Tractography of the amygdala and hippocampus: anatomical study and application to selective amygdalohippocampectomy.
OBJECTIVE
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.
Colnat-Coulbois
Sophie
S
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada. sophie.colnat@wanadoo.fr
Mok
Kelvin
K
Klein
Denise
D
Pénicaud
Sidonie
S
Tanriverdi
Taner
T
Olivier
André
A
D000328:Adult; D000679:Amygdala / Q000033:anatomy & histology* / Q000601:surgery; D056324:Diffusion Tensor Imaging; D004827:Epilepsy / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D055815:Young Adult