Name: fiber connections of the supplementary motor area revisited: methodology of fiber dissection, dti, and three dimensional documentation
Uploaded: 2017-05-23T14:00:00
Description: Watch this Scientific Journal Video about Fiber Connections of the Supplementary Motor Area Revisited: Methodology of Fiber Dissection, DTI, and Three Dimensional Documentation at JoVE.com

The data were provided in part by the Human Connectome Project, WU-Minn Consortium (Principal Investigators: David Van Essen and Kamil Ugurbil; 1U54MH091657), funded by the 16 NIH Institutes and Centers that support the NIH Blueprint for Neuroscience Research; and by the McDonnell Center for Systems Neuroscience at Washington University. Figures 2A and 2D were reproduced with permission from the Rhoton collection57 (http://rhoton.ineurodb.org/?page=21899).

The deceased are included here as a population, although deceased persons are not technically human subjects; human subjects are defined by 45 CF 46 as &#34;living human beings15,16.&#34;
1. Preparation of Specimens
<ol>
	<li>Examine 5 formalin-fixed brains (10 hemispheres) and 2 whole human heads.</li>
	<li>Fix the specimens in a 10% formalin solution for at least 2 months according to Klingler&#39;s method17...

The Importance of and Study Techniques for the White Matter Pathways
The cerebral cortex is accepted as a principal neural structure associated with 2.5 million years of human life. Approximately 20 billion neurons have separated into various parts based upon morphological and cellular specification40. The architecture of each of these cortical parts has been functionally sub-grouped, such as sensorimotor sense and movement, emotional experience, and complex reasoning. It ...

Among the 14 frontal areas delineated by Brodmann, the premotor and prefrontal area that lies in front of the precentral motor cortex has long been considered as a silent module, despite the fact that the frontal lobe plays an important role in cognition, behavior, learning, and speech processing. In addition to the supplementary motor area (SMA) complex, consisting of the pre-SMA and the SMA proper (Brodmann Area; BA 6) that extends medially, the pre-motor/frontal module includes the dorsolateral prefrontal (BA 46, 8, and 9), frontopolar (BA 10), and ventrolateral prefrontal (BA 47) cortices, as well as part of the orbitofrontal cortex (BA 11) on the lateral surface of the brain1,2.
The SMA complex is a significant anatomical area that is defined by its functions and its connections. The resection and damage of this region causes significant clinical deficits known as the SMA syndrome. The SMA syndrome is an important clinical condition that is particularly observed in frontal glioma cases that contain the SMA complex3. The SMA complex has connections with the limbic system, basal ganglia, cerebellum, thalamus, contralateral SMA, superior parietal lobe, and portions of the frontal lobes via fiber tracts. The clinical effect of damage to these white matter connections may be more severe than to the cortex. This is because the consequences of injury to the cortex can be ameliorated over time due to high cortical plasticity 4,5,6,7,8,9,10,11,12,. Therefore, the SMA regional anatomy and the white matter pathways should be deeply understood, in particular for glioma surgery.
A comprehensive understanding of the anatomy of white matter pathways is important for the wide-spectrum treatment of neurosurgical lesions. Recent studies of the three-dimensional documentation of the anatomical results that were obtained in microsurgery were used to gain a better understanding of the topographical anatomy and the interrelationship of brain white matter pathways13,14. Therefore, the purpose of this study was to examine the white matter connections of the SMA complex (pre-SMA and SMA proper) using a combination of fiber dissection techniques on cadaveric specimens and magnetic resonance imaging (MRI) tractography and to explain all the methods and principles of both techniques and their detailed documentation.
Planning and Strategy of Study
Prior to performing the experiments, a literature search on the basic principles of fiber dissections, the procedures that need to be applied to specimens before and during dissections, and all connections between SMA regions that have been revealed with dissection and DTI was conducted. The previous studies on the anatomical localization and separation of pre-SMA and SMA-proper regions and on the topographic anatomy of their connections were reviewed.

