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Now before that we move on to sharing the free PDF download of Surgery of the Brainstem PDF with you, here are a few important details regarding this book which you might be interested.
The brainstem is one of the most densely packed areas of the central nervous system in terms of gray, but also white, matter structures and, therefore, is a highly functional hub. It has mainly been studied by the means of histological techniques, which requires several hundreds of slices with a loss of the 3D coherence of the whole specimen. Access to the inner structure of the brainstem is possible using Magnetic Resonance Imaging (MRI), but this method has a limited spatial resolution and contrast in vivo. Here, we scanned an ex vivo specimen using an ultra-high field (11.7T) preclinical MRI scanner providing data at a mesoscopic scale for anatomical T2-weighted (100 µm and 185 µm isotropic) and diffusion-weighted imaging (300 µm isotropic). We then proposed a hierarchical segmentation of the inner gray matter of the brainstem and defined a set of rules for each segmented anatomical class. These rules were gathered in a freely accessible web-based application, WIKIBrainStem (https://fibratlas.univ-tours.fr/brainstems/index.html), for 99 structures, from which 13 were subdivided into 29 substructures.
This segmentation is, to date, the most detailed one developed from ex vivo MRI of the brainstem. This should be regarded as a tool that will be complemented by future results of alternative methods, such as Optical Coherence Tomography, Polarized Light Imaging or histology… This is a mandatory step prior to segmenting multiple specimens, which will be used to create a probabilistic automated segmentation method of ex vivo, but also in vivo, brainstem and may be used for targeting anatomical structures of interest in managing some degenerative or psychiatric disorders.
Brainstem Connectome Atlas
This is a probabilistic atlas of 23 brainstem bundles using high-quality connectome imaging data and advanced analysis techniques. We performed rigorous quality control on connectome imaging data from the Human Connectome Project (HCP) and only accepted high-quality imaging data with minimal residual distortions for atlas construction. A systematic protocol is then developed to manually delineate 1300 ROIs on 20 HCP subjects (10 males; 10 females) for the reconstruction of brainstem fiber bundles and the probabilistic atlases in the MNI152 space. The 23 brainstem bundles can be divided into three groups: 1) Major motor tracts: the corticospinal tract (CST), the fronto-pontine tract (FPT), and the parieto-occipito-temporo-pontine tract (POTPT); 2) Major sensory tracts: the medial lemniscus (ML), the spinothalamic tract (STT), and the lateral lemniscus (LL); 3) Cerebellar peduncles: superior cerebellar peduncle (SCP), the middle cerebellar peduncle (MCP), and the inferior cerebellar peduncle (ICP).
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