Mapping Connectivity Damage in the Case of Phineas Gage

White matter (WM) mapping of the human brain using neuroimaging techniques has gained considerable interest in the neuroscience community. Using diffusion weighted (DWI) and magnetic resonance imaging (MRI), WM fiber pathways between brain regions may be systematically assessed to make inferences concerning their role in normal brain function, influence on behavior, as well as concerning the consequences of network-level brain damage. In this paper, we investigate the detailed connectomics in a noted example of severe traumatic brain injury (TBI) which has proved important to and controversial in the history of neuroscience. We model the WM damage in the notable case of Phineas P. Gage, in whom a “tamping iron” was accidentally shot through his skull and brain, resulting in profound behavioral changes. The specific effects of this injury on Mr. Gage's WM connectivity have not previously been considered in detail. Using computed tomography (CT) image data of the Gage skull in conjunction with modern anatomical MRI and diffusion imaging data obtained in contemporary right handed male subjects (aged 25–36), we computationally simulate the passage of the iron through the skull on the basis of reported and observed skull fiducial landmarks and assess the extent of cortical gray matter (GM) and WM damage. Specifically, we find that while considerable damage was, indeed, localized to the left frontal cortex, the impact on measures of network connectedness between directly affected and other brain areas was profound, widespread, and a probable contributor to both the reported acute as well as long-term behavioral changes. Yet, while significantly affecting several likely network hubs, damage to Mr. Gage's WM network may not have been more severe than expected from that of a similarly sized “average” brain lesion. These results provide new insight into the remarkable brain injury experienced by this noteworthy patient

Building connectomes using diffusion MRI: why, how and but

Why has diffusion MRI become a principal modality for mapping connectomes in vivo? How do different image acquisition parameters, fiber tracking algorithms and other methodological choices affect connectome estimation? What are the main factors that dictate the success and failure of connectome reconstruction? These are some of the key questions that we aim to address in this review. We provide an overview of the key methods that can be used to estimate the nodes and edges of macroscale connectomes, and we discuss open problems and inherent limitations. We argue that diffusion MRI-based connectome mapping methods are still in their infancy and caution against blind application of deep white matter tractography due to the challenges inherent to connectome reconstruction. We review a number of studies that provide evidence of useful microstructural and network properties that can be extracted in various independent and biologically-relevant contexts. Finally, we highlight some of the key deficiencies of current macroscale connectome mapping methodologies and motivate future developments

Intrahemispheric cortico-cortical connections of the human auditory cortex.

The human auditory cortex comprises the supratemporal plane and large parts of the temporal and parietal convexities. We have investigated the relevant intrahemispheric cortico-cortical connections using in vivo DSI tractography combined with landmark-based registration, automatic cortical parcellation and whole-brain structural connection matrices in 20 right-handed male subjects. On the supratemporal plane, the pattern of connectivity was related to the architectonically defined early-stage auditory areas. It revealed a three-tier architecture characterized by a cascade of connections from the primary auditory cortex to six adjacent non-primary areas and from there to the superior temporal gyrus. Graph theory-driven analysis confirmed the cascade-like connectivity pattern and demonstrated a strong degree of segregation and hierarchy within early-stage auditory areas. Putative higher-order areas on the temporal and parietal convexities had more widely spread local connectivity and long-range connections with the prefrontal cortex; analysis of optimal community structure revealed five distinct modules in each hemisphere. The pattern of temporo-parieto-frontal connectivity was partially asymmetrical. In conclusion, the human early-stage auditory cortical connectivity, as revealed by in vivo DSI tractography, has strong similarities with that of non-human primates. The modular architecture and hemispheric asymmetry in higher-order regions is compatible with segregated processing streams and lateralization of cognitive functions

Improving the Tractography Pipeline: on Evaluation, Segmentation, and Visualization

Recent advances in tractography allow for connectomes to be constructed in vivo. These have applications for example in brain tumor surgery and understanding of brain development and diseases. The large size of the data produced by these methods lead to a variety problems, including how to evaluate tractography outputs, development of faster processing algorithms for tractography and clustering, and the development of advanced visualization methods for verification and exploration. This thesis presents several advances in these fields. First, an evaluation is presented for the robustness to noise of multiple commonly used tractography algorithms. It employs a Monte–Carlo simulation of measurement noise on a constructed ground truth dataset. As a result of this evaluation, evidence for obustness of global tractography is found, and algorithmic sources of uncertainty are identified. The second contribution is a fast clustering algorithm for tractography data based on k–means and vector fields for representing the flow of each cluster. It is demonstrated that this algorithm can handle large tractography datasets due to its linear time and memory complexity, and that it can effectively integrate interrupted fibers that would be rejected as outliers by other algorithms. Furthermore, a visualization for the exploration of structural connectomes is presented. It uses illustrative rendering techniques for efficient presentation of connecting fiber bundles in context in anatomical space. Visual hints are employed to improve the perception of spatial relations. Finally, a visualization method with application to exploration and verification of probabilistic tractography is presented, which improves on the previously presented Fiber Stippling technique. It is demonstrated that the method is able to show multiple overlapping tracts in context, and correctly present crossing fiber configurations

