationships with Arachnoidal Membranes and Neural Structures of Anterior and Middle Incisural Spaces: Old Neuroanatomical Terms for a New Neurosurgical Speech in Cadaver Labs with Limited Resources Era. Part I: Osteology and Structural Anatomy of Dura Mater.

Purpose The role of cadaver labs in preparing new generations of effective neurosurgeons is of paramount importance. The Authors describe a personal cadaver lab experience aimed at improving the knowledge of a difficult region of the central skull base. The anterior and middle incisural spaces are regions of remarkable anatomical, and surgical interest due to complex relationships between bony, dural, arachnoidal, and neurovascular structures. The primary purpose of this study is (1) to describe the anatomy of this region with particular emphasis on the relationships between the anterior margin of the free edge of the tentorium and the sphenoid and petrous bone; (2) to identify surgical implications in many different types of neurosurgical procedures dealing with this challenging complex anatomic area.Methods Eight fresh, non-formalin-fixed non-silicon-injected adult cadaver heads and five injected formalin-fixed adult cadaver heads were analyzed in this study.Results The anatomical study was focused on the description of the relationships between bony, dural, arachnoid, and neurovascular structures. Surgical implications are described accordingly.Conclusions Detailed anatomical knowledge of this region finds concrete applications in neurosurgical practice since the anterior and middle incisural spaces are often surgically exposed in neoplastic and vascular diseases.

Petroclival Clinoidal Folds and Relationships with Arachnoidal Membranes of Medial Incisural Space: Old Neuroanatomical Terms for a New Neurosurgical Speech in Cadaver Labs with Limited Resources Era. Part III: Arachnoid Membranes, Cranial Nerves, and Surgical Implications.

BACKGROUND Anatomical dissections play an irreplaceable role in the training of new generations of effective neurosurgeons, especially when addressing skull base lesions is required.The Authors describe an inter-laboratory dissection study aimed at improving the knowledge of a complex region of the skull base. The anterior and middle incisural spaces are of remarkable anatomical and surgical interest due to complex relationships between bony, dural, arachnoidal, and neurovascular structures. The primary purposes of this study are to describe the anatomy of this region with particular emphasis on the relationships between the anterior margin of the free edge of the tentorium and the sphenoid and petrous bone; to identify surgical implications in many different types of neurosurgical procedures dealing with this challenging complex anatomic area.METHODS Thirteen anatomical specimens, including five injected specimens, were dissected in this study. In the formalin-fixed specimens, vessels were injected with colored silicone.RESULTS The anatomical study focused on the description of the relationships between bony dural, arachnoid, and neurovascular structures. Surgical implications are described accordingly.CONCLUSIONS Detailed anatomical knowledge of this region finds concrete applications in neurosurgical practice since the anterior and middle incisural spaces are often surgically exposed in neoplastic and vascular diseases. The high-definition pictures reported in this study could represent useful support to understand the anatomy of this complex region.Finally, our study could provide guidance to neurosurgical centers in which resources are limited that are either planning to establish their own cadaver dissection laboratory or failed to do so because of the supposed high-costs.

Petroclival Clinoidal Folds and Relationships with Arachnoidal Membranes of Anterior and Middle Incisural Spaces: Old Neuroanatomical Terms for a New Neurosurgical Speech in Cadaver Labs with Limited Resources Era. Part II: Free Edge of the Tentorium, Petroclinoid Folds, and Incisural Spaces.

