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BACKGROUND: For surgical interventions, a precise understanding of the anatomical variations of the brain and defined anatomical landmarks to demarcate the regions of the temporal lobe is essential. Many anatomical studies have facilitated important surgical approaches to the temporobasal region. Because there is considerable sulcal variability, morphological analysis of the brain is imperative. The aim of this study was to define the boundaries of the temporal and occipital lobes and to define the variations in sulci and gyri in the inferior aspect. METHODS: In 110 cerebral hemispheres variations were identified and the major landmarks of the gyral-sulcal pattern at the inferior aspect of the brain were defined. RESULTS: The anatomy of the inferior aspect of the brain is defined in detail by morphological analysis of formalin-fixed hemispheres with a view to informing important surgical approaches. CONCLUSIONS: Since the literature defines no clear separation between the temporal and occipital lobes, certain landmarks such as the preoccipital notch and a basal temporo-occipital line were suggested as ways of making the distinction. The parahippocampal ramus is a constant structure that can be used as a reliable landmark for the posterior end of the hippocampus.

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The temporo-basal region of the human brain is composed of the collateral, the occipito-temporal, and the rhinal sulci. We manually rated (using a novel protocol) the connections between rhinal/collateral (RS-CS), collateral/occipito-temporal (CS-OTS) and rhinal/occipito-temporal (RS-OTS) sulci, using the MRI of nearly 3400 individuals including around 1000 twins. We reported both the associations between sulcal polymorphisms as well with a wide range of demographics (e.g. age, sex, handedness). Finally, we also estimated the heritability, and the genetic correlation between sulcal connections. We reported the frequency of the sulcal connections in the general population, which were hemisphere dependent. We found a sexual dimorphism of the connections, especially marked in the right hemisphere, with a CS-OTS connection more frequent in females (approximately 35-40% versus 20-25% in males) and an RS-CS connection more common in males (approximately 40-45% versus 25-30% in females). We confirmed associations between sulcal connections and characteristics of incomplete hippocampal inversion (IHI). We estimated the broad sense heritability to be 0.28-0.45 for RS-CS and CS-OTS connections, with hints of dominant contribution for the RS-CS connection. The connections appeared to share some of their genetic causing factors as indicated by strong genetic correlations. Heritability appeared much smaller for the (rarer) RS-OTS connection.

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Brain areas at the parahippocampal gyrus of the temporal-occipital transition region are involved in different functions including processing visual-spatial information and episodic memory. Results of neuroimaging experiments have revealed a differentiated functional parcellation of this region, but its microstructural correlates are less well understood. Here we provide probability maps of four new cytoarchitectonic areas, Ph1, Ph2, Ph3 and CoS1 at the parahippocampal gyrus and collateral sulcus. Areas have been identified based on an observer-independent mapping of serial, cell-body stained histological sections of ten human postmortem brains. They have been registered to two standard reference spaces, and superimposed to capture intersubject variability. The comparison of the maps with functional imaging data illustrates the different involvement of the new areas in a variety of functions. Maps are available as part of Julich-Brain atlas and can be used as anatomical references for future studies to better understand relationships between structure and function of the caudal parahippocampal cortex.

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OBJECTIVE: The fusiform gyrus and the collateral sulcus are the anatomical structures located in the temporobasal region. In this study, the topographic anatomy of the fusiform gyrus and the collateral sulcus is detailed to make a contribution for a successful course of temporal lobe surgery. METHODS: We studied the basal surface of the temporal lobes of 38 formalin-fixed adult human brain specimens. In the morphometric analysis, the distance between anterior and posterior transverse collateral sulcus and the distance between the occipitotemporal sulcus and fusiform apex were used as parameters. The topographic anatomy of collateral sulcus was identified in detail, and 4 sulcal patterns were used to classify the sulcal arrangement of basal surface of temporal lobe in each hemisphere: type 1, single-branch and unbroken collateral sulcus with no connection; type 2, continuous with the rhinal sulcus; type 3, continuous with the occipitotemporal sulcus and; type 4, continuous with both rhinal and occipitotemporal sulcus. RESULTS: The current study showed that type 1 was the pattern seen most frequently (42.1%, 16/38), whereas type 4 was the least (7.9%, 3/38). Overall, 63.2% (12/19) of subjects had the same sulcal pattern in both temporal lobes. The morphometric analysis showed that the mean distance between anterior and posterior transverse collateral sulcus was 50 ± 16.2 mm and the mean distance between occipitotemporal sulcus and fusiform apex was 26 ± 8.4 mm. CONCLUSIONS: The topographic anatomy of the collateral sulcus with its surrounding structures is detailed in this study. This study clarifies and supplements the knowledge presently available to help develop a more feasible surgical concept.