Tractographie adaptative basée sur la microstructure pour des analyses précises de la connectivité cérébrale

Le cerveau est un sujet de recherche depuis plusieurs décennies, puisque son rôle est central dans la compréhension du genre humain. Le cerveau est composé de neurones, où leurs dendrites et synapses se retrouvent dans la matière grise alors que les axones en constituent la matière blanche. L’information traitée dans les différentes régions de la matière grise est ensuite transmise par l’intermédiaire des axones afin d’accomplir différentes fonctions cognitives. La matière blanche forme une structure d’interconnections complexe encore dif- ficile à comprendre et à étudier. La relation entre l’architecture et la fonction du cerveau a été étudiée chez les humains ainsi que pour d’autres espèces, croyant que l’architecture des axones déterminait la dynamique du réseau fonctionnel. Dans ce même objectif, l’Imagerie par résonance (IRM) est un outil formidable qui nous permet de visualiser les tissus cérébraux de façon non-invasive. Plus partic- ulièrement, l’IRM de diffusion permet d’estimer et de séparer la diffusion libre de celle restreinte par la structure des tissus. Cette mesure de restriction peut être utilisée afin d’inférer l’orientation locale des faisceaux de matière blanche. L’algorithme de tractographie exploite cette carte d’orientation pour reconstruire plusieurs connexions de la matière blanche (nommées “streamlines”). Cette modélisation de la matière blanche permet d’estimer la connectivité cérébrale dite structurelle entre les différentes régions du cerveau. Ces résultats peuvent être employés directement pour la planification chirurgicale ou indirectement pour l’analyse ou une évaluation clinique. Malgré plusieurs de ses limitations, telles que sa variabilité et son imprécision, la tractographie reste l’unique moyen d’étudier l’architecture de la matière blanche ainsi que la connectivité cérébrale de façon non invasive. L’objectif de ce projet de doctorat est de répondre spécifiquement à ces limitations et d’améliorer la précision anatomique des estimations de connectivité structurelle. Dans ce but, nous avons développé un algorithme d’optimisation globale qui exploite les informations de micro et macrostructure, en introduisant une procédure itéra- tive qui utilise les propriétés sous-jacentes des tissus pour piloter la reconstruction en utilisant une approche semi-globale. Ensuite, nous avons étudié la possibilité d’adapter dynamiquement la position d’un ensemble de lignes de courant candidates tout en intégrant le préalable anatomique de la douceur des trajectoires et en adap- tant la configuration en fonction des données observées. Enfin, nous avons introduit le concept de bundle-o-graphy en mettant en œuvre une méthode pour modéliser des groupes de lignes de courant basées sur le concept que les axones sont organisés en fascicules, en adaptant leur forme et leur étendue en fonction de la microstructure sous-jacente.Abstract : Human brain has been subject of deep interest for centuries, given it’s central role in controlling and directing the actions and functions of the body as response to external stimuli. The neural tissue is primarily constituted of neurons and, together with dendrites and the nerve synapses, constitute the gray matter (GM) which plays a major role in cognitive functions. The information processed in the GM travel from one region to the other of the brain along nerve cell projections, called axons. All together they constitute the white matter (WM) whose wiring organization still remains challenging to uncover. The relationship between structure organization of the brain and function has been deeply investigated on humans and animals based on the assumption that the anatomic architecture determine the network dynamics. In response to that, many different imaging techniques raised, among which diffusion-weighted magnetic resonance imaging (DW-MRI) has triggered tremendous hopes and expectations. Diffusion-weighted imaging measures both restricted and unrestricted diffusion, i.e. the degree of movement freedom of the water molecules, allowing to map the tissue fiber architecture in vivo and non-invasively. Based on DW-MRI data, tractography is able to exploit information of the local fiber orien- tation to recover global fiber pathways, called streamlines, that represent groups of axons. This, in turn, allows to infer the WM structural connectivity, becoming widely used in many different clinical applications as for diagnoses, virtual dissections and surgical planning. However, despite this unique and compelling ability, data acqui- sition still suffers from technical limitations and recent studies have highlighted the poor anatomical accuracy of the reconstructions obtained with this technique and challenged its effectiveness for studying brain connectivity. The focus of this Ph.D. project is to specifically address these limitations and to improve