BACKGROUND Anatomical dissections play an irreplaceable role in the training of new generations of effective neurosurgeons, especially when addressing skull base lesions is required.The Authors describe an inter-laboratory dissection study aimed at improving the knowledge of a complex region of the skull base. The anterior and middle incisural spaces are of remarkable anatomical and surgical interest due to complex relationships between bony, dural, arachnoidal, and neurovascular structures. The primary purposes of this study are to describe the anatomy of this region with particular emphasis on the relationships between the anterior margin of the free edge of the tentorium and the sphenoid and petrous bone; to identify surgical implications in many different types of neurosurgical procedures dealing with this challenging, complex anatomic area.METHODS Thirteen anatomical specimens, including five injected specimens, were dissected in this study. In the formalin-fixed specimens, vessels were injected with colored silicone.RESULTS The anatomical study was focused on the description of the relationships between bony dural, arachnoid, and neurovascular structures. Surgical implications are described accordingly.CONCLUSIONS Detailed anatomical knowledge of this region finds concrete applications in neurosurgical practice since the anterior and middle incisural spaces are often surgically exposed in neoplastic and vascular diseases. The high-definition pictures reported in this study could represent useful support to understand the anatomy of this complex region.Finally, our study could provide guidance to neurosurgical centers in which resources are limited that are either planning to establish their own cadaver dissection laboratory or failed to do so because of the supposed high-costs.

Divergences Between Resting State Networks and Meta-Analytic Maps Of Task-Evoked Brain Activity

Background: Spontaneous human neural activity is organized into resting state networks, complex patterns of synchronized activity that account for the major part of brain metabolism. The correspondence between these patterns and those elicited by the performance of cognitive tasks would suggest that spontaneous brain activity originates from the stream of ongoing cognitive processing. Objective: To investigate a large number of meta-analytic activation maps obtained from Neurosynth (www.neurosynth.org), establishing the extent of task-rest similarity in large-scale human brain activity. Methods: We applied a hierarchical module detection algorithm to the Neurosynth activation map similarity network, and then compared the average activation maps for each module with a set of resting state networks by means of spatial correlations. Results: We found that the correspondence between resting state networks and task-evoked activity tended to hold only for the largest spatial scales. We also established that this correspondence could be biased by the inclusion of maps related to neuroanatomical terms in the database (e.g. “parietal”, “occipital”, “cingulate”, etc.). Conclusion: Our results establish divergences between brain activity patterns related to spontaneous cognition and the spatial configuration of RSN, suggesting that anatomically-constrained homeostatic processes could play an important role in the inception and shaping of human resting state activity fluctuations.

Neurophysiology of Juvenile and Progressive Myoclonic Epilepsy.

Myoclonus can be epileptic or nonepileptic. Epileptic myoclonus has been defined in clinical, neurophysiological, and neuroanatomical terms. Juvenile myoclonic epilepsy (JME) is typically considered to be an adolescent-onset idiopathic generalized epilepsy with a combination of myoclonic, generalized tonic-clonic, and absence seizures and normal cognitive status that responds well to anti-seizure medications but requires lifelong treatment. EEG shows generalized epileptiform discharges and photosensitivity. Recent observations indicate that the clinical picture of JME is heterogeneous and a number of neuropsychological and imaging studies have shown structural and functional abnormalities in the frontal lobes and thalamus. Advances in neurophysiology and imaging suggest that JME may not be a truly generalized epilepsy, in that restricted cortical and subcortical networks appear to be involved rather than the entire brain. Some patients with JME may be refractory to anti-seizure medications and attempts have been made to identify neurophysiological biomarkers predicting resistance. Progressive myoclonic epilepsy is a syndrome with multiple specific causes. It is distinct from JME because of the occurrence of progressive neurologic dysfunction in addition to myoclonus and generalized tonic-clonic seizures but may sometimes be difficult to distinguish from JME or misdiagnosed as drug-resistant JME. This article provides an overview of progressive myoclonic epilepsy and focuses on the clinical and neurophysiological findings in the two most commonly recognized forms of progressive myoclonic epilepsy-Unverricht-Lundborg disease (EPM1) and Lafora disease (EPM2). A variety of neurophysiological tests can be used to distinguish between JME and progressive myoclonic epilepsy and between EPM1 and EPM2.

Etymology of terms in anatomy of central nervous system

We consider the origin of neuroanatomical terms and their formation as such in the history of medicine. Along with the terms originating from common Indo-European roots and reflecting the typical process of metaphorization of trivial objects and phenomena, in this sphere we find semantic calques (one of the types of borrowing) and formations originating from late Latin. The prevailing simple metaphor testifies to the early origin of most terminological units.