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Objective: The authors investigated the specific topographic relationship of the optic radiation fibers to the roof and floor of the ventricular atrium because the current literature is ambiguous. Methods: Thirty-five normal, adult, formalin-fixed cerebral hemispheres and 30 focused MRI slices at the level of the atrium were included in the study. The correlative anatomy of the optic radiation with regard to the atrial roof and floor was investigated in 15 specimens, each through focused fiber microdissections. The remaining 5 hemispheres were explored with particular emphasis on the trajectory of the collateral sulcus in relation to the floor of the atrium. In addition, the trajectory of the collateral sulcus was evaluated in 30 MRI scans. Results: The atrial roof was observed to be devoid of optic radiations in all studied hemispheres, whereas the atrial floor was seen to harbor optic fibers on its lateral part. Moreover, the trajectory of the intraparietal sulcus, when followed, was always seen to correspond to the roof of the atrium, thus avoiding the optic pathway, whereas that of the collateral sulcus was found to lead to either the lateral atrial floor or outside the ventricle in 88% of the cases, therefore hitting the visual pathway. Conclusions: Operative corridors accessing the ventricular atrium should be carefully tailored through detailed preoperative planning and effective use of intraoperative navigation to increase patient safety and enhance the surgeon's maneuverability. The authors strongly emphasize the significance of accurate anatomical knowledge.

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The parahippocampal place area (PPA) is a widely studied high-level visual region in the human brain involved in place and scene processing. The goal of the present study was to identify the most probable location of place-selective voxels in medial ventral temporal cortex. To achieve this goal, we first used cortex-based alignment (CBA) to create a probabilistic place-selective region of interest (ROI) from one group of 12 participants. We then tested how well this ROI could predict place selectivity in each hemisphere within a new group of 12 participants. Our results reveal that a probabilistic ROI (pROI) generated from one group of 12 participants accurately predicts the location and functional selectivity in individual brains from a new group of 12 participants, despite between subject variability in the exact location of place-selective voxels relative to the folding of parahippocampal cortex. Additionally, the prediction accuracy of our pROI is significantly higher than that achieved by volume-based Talairach alignment. Comparing the location of the pROI of the PPA relative to published data from over 500 participants, including data from the Human Connectome Project, shows a striking convergence of the predicted location of the PPA and the cortical location of voxels exhibiting the highest place selectivity across studies using various methods and stimuli. Specifically, the most predictive anatomical location of voxels exhibiting the highest place selectivity in medial ventral temporal cortex is the junction of the collateral and anterior lingual sulci. Methodologically, we make this pROI freely available (vpnl.stanford.edu/PlaceSelectivity), which provides a means to accurately identify a functional region from anatomical MRI data when fMRI data are not available (for example, in patient populations). Theoretically, we consider different anatomical and functional factors that may contribute to the consistent anatomical location of place selectivity relative to the folding of high-level visual cortex.

