title: The Structural Connectome of the Human Central Homeostatic Network.
abstract: Homeostatic adaptations to stress are regulated by interactions between the brainstem and regions of the forebrain, including limbic sites related to respiratory, autonomic, affective, and cognitive processing. Neuroanatomic connections between these homeostatic regions, however, have not been thoroughly identified in the human brain. In this study, we perform diffusion spectrum imaging tractography using the MGH-USC Connectome MRI scanner to visualize structural connections in the human brain linking autonomic and cardiorespiratory nuclei in the midbrain, pons, and medulla oblongata with forebrain sites critical to homeostatic control. Probabilistic tractography analyses in six healthy adults revealed connections between six brainstem nuclei and seven forebrain regions, several over long distances between the caudal medulla and cerebral cortex. The strongest evidence for brainstem-homeostatic forebrain connectivity in this study was between the brainstem midline raphe and the medial temporal lobe. The subiculum and amygdala were the sampled forebrain nodes with the most extensive brainstem connections. Within the human brainstem-homeostatic forebrain connectome, we observed that a lateral forebrain bundle, whose connectivity is distinct from that of rodents and nonhuman primates, is the primary conduit for connections between the brainstem and medial temporal lobe. This study supports the concept that interconnected brainstem and forebrain nodes form an integrated central homeostatic network (CHN) in the human brain. Our findings provide an initial foundation for elucidating the neuroanatomic basis of homeostasis in the normal human brain, as well as for mapping CHN disconnections in patients with disorders of homeostasis, including sudden and unexpected death, and epilepsy.
authors.affiliation: 1 Department of Neurology, Massachusetts General Hospital , Harvard Medical School, Boston, Massachusetts.|2 Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Charlestown, Massachusetts.
authors.forename: Brian L
authors.initials: BL
authors.lastname: Edlow
authors.affiliation: 2 Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Charlestown, Massachusetts.|3 Department of Radiology, R.M. Lucas Center for Imaging, Stanford University , Stanford, California.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: McNab
authors.affiliation: 2 Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital , Charlestown, Massachusetts.
authors.forename: Thomas
authors.initials: T
authors.lastname: Witzel
authors.affiliation: 4 Department of Pathology, Boston Children's Hospital and Harvard Medical School , Boston, Massachusetts.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Kinney
mesh_terms: D000328:Adult; D000679:Amygdala / Q000033:anatomy & histology / Q000502:physiology; D001921:Brain / Q000033:anatomy & histology / Q000502:physiology; D001933:Brain Stem / Q000033:anatomy & histology / Q000502:physiology; D063132:Connectome / Q000379:methods*; D056324:Diffusion Tensor Imaging / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000473:pathology; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008032:Limbic System / Q000033:anatomy & histology / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008474:Medial Forebrain Bundle / Q000033:anatomy & histology / Q000502:physiology*; D009434:Neural Pathways; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000502:physiology
keywords: brainstem; diffusion MRI; limbic system; medial forebrain bundle; sudden unexplained death in epilepsy (SUDEP); tractography