Back to the Drawing Paper : Active Learning Approaches That Are Not All Boring

The most traditional approach for delivering gross anatomical information today is the traditional lecture and/or laboratory cadaver dissection or prosection. The anatomy laboratory provides the most active learning approach to learning body structure and function. Some anatomical concepts, however, cannot be visualized in a dissection or prosection, one of which is the concept of the somatic and visceral nervous systems peripheral structure and pathways. The objective of this study was to evaluate the use of drawing and labeling to gain appreciation of basic nervous systems concepts. Before the scheduled learning session, students were assigned a section to read in their textbook regarding the nervous system. At the beginning of the scheduled session, students were provided a sheet of paper with 4 boxes. In box 1 they were to copy a list of neuroanatomical terms that were shown on a Power Point slide. Next, they were shown on a Power Point slide an unlabeled drawing of the spinal cord and peripheral nerves. Using the terms listed in box 1, the various parts of the drawing were identified by the instructor for the students. The students were then asked to draw/sketch the drawing in box 2. In box 3, the students were asked to again copy the terms in box 1. In box 4, the students were asked to re‐draw/sketch the drawing in box 2 and label the drawing. When drawing and labeling in box 4, students were encouraged to check their neighbors’ drawing and labeling. Following this exercise, a shortened lecture was presented regarding the gross and cellular aspects of the neuroanatomical structures. This was followed by a Turning Point quiz using pictures from the textbook and lecture, and students were asked to check their answer with neighboring peers before submitting their answer. At the end of the neuroanatomical learning sessions, a survey with three questions using a five‐point scale was given to the students for them to evaluate the value for their learning of each segment (the list and drawing, lecture, and Turning Point quiz) of this learning session. Suggestions and comments were asked for. On a scale of 1–5, the value for each learning segment was as follows: list and drawing 4.3, lecture 3.8, Turning Point quiz 4.6. The survey results, and suggestions and comments, indicate that these various approaches to learning facilitate the learning process, and they serve as an active learning and peer teaching approach that is not boring.

¿Por qué llamamos cerebro al cerebro?

Every day millions of professionals use a countless number of technical words to refer to the different structures inside the skull. But few of them would know how to explain their origin. In this study we take an in-depth look into the etymological origins of some of these neuroanatomical terms. The study takes an etymological tour of the central nervous system. It is in no way meant to be an exhaustive, detailed review of the terms currently in use, but instead a means to familiarise the reader with the linguistic past of words like brain, hippocampus, thalamus, claustrum, fornix, corpus callosum or limbic system. All of them come from either Greek or Latin, which were used for centuries as the lingua francas of science. The study also analyses the evolution of the word meninges, originally of Greco-Latin origin, although its current usages derive from Arabic. The neuroanatomical terms that are in use today do not come from words that associate a particular brain structure with its function, but instead from words that reflect the formal or conceptual similarity between a structure and a familiar or everyday entity (for example, an object or a part of the human body). In other cases, these words indicate the spatial location of the neuroanatomical structure with respect to a third, or they may be terms derived from characters in Greco-Latin mythology.

An unwritten anatomy lesson: The influence of Roman clothing on neuroanatomical terminology: In memoriam Albert L. Rhoton, Jr. (1932-2016).

Throughout the centuries, anatomists attempting to denominate the new structures they discovered have found inspiration in the civilization of ancient Rome and the clothing worn by its citizens. This aricle presents the origins of seven neuroanatomical terms, fimbria, velum, funiculus, lemniscus, corona, splenium, and cingulum, inspired by the clothing and jewellery of Roman women and the military attire of Roman soldiers. Thus, through their apparel, the Romans influenced the Terminologia Anatomica and "clothed" the structures of the brain and spinal cord, making them immortal. Clin. Anat. 29:685-690, 2016. © 2016 Wiley Periodicals, Inc.

Can psychiatry and neurology 'simply' merge?