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The location and topography of the first three visual field maps in the human brain, V1-V3, are well agreed upon and routinely measured across most laboratories. The position of 4 th visual field map, 'hV4', is identified with less consistency in the neuroimaging literature.  Using magnetic resonance imaging data, we describe landmarks to help identify the position and borders of 'hV4'. The data consist of anatomical images, visualized as cortical meshes to highlight the sulcal and gyral patterns, and functional data obtained from retinotopic mapping experiments, visualized as eccentricity and angle maps on the cortical surface. Several features of the functional and anatomical data can be found across nearly all subjects and are helpful for identifying the location and extent of the hV4 map. The medial border of hV4 is shared with the posterior, ventral portion of V3, and is marked by a retinotopic representation of the upper vertical meridian. The anterior border of hV4 is shared with the VO-1 map, and falls on a retinotopic representation of the peripheral visual field, usually coincident with the posterior transverse collateral sulcus. The ventro-lateral edge of the map typically falls on the inferior occipital gyrus, where functional MRI artifacts often obscure the retinotopic data. Finally, we demonstrate the continuity of retinotopic parameters between hV4 and its neighbors; hV4 and V3v contain iso-eccentricity lines in register, whereas hV4 and VO-1 contain iso-polar angle lines in register. Together, the multiple constraints allow for a consistent identification of the hV4 map across most human subjects.

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Recent advances in MRI and increasing knowledge on the characterization and anatomical variability of medial temporal lobe (MTL) anatomy have paved the way for more specific subdivisions of the MTL in humans. In addition, recent studies suggest that early changes in many neurodegenerative and neuropsychiatric diseases are better detected in smaller subregions of the MTL rather than with whole structure analyses. Here, we developed a new protocol using 7 Tesla (T) MRI incorporating novel anatomical findings for the manual segmentation of entorhinal cortex (ErC), perirhinal cortex (PrC; divided into area 35 and 36), parahippocampal cortex (PhC), and hippocampus; which includes the subfields subiculum (Sub), CA1, CA2, as well as CA3 and dentate gyrus (DG) which are separated by the endfolial pathway covering most of the long axis of the hippocampus. We provide detailed instructions alongside slice-by-slice segmentations to ease learning for the untrained but also more experienced raters. Twenty-two subjects were scanned (19-32 yrs, mean age = 26 years, 12 females) with a turbo spin echo (TSE) T2-weighted MRI sequence with high-resolution oblique coronal slices oriented orthogonal to the long axis of the hippocampus (in-plane resolution 0.44 × 0.44 mm2) and 1.0 mm slice thickness. The scans were manually delineated by two experienced raters, to assess intra- and inter-rater reliability. The Dice Similarity Index (DSI) was above 0.78 for all regions and the Intraclass Correlation Coefficients (ICC) were between 0.76 to 0.99 both for intra- and inter-rater reliability. In conclusion, this study presents a fine-grained and comprehensive segmentation protocol for MTL structures at 7 T MRI that closely follows recent knowledge from anatomical studies. More specific subdivisions (e.g. area 35 and 36 in PrC, and the separation of DG and CA3) may pave the way for more precise delineations thereby enabling the detection of early volumetric changes in dementia and neuropsychiatric diseases.

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OBJECTIVE Conventional approaches to the atrium of the lateral ventricle may be associated with complications related to direct cortical injury or brain retraction. The authors describe a novel approach to the atrium through a retrosigmoid transtentorial transcollateral sulcus corridor. METHODS Bilateral retrosigmoid craniotomies were performed on 4 formalin-fixed, colored latex-injected human cadaver heads (a total of 8 approaches). Microsurgical dissections were performed under 3× to 24× magnification, and endoscopic visualization was provided by 0° and 30° rigid endoscope lens systems. Image guidance was provided by coupling an electromagnetic tracking system with an open source software platform. Objective measurements on cortical thickness traversed and total depth of exposure were recorded. Additionally, the basal occipitotemporal surfaces of 10 separate cerebral hemisphere specimens were examined to define the surface topography of sulci and gyri, with attention to the appearance and anatomical patterns and variations of the collateral sulcus and the surrounding gyri. RESULTS The retrosigmoid approach allowed for clear visualization of the basal occipitotemporal surface. The collateral sulcus was identified and permitted easy endoscopic access to the ventricular atrium. The conical corridor thus obtained provided an average base working area of 3.9 cm2 at an average depth of 4.5 cm. The mean cortical thickness traversed to enter the ventricle was 1.4 cm. The intraventricular anatomy of the ipsilateral ventricle was defined clearly in all 8 exposures in this manner. The anatomy of the basal occipitotemporal surface, observed in a total of 18 hemispheres, showed a consistent pattern, with the collateral sulcus abutted by the parahippocampal gyrus medially, and the fusiform and lingual gyrus laterally. The collateral sulcus was found to be caudally bifurcated in 14 of the 18 specimens. CONCLUSIONS The retrosigmoid supracerebellar transtentorial transcollateral sulcus approach is technically feasible. This approach has the potential advantage of providing a short and direct path to the atrium, hence avoiding violation of deep neurovascular structures and preserving eloquent areas. Although this approach appears unconventional, it may provide a minimally invasive option for the surgical management of selected lesions within the atrium of the lateral ventricle.

