The dogma that brain function relied on the cortex has dominated clinical neurology, neurosurgery and psychiatry for the last 100 years. Since the start of the 2000s, it has become evident that brain function is orchestrated as a network through white matter connections. This framework provides an understanding of brain function and dysfunction, and has radically changed how neurosurgical resections are performed. There is currently no manual for clinicians to visualize this functional anatomy in a fast, easy and user-friendly way. This is particularly important for senior clinicians who may have an understanding of cortical anatomy but may struggle with newly described white matter connections as they may now be visualized with MRI, and also for trainees who are learning the subject of applied neuro-anatomy. With this book, we aim to bridge this gap.

In 1995 Jackson and Duncan produced MRI Neuroanatomy: a new angle on the brain using the best clinical MRI available at the time and did not demonstrate white matter tracts. This was very well received, and it is time now to produce an atlas that shows the 3D anatomy of gray and white matter to contemporary standards.

This atlas is based on a high-quality MRI of a healthy subject which resembles the type of imaging is regularly available to clinicians. It is structured in sections (cortical anatomy, subcortical anatomy, and network anatomy) that are intended to guide clinicians from the classical cortical paradigms into a network neuroscience perspective. The 2D orthogonal slices are organized in two orientations:

(A) following the plane of the anterior and posterior commissure, as has been traditionally used in stereotactic atlases

(B) following the plane of the hippocampus, as is commonly used in clinical epilepsy practice.

The first part shows the 3D anatomy of the cerebral hemisphere, deep nuclei, brainstem and cerebellum.

The second part shows the same brain cut in 2D orthogonal slices (axial, coronal, sagittal) with a raw T1-weighted image, accompanied by a labelled image showing the gross anatomy of the brain and grey matter structures and, also, the labelled white matter tracts in that slice. This is particularly relevant for neurosurgeons, who will be able to appreciate before planning a resection the relationship between each tract's trajectory and the gray matter. This will also benefit neurologists, enabling clarity as to how single lesions can cause multiple disconnection and impact on different functions and behaviours.

The third part demonstrates the 3D anatomy of the major white matter tracts in the brain, to indicate how distant lesions can impact the same function.

Detailed images of an individual brain showing detailed grey and white matter anatomy Demonstration of inter-relationships between grey matter and white matter tracts and cortical and nuclear terminations Atlas of brainstem nuclei and the relevant brainstem connections

Autorentext

John S Duncan MA DM FRCP FMedSci

John Duncan qualified from Oxford University Medical School and in Medicine in Sheffield and then in Neurology at the Radcliffe Infirmary, Oxford and the National Hospital for Neurology and Neurosurgery, Queen Square, London. Since 1989 he has been a Consultant Neurologist specialising in epilepsy at the National Hospital for Neurology and Neurosurgery and at The Chalfont Centre for Epilepsy. His personal research focus is neuroimaging applied to epilepsy surgery.

He was appointed Professor of Neurology at the UCL Institute of Neurology in 1998. From 2012 to 2018 he was Clinical Director of the National Hospital for Neurology and Neurosurgery. He is NIHR Senior Investigator and Governor of UCL Hospitals.

He is also Honorary Professor of Neurology, Fudan University, Shanghai, China and Visiting Professor, Faculty of Life Sciences & Medicine, Kings College London.

In 2004 he received the annual Clinical Research recognition award of the American Epilepsy Society. He is past-President and past treasurer of the UK chapter of ILAE. In 2005 he was elected Ambassador for Epilepsy and to be a Fellow of the Academy of Medical Sciences.

Davide Giampiccolo MD

Davide Giampiccolo is an Honorary Senior Neurosurgical Fellow in Complex Epilepsy at the National Hospital for Neurology and Neurosurgery in Queen Square and a Senior Research Fellow in the Department of Clinical and Experimental Epilepsy at the UCL Institute of Neurology. He qualified in Medicine and Surgery between the Charité - Universitätsmedizin Berlin, Germany and the University of Verona, Italy in 2015 and completed his training in Neurosurgery in Verona, Italy under Prof. Francesco Sala and Montpellier, France under Prof. Hugues Duffau in 2021. He previously studied white matter anatomy under Prof. Marco Catani at King's College London in 2016.

His work focused on bridging electrophysiology and white matter anatomy in resective surgery. He has been awarded prizes by the Organisation for Human Brain Mapping (2016), the International Society for Intraoperative Neurophysiology (2018), the European Association of Neurosurgical Societies (2020), and the American Epilepsy Society (2024). In 2019 he was the first non-North American to receive the Academy Award from the American Academy of Neurological Surgery. In 2024 he was awarded the Emerging Leaders fellowship by the Epilepsy Research Institute UK. He is a board member of the International Society for Intraoperative Neurophysiology and is PI in the Department of Clinical and Experimental Epilepsy at the UCL Institute of Neurology.

Inhalt

Introduction to three dimensional anatomy.- 3-dimensional anatomy of the cerebral hemisphere.- 3-dimensional anatomy of the deep nuclei.- 3-dimensional anatomy of the brainstem and cerebellum. 3-dimensional anatomy of brainstem and cerebellar nuclei.- Axial slices of cerebral hemisphere: AC-PC orientation.- Coronal slices of cerebral hemisphere: AC-PC orientation.- Sagittal slices of cerebral hemisphere.- Axial slices of cerebral hemisphere: Hippocampal orientation.- Coronal slices of cerebral hemisphere: Hippocampal orientation.- Axial slices of brainstem and cerebellum: AC-PC orientation.- Coronal slices of brainstem and cerebellum: AC-PC orientation.- Sagittal slices of brainstem and cerebellum.- Introduction to individual tracts in the brain.- Arcuate fasciculus.- Inferior fronto-occipital fasciculus.- Uncinate fasciculus.- Third branch of the superior longitudinal fasciculus.- Second branch of the superior longitudinal fasciculus.- First branch of the superior longitudinal fasciculus.- Posterior segment of the arcuate fasciculus.- Middle longitudinal fasciculus.- Inferior longitudinal fasciculus.- Temporal longitudinal fasciculus.