I appreciate Professor Fitzgerald's citation of my 2005 article, titled ‘Why psychiatry and neurology cannot simply merge’,1,2 however, he seems to have misconstrued the essential nature of my argument. He positions his discussion of my article just after the statement, ‘The chorus of disapproval against neuropsychiatry has certainly grown’. But I would like to assure Professor Fitzgerald that I am not, nor have I ever been, part of such a ‘chorus’. A careful reading of my article will show that the key word in my argument is ‘simply’. I am not opposed in any way to integrating neurology and psychiatry; rather, I argue that certain types of ‘bridging’ concepts and constructs would be necessary to bring about such a union. I describe neuropsychiatry as ‘a vitally important transitional stage in the development of brain science’. Indeed, I would argue that neuropsychiatry is the crucible within which the discourses of psychiatry and neurology will eventually ‘bond’, producing a narrative that incorporates the dialectical and subtextual understanding of psychiatry into the framework of neurophysiology and neuropathology. But until such a meta-narrative has evolved, there cannot be a genuine merger of psychiatry and neurology. Or rather, we should say that without such a meta-narrative, the nature of the merger would be more like the grafting of an oak branch onto a maple tree than the hybridisation of two varieties of rose.2 I fully agree with Professor Fitzgerald that ‘the separation of neurology from psychiatry has led to a separation of the brain from the mind – the physical from the mental – which has been unhelpful for both disciplines’. That said, I do not accept the view that psychiatric disease is best described as ‘brain disease’ or that mental constructs are ‘reducible’ to mere physiological or neuroanatomical terms. But this is a complicated philosophical issue best left for a longer communication.3 Stated briefly, I believe that ‘disease’ is most usefully predicated of persons, not minds or brains, and that there are ways in which a union of neurology and psychiatry could contribute to a very rich understanding of the human person, and how personhood is undermined and compromised by disease states like schizophrenia.4

Functions of the corticospinal and corticobulbar tracts in the human newborn

The corticospinal and corticobulbar tracts (CST, CBT) are immature at birth, in neuroanatomical terms of myelination and terminal axonal sprouting for multiple synaptic contact; these developmental features are not mature until 2 years of age. Physiologically, the CST is mainly inhibitory. Nevertheless, these pathways have an important role to play in normal neurological function at this age, though different from their functions in the older child and adult. They are important in the neonate by 1) inhibition of the monosynaptic stretch reflexes at spinal cord levels, beginning at 25 weeks gestation or earlier; 2) influence upon muscle tone, hence posture, by mediating proximal flexion in axial and limb girdle muscles and distal extension of the fingers and toes and abduction of the thumbs; 3) antagonism of the proximal extension and distal flexion and adduction from the medial subcorticospinal pathways of Lawrence and Kuypers; 4) reinforcement of tactile reflexes, the most important of which are suck and swallow; 5)early individualization of finger movements; 6) transmission of epileptic activity from the cerebral cortex. Understanding the unique roles of the CST at birth provide rational, physiological explanations of such neonatal phenomena as clonus, opisthotonus, strong distal flexion and adduction (“cortical thumb”) and fisting), and poor suck and swallow in affected neonates, regardless of the cause of cerebral cortical impairment or its reversibility or irreversibility. In summary, the CST and CBT are indeed important functional pathways in the neonate, but many of their functions are very different than in the adult. (J Pediatr Neurol 2003; 1(1): 3-8).

Developing an HTML5 Neuroanatomical Learning Tool for the Computer, Tablet and Smartphone