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Understanding the anatomy of temporal lobe sulci and their variations can allow for safer neurosurgical approaches. Although the inferior temporal sulci and their relations to each other has been described by several authors, the nomenclature used has not been universal. The aim of this study was to investigate the anatomic features of the three main sulci of the inferior temporal lobe and provide a simple description of complex patterns among these sulci. Sulcal variations and their relations were examined in seventy formalin-fixed, adult cadaveric cerebral hemispheres. We recommend a simple but modified classification specifically for anatomic variations of the rhinal and collateral sulci. Furthermore, we describe the frequency of occipitotemporal sulci that contain 5 and 6 segments, not previously mentioned. The length and depth of all sulci were measured in all samples. Additionally, more detailed results regarding the patterns, courses, connections, relationships and measurements were given. Understanding of the complex anatomy of this clinically important region is of benefit to neurosurgeons, providing necessary guidance for neurosurgical approaches to the inferior surface of the temporal lobe. Clin. Anat. 29:932-942, 2016. © 2016 Wiley Periodicals, Inc.

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The sulcal segments of the collateral sulcal complex on the medial part of the temporal lobe delineate the parahippocampal gyrus involved in memory processing from the laterally adjacent fusiform gyrus. The rhinal sulcus delineates the entorhinal cortex on the anterior portion of the parahippocampal gyrus. Posterior to the rhinal sulcus lies the collateral sulcus proper which delineates the parahippocampal cortex that occupies the posterior part of the parahippocampal gyrus. A small sulcus, the parahippocampal extension of the collateral sulcus, runs transversely within the parahippocampal gyrus. The rhinal sulcus, the collateral sulcus proper, and the parahippocampal extension of the collateral sulcus were identified on magnetic resonance images of 40 healthy human brains and probability maps were created to provide quantification of the location variability within standard stereotaxic space. These probability maps can act as a reference frame for the accurate identification of key components of the parahippocampal region and assist in the interpretation of structural and functional changes obtained in neuroimaging studies.

