Toward an In Vivo Neuroimaging Template of Human Brainstem Nuclei of the Ascending Arousal, Autonomic, and Motor Systems
Toward an In Vivo Neuroimaging Template of Human Brainstem Nuclei of the Ascending Arousal, Autonomic, and Motor Systems
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DOI：
10.1089/brain.2015.0347
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发表时间：
2015-12-01
影响因子：
3.4
通讯作者：
Wald, Lawrence L.
中科院分区：
文献类型：
--
作者：
Bianciardi, Marta;Toschi, Nicola;Wald, Lawrence L.
脑干核（Brainstem nucleus，Bn）在人类的生命功能中起着至关重要的作用，例如唤醒、自主稳态、感觉和运动中继、伤害感受、睡眠和颅神经功能，并且它们已经涉及大量的脑病理。然而，大多数人Bn的体内描绘一直难以捉摸，因为使用标准神经成像方法检测这些小区域的灵敏度和对比度有限。为了精确地识别几个人体Bn在体内，我们采用了7特斯拉的扫描仪配备多通道接收线圈阵列，它提供了高磁共振成像灵敏度，和多对比度（扩散分数各向异性和T2加权）回波平面成像方法，它提供了互补的对比度Bn解剖匹配的几何失真和分辨率。通过对健康成年人获得的1.3 mm（3）多对比度解剖图像的组合检查，我们半自动地生成了上升觉醒的体内概率Bn标签（中缝和中缝背侧），自主神经（大缝，导水管周围灰质），和运动（下橄榄核，黑质的两个亚区，红核的两个亚区，以及间脑中丘脑底核的两个亚区）系统。这些标签构成了在标准空间中开发Bn的体内神经成像模板的第一步，以促进人类脑干功能和病理学的未来临床和研究调查。这个模板的概念验证的临床应用被证明在一个最低限度的意识患者与创伤性脑干血管精确定位到中缝Bn参与觉醒。
Brainstem nuclei (Bn) in humans play a crucial role in vital functions, such as arousal, autonomic homeostasis, sensory and motor relay, nociception, sleep, and cranial nerve function, and they have been implicated in a vast array of brain pathologies. However, an in vivo delineation of most human Bn has been elusive because of limited sensitivity and contrast for detecting these small regions using standard neuroimaging methods. To precisely identify several human Bn in vivo, we employed a 7 Tesla scanner equipped with multi-channel receive-coil array, which provided high magnetic resonance imaging sensitivity, and a multi-contrast (diffusion fractional anisotropy and T2-weighted) echo-planar-imaging approach, which provided complementary contrasts for Bn anatomy with matched geometric distortions and resolution. Through a combined examination of 1.3 mm(3) multi-contrast anatomical images acquired in healthy human adults, we semi-automatically generated in vivo probabilistic Bn labels of the ascending arousal (median and dorsal raphe), autonomic (raphe magnus, periaqueductal gray), and motor (inferior olivary nuclei, two subregions of the substantia nigra compatible with pars compacta and pars reticulata, two subregions of the red nucleus, and, in the diencephalon, two subregions of the subthalamic nucleus) systems. These labels constitute a first step toward the development of an in vivo neuroimaging template of Bn in standard space to facilitate future clinical and research investigations of human brainstem function and pathology. Proof-of-concept clinical use of this template is demonstrated in a minimally conscious patient with traumatic brainstem hemorrhages precisely localized to the raphe Bn involved in arousal.