In order to meet the medical neuroscience laboratory educational needs in a revised and condensed curriculum, an HTML5 interactive neuroanatomical learning tool is being developed and tested for use in an integrated neuroscience laboratory. The learning tool is available online for student use and facilitates learning neuroanatomical structures, structural relationships, significant morphological and functional features of the human central nervous system, and the clinical relevance of the neuroanatomical structures. Gross images of intact and dissected brains, thick and stained thin brain sections, thin stained brainstem and spinal cord sections, and MR images are available for study. Neural structures to be identified are listed on the right‐hand side of the screen. Clicking on the name of a specific structure produces a transparent overlay of that structure. Structures can be identified also by moving the pointer over the image and clicking on a specific structure. With either approach, the structure is identified by a colored overlay and a collapsible dialog box at the bottom of the screen providing a brief description of the structure and its functional role in the nervous system. A student can scroll from one image to another. A glossary of neuroanatomical terms used in the program allows the student to select and view the neuroanatomical structures in the gross and sectioned specimens, and the MR images. Student comments indicate that this is an efficient and effective way to learn the neuroanatomical and functional aspects of the nervous system available online at the student's convenience. The computer‐assisted learning tool accomplishes our neuroscience laboratory goals.

Mapping the Semantic Structure of Cognitive Neuroscience

Cognitive neuroscience, as a discipline, links the biological systems studied by neuroscience to the processing constructs studied by psychology. By mapping these relations throughout the literature of cognitive neuroscience, we visualize the semantic structure of the discipline and point to directions for future research that will advance its integrative goal. For this purpose, network text analyses were applied to an exhaustive corpus of abstracts collected from five major journals over a 30-month period, including every study that used fMRI to investigate psychological processes. From this, we generate network maps that illustrate the relationships among psychological and anatomical terms, along with centrality statistics that guide inferences about network structure. Three terms--prefrontal cortex, amygdala, and anterior cingulate cortex--dominate the network structure with their high frequency in the literature and the density of their connections with other neuroanatomical terms. From network statistics, we identify terms that are understudied compared with their importance in the network (e.g., insula and thalamus), are underspecified in the language of the discipline (e.g., terms associated with executive function), or are imperfectly integrated with other concepts (e.g., subdisciplines like decision neuroscience that are disconnected from the main network). Taking these results as the basis for prescriptive recommendations, we conclude that semantic analyses provide useful guidance for cognitive neuroscience as a discipline, both by illustrating systematic biases in the conduct and presentation of research and by identifying directions that may be most productive for future research.

Dynamic motor compensations with permanent, focal loss of forelimb force after cervical spinal cord injury.

Incomplete cervical lesion is the most common type of human spinal cord injury (SCI) and causes permanent paresis of arm muscles, a phenomenon still incompletely understood in physiopathological and neuroanatomical terms. We performed spinal cord hemisection in adult rats at the caudal part of the segment C6, just rostral to the bulk of triceps brachii motoneurons, and analyzed the forces and kinematics of locomotion up to 4 months postlesion to determine the nature of motor function loss and recovery. A dramatic (50%), immediate and permanent loss of extensor force occurred in the forelimb but not in the hind limb of the injured side, accompanied by elbow and wrist kinematic impairments and early adaptations of whole-body movements that initially compensated the balance but changed continuously over the follow-up period to allow effective locomotion. Overuse of both contralateral legs and ipsilateral hind leg was evidenced since 5 days postlesion. Ipsilateral foreleg deficits resulted mainly from interruption of axons that innervate the spinal cord segments caudal to the lesion, because chronic loss (about 35%) of synapses was detected at C7 while only 14% of triceps braquii motoneurons died, as assessed by synaptophysin immunohistochemistry and retrograde neural tracing, respectively. We also found a large pool of propriospinal neurons projecting from C2-C5 to C7 in normal rats, with topographical features similar to the propriospinal premotoneuronal system of cats and primates. Thus, concurrent axotomy at C6 of brain descending axons and cervical propriospinal axons likely hampered spontaneous recovery of the focal neurological impairments.

