title: Toward an In Vivo Neuroimaging Template of Human Brainstem Nuclei of the Ascending Arousal, Autonomic, and Motor Systems.
abstract: Brainstem nuclei (Bn) in humans play a crucial role in vital functions, such as arousal, autonomic homeostasis, sensory and motor relay, nociception, sleep, and cranial nerve function, and they have been implicated in a vast array of brain pathologies. However, an in vivo delineation of most human Bn has been elusive because of limited sensitivity and contrast for detecting these small regions using standard neuroimaging methods. To precisely identify several human Bn in vivo, we employed a 7 Tesla scanner equipped with multi-channel receive-coil array, which provided high magnetic resonance imaging sensitivity, and a multi-contrast (diffusion fractional anisotropy and T2-weighted) echo-planar-imaging approach, which provided complementary contrasts for Bn anatomy with matched geometric distortions and resolution. Through a combined examination of 1.3 mm(3) multi-contrast anatomical images acquired in healthy human adults, we semi-automatically generated in vivo probabilistic Bn labels of the ascending arousal (median and dorsal raphe), autonomic (raphe magnus, periaqueductal gray), and motor (inferior olivary nuclei, two subregions of the substantia nigra compatible with pars compacta and pars reticulata, two subregions of the red nucleus, and, in the diencephalon, two subregions of the subthalamic nucleus) systems. These labels constitute a first step toward the development of an in vivo neuroimaging template of Bn in standard space to facilitate future clinical and research investigations of human brainstem function and pathology. Proof-of-concept clinical use of this template is demonstrated in a minimally conscious patient with traumatic brainstem hemorrhages precisely localized to the raphe Bn involved in arousal.
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Marta
authors.initials: M
authors.lastname: Bianciardi
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.|2 Medical Physics Section, Department of Biomedicine and Prevention, Faculty of Medicine, University of Rome "Tor Vergata ," Rome, Italy .
authors.forename: Nicola
authors.initials: N
authors.lastname: Toschi
authors.affiliation: 3 Department of Neurology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Edlow
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Cornelius
authors.initials: C
authors.lastname: Eichner
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Kawin
authors.initials: K
authors.lastname: Setsompop
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Polimeni
authors.affiliation: 4 Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital , Boston, Massachusetts.
authors.forename: Emery N
authors.initials: EN
authors.lastname: Brown
authors.affiliation: 5 Department of Pathology, Boston Children's Hospital , Harvard Medical School, Boston, Massachusetts.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Kinney
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Rosen
authors.affiliation: 1 Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging , Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, Massachusetts.
authors.forename: Lawrence L
authors.initials: LL
authors.lastname: Wald
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001341:Autonomic Nervous System / Q000033:anatomy & histology* / Q000502:physiology*; D001931:Brain Mapping; D001933:Brain Stem / Q000033:anatomy & histology* / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D059906:Neuroimaging / Q000379:methods*
keywords: 7 Tesla; ascending arousal system; autonomic system; high spatial resolution diffusion-weighted imaging; human brainstem nuclei; in vivo preliminary neuroimaging template; motor system; multi-contrast EPI