Tractography of the amygdala and hippocampus: anatomical study and application to selective amygdalohippocampectomy

Laboratory investigation

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Object

The aim of this study was to evaluate, using diffusion tensor tractography, the white matter fibers crossing the hippocampus and the amygdala, and to perform a volumetric analysis and an anatomical study of the connections of these 2 structures. As a second step, the authors studied the white matter tracts crossing a virtual volume of resection corresponding to a selective amygdalohippocampectomy.

Methods

Twenty healthy right-handed individuals underwent 3-T MR imaging. Volumetric regions of interest were manually created to delineate the amygdala, the hippocampus, and the volume of resection. White matter fiber tracts were parcellated using the fiber assignment for continuous tracking tractography algorithm. All fibers were registered with the anatomical volumes.

Results

In all participants, the authors identified fibers following the hippocampus toward the fornix, the splenium of the corpus callosum, and the dorsal hippocampal commissure. With respect to the fibers crossing the amygdala, the authors identified the stria terminalis and the uncinate fasciculus. The virtual resection disrupted part of the fornix, fibers connecting the 2 hippocampi, and fibers joining the orbitofrontal cortex. The approach created a theoretical frontotemporal disconnection and also interrupted fibers joining the temporal pole and the occipital area.

Conclusions

This diffusion tensor tractography study allowed for good visualization of some of the connections of the amygdala and hippocampus. The authors observed that the virtual selective amygdalohippocampectomy disconnected a large number of fibers connecting frontal, temporal, and occipital areas.

Abbreviations used in this paper: DTT = diffusion tensor tractography; MNI = Montreal Neurological Institute; ROI = region of interest; selAH = selective amygdalohippocampectomy.

Article Information

Address correspondence to: Sophie Colnat-Coulbois, M.D., Ph.D., Département de Neurochirurgie, Hôpital Central, 27 avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France. email: sophie.colnat@wanadoo.fr.

Please include this information when citing this paper: published online May 7, 2010; DOI: 10.3171/2010.3.JNS091832.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Three-dimensional reconstruction of the virtual resection overlayed on an axial T1-weighted MR image. The blue area represents the surgical corridor across the second temporal gyrus in combination with the volume of resection that includes the amygdala and the anterior third of the hippocampus.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on an axial T1-weighted MR image. The red and green fibers represent those crossing the left and the right amygdala, respectively. These fibers join the orbitofrontal cortex and the temporal lobe on both sides. The blue and yellow fibers represent those that cross the left and the right hippocampus, respectively, and follow the shape of the fornix. Some fibers join the 2 hippocampi across the splenium of the corpus callosum and, in this individual, these fibers predominantly come from the left side. In both hemispheres, we observed some fibers joining the occipital area.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on a coronal T1-weighted MR image. The green and blue fibers, respectively, represent the fibers that cross the left and the right hippocampus. These fibers pass through the body of the fornix (yellow arrow). We observed some fibers joining the anterior part of the brainstem (white arrow). Red fibers and partially visible yellow fibers represent those that cross the left and the right amygdala, respectively.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on a sagittal T1-weighted MR image. The green and blue fibers represent those that cross the left and the right hippocampus, respectively. Fibers originating in the right hippocampus cross the midline through the splenium of the corpus callosum toward the left hippocampus (arrow). The yellow fibers correspond to those that cross the right amygdala.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on a sagittal T1-weighted MR image. The green fibers represent those that originate from the left hippocampus that cross the midline through the dorsal hippocampal commissure (arrow) at the anterior and inferior part of the splenium of the corpus callosum. The red fibers represent those that cross the left amygdala.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on a sagittal T1-weighted MR image. The red and green fibers represent those that cross the right amygdala and the right hippocampus, respectively. The fibers that cross the amygdala join the orbitofrontal area and the anterior temporal area through the uncinate fasciculus (arrow).

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the amygdala and the hippocampus overlayed on an axial T1-weighted MR image. The green and blue fibers represent those that cross the left and the right hippocampus, respectively. The yellow and red fibers represent those that cross the right and left amygdala, respectively. Some fibers cross the midline through the anterior commissure (arrow), predominantly from the right side.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts (red) crossing the left amygdala overlayed on a coronal T1-weighted MR image. Some fibers are located between the thalamus and the head of the caudate nucleus on the floor of the lateral ventricle and correspond to the stria terminalis (arrow).

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the volume of the virtual resection. The blue area corresponds to the surgical corridor. The fibers crossing the virtual resection (green) join the orbitofrontal cortex, the fornix, and the splenium of the corpus callosum.

  • View in gallery

    Three-dimensional reconstruction of the fiber tracts crossing the volume of resection in conjunction with the corridor corresponding to the surgical approach. The fibers crossing to the amygdalohippocampal volume are green. The fibers crossing the surgical corridor are red. The approach disrupts additional orbitofrontal fibers and also fibers joining the anterolateral temporal cortex, the temporal pole, and the occipital area.

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