Syntax in a pianist's hand: ERP signatures of “embodied” syntax processing in music

Syntactic operations in language and music are well established and known to be linked in cognitive and neuroanatomical terms. What remains a matter of debate is whether the notion of syntax also applies to human actions and how those may be linked to syntax in language and music. The present electroencephalography (EEG) study explored syntactic processes during the observation, motor programming, and execution of musical actions. Therefore, expert pianists watched and imitated silent videos of a hand playing 5-chord sequences in which the last chord was syntactically congruent or incongruent with the preceding harmonic context. 2-chord sequences that diluted the syntactic predictability of the last chord (by reducing the harmonic context) served as a control condition. We assumed that behavioural and event-related potential (ERP) effects (i.e., differences between congruent and incongruent trials) that were significantly stronger in the 5-chord compared to the 2-chord sequences are related to syntactic processing. According to this criterion, the present results show an influence of syntactic context on ERPs related to (i) action observation and (ii) the motor programming for action imitation, as well as (iii) participants' execution times and accuracy. In particular, the occurrence of electrophysiological indices of action inhibition and reprogramming when an incongruent chord had to be imitated implies that the pianist's motor system anticipated (and revoked) the congruent chord during action observation. Notably, this well-known anticipatory potential of the motor system seems to be strongly based upon the observer's music-syntactic knowledge, thus suggesting the “embodied” processing of musical syntax. The combined behavioural and electrophysiological data show that the notion of musical syntax not only applies to the auditory modality but transfers – in trained musicians – to a “grammar of musical action”.

Donde fueres haz lo que vieres. aportaciones de la neurociencia al desarrollo de la competencia pragmÁtica. un nuevo horizonte en la enseñanza del ele

Abstract The current trend in teaching foreign languages is to conceive the development of pragmatic competence as an essential and inseparable part of communicative competence. Today, progress of Cognitive Neuroscience enables one to consider social behavior in neuroanatomical terms: knowing how the brain integrates complex concepts of pragmatic competence proves highly effective in developing methodologies used in the language classroom to address these issues. The use of games and learning by doing in virtual worlds may be regarded as a very interesting option in order to acquire this competence. In this contribution, we have aimed at combining theoretical principles of Neuroscience and didactics to offer, in the specific case of Teaching Spanish as a Foreign Language (TSFL), a relatively new type of teaching material: the Serious Game, as well as to present the results of a first qualitative study of the use of this type of material in the field of language acquisition.

Nuclear organization and distribution in the brain regions of the snake headed fish, Channa marulius.

Morphological variations have arisen due to diverse environmental conditions. Application of cytoarchitectonic criteria permits the delineation of distinct nuclear complexes from the brain region. Very less information is available on the cytoarchitectonic pattern of the brain, of the giant snake headed murrel, Channa marulius. The murrel is much neglected in neuroanatomical terms and their study is a necessary step in tracing the evolutionary trends. Hence, in the present investigation, the brain of the snake headed fish, Channa marulius has been investigated to reveal the organization of different nuclear complexes. Different nuclear complexes were identified and studied using Cresyl violet and Haematoxyline-Eosin staining techniques from the brain region of Channa marulius. Five distinct nuclear complexes namely pars medialis, pars centralis, pars lateralis dorsalis and pars lateralis ventralis respectively were observed in the area dorsalis telencephali and five nuclear groups pars ventralis, pars lateralis, pars dorsalis, pars supracommissuralis and nucleus entopeduncularis were identified in the area ventralis telencephali. Three nuclear groups namely pars posterioris, pars dorsalis, pars ventralis were identified in preoptic area. The inferior lobes are massive and consist of five circumscrible nuclear complexes. Midbrain consists of optic tectum, torus longitudinalis and tegmentum where different nuclear groups were identified.

Invertebrate neurophylogeny: suggested terms and definitions for a neuroanatomical glossary.

BackgroundInvertebrate nervous systems are highly disparate between different taxa. This is reflected in the terminology used to describe them, which is very rich and often confusing. Even very general terms such as 'brain', 'nerve', and 'eye' have been used in various ways in the different animal groups, but no consensus on the exact meaning exists. This impedes our understanding of the architecture of the invertebrate nervous system in general and of evolutionary transformations of nervous system characters between different taxa.ResultsWe provide a glossary of invertebrate neuroanatomical terms with a precise and consistent terminology, taxon-independent and free of homology assumptions. This terminology is intended to form a basis for new morphological descriptions. A total of 47 terms are defined. Each entry consists of a definition, discouraged terms, and a background/comment section.ConclusionsThe use of our revised neuroanatomical terminology in any new descriptions of the anatomy of invertebrate nervous systems will improve the comparability of this organ system and its substructures between the various taxa, and finally even lead to better and more robust homology hypotheses.