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OBJECTIVE Diagnostic criteria for hippocampal malrotation (HIMAL) on brain MRI typically include a rounded hippocampus, vertical collateral sulcus, and architectural blurring. Relationship to epileptogenesis remains speculative, and usefulness for surgical guidance is unknown. The study was performed to determine the prevalence of hippocampal rotational anomalies in a cohort of pediatric patients with intractable epilepsy undergoing evaluation for surgery and to determine the significance of this finding in the context of surgical planning. METHODS Forty-eight surgically treated children with intractable epilepsy were compared with matched healthy subjects; reviewers were blinded to surgical side. Each temporal lobe was evaluated for rounded hippocampus, blurring, vertical collateral sulcus, wide choroidal fissure, enlarged temporal horn, low fornix, hippocampal signal, and findings of hippocampal sclerosis. A mesial temporal lobe (MTL) score was calculated by summing the number of features, and the collateral sulcus angle (CSA) was measured in each temporal lobe. Surgical side, pathological diagnosis, and imaging findings elsewhere in the brain were tabulated. Presence of HIMAL, associated imaging features, and MTL score were compared between sides, between epilepsy and control groups, in relationship to side of surgery, and in relationship to postoperative outcome. RESULTS Only 3 epilepsy patients (6.2%) and no controls exhibited all 3 features of HIMAL (p = 0.12). Eight of 48 (16.7%) epilepsy versus 2 of 48 (4.6%) control subjects had both a rounded hippocampus and vertical collateral sulcus (suggesting HIMAL) (p = 0.045). In control and epilepsy subjects, most findings were more prevalent on the left, and the left CSA was more vertical (p < 0.0001). Epilepsy subjects had higher MTL scores (z = -2.95, p = 0.002) and more acute CSAs (p = 0.04) than controls. Only lateralizing raw MTL score had a significant association with surgical side (p = 0.03, OR 7.33); however, this was not significant when hippocampal sclerosis cases were excluded. HIMAL findings were more prevalent and MTL scores were higher in patients with resections involving the temporal lobes. On group analysis, HIMAL findings did not predict eventual surgical side and did not predict outcome, although the numbers are small. In 4 patients the abnormally rotated hippocampus was resected and showed hippocampal sclerosis and/or dysplastic changes on histopathology. All of these patients had a good outcome after surgery. CONCLUSIONS While increased in prevalence in children with intractable epilepsy, imaging findings of HIMAL did not have preoperative lateralizing utility in this group. Findings of HIMAL (including round hippocampus, architectural blurring, and vertical collateral sulcus) did not predict outcome after surgery, although the small number of patients with these findings limits evaluation. In the small number of patients in which the malrotated hippocampus was removed, outcome was good. Further research is needed to continue to define this association in children with intractable epilepsy, focusing on a temporal lobe cohort.

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PURPOSE: The temporal lobe is anatomically and functionally complex. However, relatively few radiologic signs are described to facilitate recognition of temporal lobe sulci and gyri in clinical practice. We devised and tested 8 radiologic signs of temporal lobe anatomy. METHODS: Images from volumetric magnetization-prepared rapid gradient-echo imaging were analyzed of 100 temporal lobes from 26 female and 24 male patients. Patient age ranged from 1 to 79 years (mean 19 years; standard deviation 16 years). Standardized axial, coronal, and sagittal planes were evaluated and cross-referenced. Eight signs to delineate the superior temporal gyrus, Heschl gyrus (HG), parahippocampal gyrus, rhinal sulcus, collateral sulcus proper, or the occipitotemporal sulcus, or a combination, were evaluated in the sagittal or axial plane. Two neuroradiologists independently evaluated each sign; the sign was considered present only with positive reader agreement. RESULTS: All 8 signs were present in most patients. The most frequent signs were the posterior insular corner to identify HG in the axial plane (100 %), pointed STG to identify STG in the axial plane (98 %), and parahippocampal Y to identify the posterior parahippocampal gyrus in the sagittal plane (98 %). The frequencies were similar between the right and left cerebral hemispheres. CONCLUSIONS: Temporal lobe gyri and sulci can be reliably identified in multiple planes using anatomic signs.

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Shape and texture provide cues to object identity, both when objects are explored using vision and via touch (haptics). Visual shape information is processed within the lateral occipital complex (LOC), while texture is processed in medial regions of the collateral sulcus (CoS). Evidence indicates that the LOC is recruited during both visual and haptic shape processing. Here we used functional magnetic resonance imaging (fMRI) to examine whether 'visual' texture-selective areas are similarly recruited when observers discriminate texture via touch. We used a blocked design in which participants discriminated either the texture or shape of unfamiliar 3-dimensional (3D) objects, via vision or touch. We observed significant haptic texture-selective fMRI responses in medial occipitotemporal cortex within areas adjacent to, but not overlapping, those recruited during visual texture discrimination. Although areas of ventromedial temporal cortex are recruited during visual and haptic texture perception, these areas appear to be spatially distinct and modality-specific.

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