Transcallosal Approach to the Third Ventricle: Normative Morphometric Data Based on Magnetic Resonance Imaging Scans, with Special Reference to the Fornix and Forniceal Insertion

Winkler, Peter; Weis, Serge; Wenger, Emanuel; Herzog, Christopher; Dahl, Annette L; Reulen, H. J.

doi:10.1097/00006123-199908000-00023

Cited by 29 publications

(15 citation statements)

References 16 publications

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“…The fornix, which is composed of arch-shaped white matter fibers connecting the hippocampus to the mammillary body (Carpenter, 1985;Mark et al, 1993), has been suggested to play an important role in memory function (Tsivilis et al, 2008;Laxton et al, 2010) and has been shown to be morphologically altered in patients with temporal epilepsy (Supprian and Hofmann, 1997;Freeman et al, 2004;Concha et al, 2010). Its detailed examination is required for the surgical planning of transcallosal or transventricular tumor resection (Winkler et al, 1999). Within the mammillary region, the fornix that runs in between the medial hypothalamus, where the posterior hypothalamic area resides, and the lateral hypothalamic area, a candidate target area for deep brain stimulation to trigger weight loss, constitutes, together with the mammillo-thalamic tract a useful anatomical landmark for the placement of deep brain stimulation electrodes for chronic cluster headaches and in putative treatments for obesity, respectively.…”

Section: Discussionmentioning

confidence: 99%

MRI atlas of the human hypothalamus

et al. 2012

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Gaining new insights into the anatomy of the human hypothalamus is crucial for the development of new treatment strategies involving functional stereotactic neurosurgery. Here, using anatomical comparisons between histology and magnetic resonance images of the human hypothalamus in the coronal plane, we show that discrete gray and white hypothalamic structures are consistently identifiable by MRI. Macroscopic and microscopic images were used to precisely annotate the MRI sequences realized in the coronal plane in twenty healthy volunteers. MRI was performed on a 1.5T scanner, using a protocol including T1-weighted 3D fast field echo, T1-weighted inversionrecovery, turbo spin echo and T2-weighted 2D fast field echo imaging. For each gray matter structure as well as for white matter bundles, the different MRI sequences were analyzed in comparison to each other. The anterior commissure and the fornix were often identifiable, while the mammillothalamic tract was more difficult to spot. Qualitative analyses showed that MRI could also highlight finer structures such as the paraventricular nucleus, the ventromedial nucleus of the hypothalamus and the infundibular (arcuate) nucleus, brain nuclei that play key roles in the regulation of food intake and energy homeostasis. The posterior hypothalamic area, a target for deep brain stimulation in the treatment of cluster headaches, was readily identified, as was the lateral hypothalamic area, which similar to the aforementioned hypothalamic nuclei, could be a putative target for deep brain stimulation in the treatment of obesity. Finally, each of the identified structures was mapped to Montreal Neurological Institute (MNI) space. Please find enclosed the revised version of our manuscript "MRI atlas of the human hypothalamus" which we have modified according to the minor comment made by the reviewer#3.We appreciated the careful and incisive evaluation of our data made by the reviewers throughout the reviewing process. We hope that the manuscript is now in suitable form for publication in Neuroimage.  New insights into the anatomy of the human hypothalamus  Specific 1.5T MRI sequences approach histological resolution within the hypothalamus  White matter bundles within the hypothalamus can be identified using 1.5T MRI  Hypothalamic gray structures can be identified using 1.5T MRI *4. HighlightsWe have revised our manuscript to address the minor point raised by reviewer 3.In the "Data analysis" paragraph of the materials and methods section it now reads: "Structures were identified visually based on our knowledge of specific landmarks obtained from anatomical-histological cross sections and with reference to previously published atlases (Swaab et al., 1993;Koutcherov et al., 2000Koutcherov et al., , 2004Koutcherov et al., 2007;Mai et al., 2008); the landmarks used, such as the optic tract, the floor of the diencephalon, the third ventricle, and the fornix, were readily and reliably identifiable in MR scans." AbstractGaining new insights into the anatomy of the hu...

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Section: Discussionmentioning

confidence: 99%

MRI atlas of the human hypothalamus

et al. 2012

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“…13) ULFO, LLFO, and MLFO were previously measured without sex classification as 35.15, 37.61, and 36.38 mm, respectively. 29) In this study, ULFO, LLFO, and MLFO were 30.16, 31.32, and 30.74 mm in the entire population. ULAFO and LLAFO were reported to be 6.56 ± 0.24 and 7.58 ± 0.25 mm, respectively.…”

Section: Discussionmentioning

confidence: 47%

“…15) Our study and previous studies divided the length of the corpus callosum into 10 equal segments or four segments to identify the insertions of the fornix. 17,19,20,29) Comparison of the results is presented in Tables 2 and 3. These results show some inconsistency in the frontal half of the corpus callosum.…”

Section: Discussionmentioning

confidence: 99%

“…10,32) Therefore, damage of the fornix may result in memory disturbances. 6,14,21,22) A rectangle bounding the corpus callosum was drawn, with one side parallel to the line connecting the anterior and posterior commissures in accordance with the previous study 29) and the bounding rectangle was divided into 10 equal parts (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…These measurements were previously defined. 29) Fornix-to-brain ratios (FBRs) were calculated as the ratio of the widest aspect of the fornix at the level of the anterior commissure to the distance between the anterior and posterior commissures. Curvatures of the fornix were measured in accordance with the previous study.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Topographic Anatomy of the Fornix as a Guide for the Transcallosal-Interforniceal Approach With a Special Emphasis on Sex Differences

Özer

Kayalıoğlu

Erturk

2005

Neurol. Med. Chir.(Tokyo)

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The topographic anatomy and morphometry of the fornix is important for standardizing the transcallosal-interforniceal approach and avoiding memory disturbances. The detailed morphometry of the fornix was investigated with a special emphasis on sex differences using midsagittal magnetic resonance imaging of 80 males and 102 females. Various parameters of the fornix, including the length of the upper and lower fornices, the curvature of the upper and lower fornices, and the insertion point of the fornix to corpus callosum, were investigated. The thickness of the fornix at the attachment point to the anterior commissure, the maximum distance to the upper and lower surfaces of the fornix, and the curvature of the upper and lower fornices showed sex differences (p º 0.5). The upper insertion point of the fornix to the corpus callosum was more frontal in females, but the functional relevance of these differences need further investigation.

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