Global Exploratory Analysis of Massive Neuroimaging Collections using Microsoft Live Labs Pivot and Silverlight

Event Abstract Back to Event Global Exploratory Analysis of Massive Neuroimaging Collections using Microsoft Live Labs Pivot and Silverlight Robert W. Williams1*, Lei Yan1, Xiaodong Zhou1, Lu Lu1, Arthur Centeno1, Leonard Kuan2, Michael Hawrylycz2 and Glenn D. Rosen3 1 University of Tennessee Health Science Center, Department of Anatomy and Neurobiology, Center for Integrative and Translational Genomics, United States 2 The Allen Institute for Brain Science, United States 3 Beth Israel Deaconess Medical Center/Harvard Medical School, Department of Neurology, United States Introduction: The Mouse Brain Library (www.mbl.org) consists of high resolution images generated for 200 genetically well defined strains of mice, 2200 cases, 8800 Nissl-stained slides, and ~120,000 coronal and horizontal sections of the brain. The MBL includes representatives for most sets of recombinant inbred strains, (BXD, LXS, AXB, BXH, CXB). This collection provides a solid foundation for studies of the genetic control of brain structure, function, and behavior (Lu et al. 2001; Yang et al., 2008; Rosen et al., 2009). A key challenge is how to deliver massive image collections such as the MBL, Allen Brain Atlas projects, and BrainMaps using modern web services. In this work we tested Microsoft Live Labs Pivot (www.getpivot.com ) as an image distribution portal. Pivot provides a unique method for delivering and exploring very large collections of high-resolution images. Methods and Results: Large slides of 30-µm celloidin sections were imaged using a 20x objective (NA 0.75) and an Aperio Scanscope CS scanner at an in-plane resolution of 1-µm/pixel and at 150-µm steps along the cutting axis. Images were segmented to extract single sections. SVS format image were converted into Advanced Forensic format (AFF), JPEG2000, and Silverlight deep zoom (DZI) pyramids. A DVI is 2x larger than its JPEG parent. DZIs were assembled into a set of Pivot image collections. Metadata for sorting and display were extracted from MBL and GeneNetwork.org data tables. Metadata types include thousands of genotypes and phenotypes for all strains, as well as data for individual cases (sex, age, body weight, brain weight, litter size). Spatial coordinate tags for each section using INCF Waxholm space and BIRNLex neuroanatomical terms are being added. A Pivot server was installed on a Linux CentOS 5 8-core system (Dell R610) running Tomcat and MySQL. The system was tested on Vista and Windows 7 using a Pivot browser (www.getpivot.com) and runs well on Mac OS X 10.6 using the VMWARE Fusion 3 virtual machine. Link to http://mbl.pivotcollections.org to view the MBL. The MBL collection is large and unwieldy and our current interface (www.mbl.org) does not provide sufficient sorting flexibility and speed to effectively explore or analyze the collection. A good exploratory interface would provide both forest and tree views and a way to effectively scan the entire collection for variation in traits such as ventricular volume, callosal architecture, cortical lamination, and differences in the cytology in specific nuclei in a matter of minutes, not hours or days. Pivot is optimal for these types of rapid review and exploratory tasks. The collection can be filtered, sorted, and viewed at a wide range of magnifications—from thumbnails of whole slide to full zooms of subnuclei—almost instantly. The collection can be split, filtered, and sorted using a range of continuous and discrete metadata variables (sex, age, strain, genotype, behavior) Limitations with the current Pivot implementation can be divided into two categories: those associated with the interface itself (no nested displays, a limit of 15 displayed categories, no graphic overlay for marking or annotation), and those associated with secondary analytic and statistical functions that would typically be used to test hypotheses (no dynamic output of group statistics nor tests for differences among groups using ANOVA or t tests) Discussion: Pivot is a superb web service architecture that provides very fluid access to massive neuroimaging databases. It is extremely well suited for both the dissemination of massive 2D collections and direct exploratory analysis as part of a web service. Pivot has also been extremely helpful as part of quality control workflow and has enabled us to search for neuroanatomical differences and patterns of variation among strains of mice in ways that far surpass any other web interface.