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			<td>%4 Paraformaldehyde Solution</td>
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			<td>Freezer</td>
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			<td>Panfield Dissector</td>
			<td>AESCULAP</td>
			<td>FD305</td>
			<td>used to dissection</td>
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			<td>Surgical Micro Scissor</td>
			<td>W. Lorenz</td>
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			<td>Surgical Micro Hook</td>
			<td>V. Mueller&#160;</td>
			<td>NL3785-009</td>
			<td>used to miscrodissection</td>
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			<td>MICRO VESSEL STRETCHER/DILATOR</td>
			<td>W. Lorenz</td>
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			<td>used to miscrodissection</td>
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			<td>Emax2 SC 2000 Electric Console</td>
			<td>Anspach Companies</td>
			<td>SC2102</td>
			<td>used to craniatomy</td>
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			<td>Drill Set</td>
			<td>Anspach Companies</td>
			<td>NS-CZ70WH6</td>
			<td>used to craniatomy</td>
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			<td>20-1000 operating microscope</td>
			<td>Moeller-Wedel,Germany</td>
			<td>FS 4-20</td>
			<td>used to miscrodissection</td>
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			<td>Canon EOS 550D 18 MP CMOS APS-C Digital SLR Camera</td>
			<td>Canon Inc.</td>
			<td>DS126271</td>
			<td>used to take photos</td>
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			<td>EF 100mm f/2.8L IS USM Macro Lens</td>
			<td>Canon Inc.</td>
			<td>4657A006</td>
			<td>used to take photos</td>
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			<td>MR-14EX II Macro Ring Lite (Flash)</td>
			<td>Canon Inc.</td>
			<td>9389B002</td>
			<td>used to take photos</td>
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			<td>Tripod</td>
			<td>Lino Manfrotto</td>
			<td>322RC2</td>
			<td>used to take photos</td>
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			<td>MAYFIELD Infinity Skull Clamp</td>
			<td>Integra Inc.</td>
			<td>A0077</td>
			<td>used to fix the head</td>
		</tr>
		<tr>
			<td>Modified Skrya 3T &#34;Connectome&#34; Scanner</td>
			<td>Siemens Company, Inc.</td>
			<td>&#160;A911IM-MR-15773-P1-4A00</td>
			<td>used to scan DTI</td>
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			<td>XstereO Player</td>
			<td>Yury Golubinsky</td>
			<td>Version 3.6(22)</td>
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			<td>EF-S 18-55mm f/3.5-5.6 IS II SLR Lens</td>
			<td>Canon Inc.</td>
			<td>2042B002</td>
			<td>used to take photos</td>
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			<td>Scalpel</td>
			<td>6B INVENT&#160;</td>
			<td>7-104-L</td>
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			<td>Compact&#160; Speed Reducer&#160;</td>
			<td>Anspach Companies</td>
			<td>CSR60</td>
			<td>used to make burr hole&#160;</td>
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		<tr>
			<td>14 mm Cranial Perforator&#160;</td>
			<td>Anspach Companies</td>
			<td>CPERF-14-11-3F</td>
			<td>used to make burr hole&#160;</td>
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			<td>2 mm x 15.6 mm Fluted Router&#160;</td>
			<td>Anspach Companies</td>
			<td>A-CRN-M</td>
			<td>used to make craniotomy</td>
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			<td>2.1 mm Pin-shaped Burrs</td>
			<td>Anspach Companies</td>
			<td>03.000.130S</td>
			<td>used to make craniotomy</td>
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fiber connections of the supplementary motor area revisited: methodology of fiber dissection, dti, and three dimensional documentation

The purpose of this study is to show the methodology for the examination of the white matter connections of the supplementary motor area (SMA) complex (pre-SMA and SMA proper) using a combination of fiber dissection techniques on cadaveric specimens and magnetic resonance (MR) tractography. The protocol will also describe the procedure for a white matter dissection of a human brain, diffusion tensor tractography imaging, and three-dimensional documentation. The fiber dissections on human brains and the 3D documentation were performed at the University of Minnesota, Microsurgery and Neuroanatomy Laboratory, Department of Neurosurgery. Five postmortem human brain specimens and two whole heads were prepared in accordance with Klingler's method. Brain hemispheres were dissected step by step from lateral to medial and medial to lateral under an operating microscope, and 3D images were captured at every stage. All dissection results were supported by diffusion tensor imaging. Investigations on the connections in line with Meynert's fiber tract classification, including association fibers (short, superior longitudinal fasciculus I and frontal aslant tracts), projection fibers (corticospinal, claustrocortical, cingulum, and frontostriatal tracts), and commissural fibers (callosal fibers) were also conducted.

The SMA complex is situated in the posterior part of the superior frontal gyrus. The borders of the SMA complex are the precentral sulcus posteriorly, the superior frontal sulcus inferior-laterally, and the cingulate sulcus inferior-medially18. The SMA complex consists of two parts: the pre-SMA anteriorly and the SMA proper posteriorly18. There are differences in terms of white matter connections and function between these two parts<sup clas...

Watch this Scientific Journal Video about Fiber Connections of the Supplementary Motor Area Revisited: Methodology of Fiber Dissection, DTI, and Three Dimensional Documentation at JoVE.com

Fiber Connections of the Supplementary Motor Area Revisited: Methodology of Fiber Dissection, DTI, and Three Dimensional Documentation

The purpose of this study is to show each step of the fiber dissection technique on human cadaveric brains, the 3D documentation of these dissections, and the diffusion tensor imaging of the anatomically dissected fiber pathways.

The purpose of this study is to show the methodology for the examination of the white matter connections of the supplementary motor area (SMA) complex ...

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