PAIN AND PSYCHO-AFFECTIVE DISORDERS

The subject of human pain can be subdivided into two broad categories: physical pain and psychological pain. Since the dawn of human consciousness, each of these two forms of pain-one clearly physical, the other having more to deal with the mind-have played a central role in human existence. Psychological pain and suffering add dimensions that go far beyond the boundaries of its physical counterpart. In the past 50 years, one of the more remarkable accomplishments of medical science has been to increasingly enable the clinician to impact, as never before, each of these critical realms of human existence. Our intention is, therefore, to initially describe a few of the many exciting neuroscientific and neurosurgical advances that have been made in the treatment of various types of pain and to speculate on some of the emergent questions that we believe need to be addressed. After this is accomplished, we will then use this information as a kind of two-pronged philosophical entrance into questions of the mind, brain, and soul that we feel are necessary to bring back into the sphere of the modern physician's practice. The goal of this article is two-fold: 1) to share some of our exciting research and 2) to renew the interest in timeless questions, such as that of the mind-brain and the brain-mind, in the conversation of the modern neurosurgeon. The International Association for the Study of Pain divides pain into two broad functions and anatomical categories. In this framework, "nociceptive" pain is defined as the kind of physical pain that results when the tissue is damaged. Given this perspective, such pain is usually considered a consequence of one's defense against one's environment. The other pain is the "neuropathic" one resulting from a lesion or a dysfunction of the human nervous system. As such, we will take the risk of crossing beyond the boundaries of neurosurgery and venture into boundaries that, at another time, might seem more natural to the discipline of psychiatry for two reasons. The first is that psychiatry seems to be so focused on the brain-its biochemistry and pharmacology--that questions of mind and soul have become rare and almost negligible. The second is to follow the course of the results of our own clinical investigations that have taken us into that very human world where questions of physical pain, psychological pain, and the experience of suffering abound. Today, however, the strategy of neuromodulation offers the advantage of being precisely tailored in neuroanatomical terms and, even more importantly, of being altogether reversible. At both our own Istituto Neurologico C. Besta and many other neurosurgical centers worldwide, many procedures have been reported in which implant neuromodulation devices successfully treat pain. For example, long-term stimulation of the spinal cord has been fairly effective in the treatment of neuropathic pain, multiple sclerosis, and various other forms of pain. Good results have been obtained in treating peripheral vascular diseases and sympathetic reflex dystrophy syndrome. Good results have also been achieved in trigeminal nerve stimulation and peripheral nerve stimulation. In the case of thalamic stimulation, there has also been an improvement of symptoms, but a long-term degree of tolerance was noticed. Hypothalamic stimulation has also been seen to be effective in controlling trigeminal autonomic cephalalgic pain, as well as the facial pain that is known to occur in multiple sclerosis. Motor cortex stimulation was found to occasionally have good results in treating neuropathic pain, whereas occipital nerve stimulation was found to achieve good results in controlling chronic cluster headache and other chronic headaches, although with only short-term follow-up so far. Recent reports of functional magnetic resonance imaging have prompted us to propose exciting new neurosurgical targets that may be effective in treating psychoaffective disorders. Our results appear to be more than promising so far. It appears that neuropathic pain and psychoaffective disorders seem to be sharing an anatomophysiological common background at the Brodmann Area 25 of the anterior cingulated gyrus. On the basis of these exciting findings, we believe that it is reasonable to suggest that neuropathic pain and psychoaffective disorders may ultimately be managed with complementary or, at least, similar, therapeutic strategies, each of which lie within the domain of the neurosurgeon.