the anatomical accuracy of the structural connectivity estimates. To this aim, we developed a global optimization algorithm that exploits micro and macro- structure information, introducing an iterative procedure that uses the underlying tissue properties to drive the reconstruction using a semi-global approach. Then, we investigated the possibility to dynamically adapt the position of a set of candidate streamlines while embedding the anatomical prior of trajectories smoothness and adapting the configuration based on the observed data. Finally, we introduced the concept of bundle-o-graphy by implementing a method to model groups of streamlines based on the concept that axons are organized into fascicles, adapting their shape and extent based on the underlying microstructure.Sommario : Il cervello umano è oggetto di profondo interesse da secoli, dato il suo ruolo centrale nel controllare e dirigere le azioni e le funzioni del corpo in risposta a stimoli esterno. Il tessuto neurale è costituito principalmente da neuroni che, insieme ai dendriti e alle sinapsi nervose, costituiscono la materia grigia (GM), la quale riveste un ruolo centrale nelle funzioni cognitive. Le informazioni processate nella GM viaggiano da una regione all’altra del cervello lungo estensioni delle cellule nervose, chiamate assoni. Tutti insieme costituiscono la materia bianca (WM) la cui organizzazione strutturale rimane tuttora sconosciuta. Il legame tra struttura e funzione del cervello sono stati studiati a fondo su esseri umani e animali partendo dal presupposto che l’architettura anatomica determini la dinamica della rete funzionale. In risposta a ciò, sono emerse diverse tecniche di imaging, tra cui la risonanza magnetica pesata per diffusione (DW-MRI) ha suscitato enormi speranze e aspettative. Questa tecnica misura la diffusione sia libera che ristretta, ovvero il grado di libertà di movimento delle molecole d’acqua, consentendo di mappare l’architettura delle fibre neuronali in vivo e in maniera non invasiva. Basata su dati DW-MRI, la trattografia è in grado di sfruttare le informazioni sull’orientamento locale delle fibre per ricostruirne i percorsi a livello globale. Questo, a sua volta, consente di estrarre la connettività strutturale della WM, utilizzata in diverse applicazioni cliniche come per diagnosi, dissezioni virtuali e pianificazione chirurgica. Tuttavia, nonostante questa capacità unica e promettente, l’acquisizione dei dati soffre ancora di limitazioni tecniche e recenti studi hanno messo in evidenza la scarsa accuratezza anatomica delle ricostruzioni ottenute con questa tecnica, mettendone in dubbio l’efficacia per lo studio della connettività cerebrale. Il focus di questo progetto di dottorato è quello di affrontare in modo specifico queste limitazioni e di migliorare l’accuratezza anatomica delle stime di connettività strutturale. A tal fine, abbiamo sviluppato un algoritmo di ottimizzazione globale che sfrutta le informazioni sia micro che macrostrutturali, introducendo una procedura iterativa che utilizza le proprietà del tessuto neuronale per guidare la ricostruzione utilizzando un approccio semi-globale. Successivamente, abbiamo studiato la possibilità di adattare dinamicamente la posizione di un insieme di streamline candidate incorporando il prior anatomico per cui devono seguire traiettorie regolari e adattando la configurazione in base ai dati osservati. Infine, abbiamo introdotto il concetto di bundle-o-graphy implementando un metodo per modellare gruppi di streamline basato sul concetto che gli assoni sono organizzati in fasci, adattando la loro forma ed estensione in base alla microstruttura sottostante

Superficial White Matter Analysis: An Efficient Point-cloud-based Deep Learning Framework with Supervised Contrastive Learning for Consistent Tractography Parcellation across Populations and dMRI Acquisitions

Diffusion MRI tractography is an advanced imaging technique that enables in vivo mapping of the brain's white matter connections. White matter parcellation classifies tractography streamlines into clusters or anatomically meaningful tracts. It enables quantification and visualization of whole-brain tractography. Currently, most parcellation methods focus on the deep white matter (DWM), whereas fewer methods address the superficial white matter (SWM) due to its complexity. We propose a novel two-stage deep-learning-based framework, Superficial White Matter Analysis (SupWMA), that performs an efficient and consistent parcellation of 198 SWM clusters from whole-brain tractography. A point-cloud-based network is adapted to our SWM parcellation task, and supervised contrastive learning enables more discriminative representations between plausible streamlines and outliers for SWM. We train our model on a large-scale tractography dataset including streamline samples from labeled SWM clusters and anatomically implausible streamline samples, and we perform testing on six independently acquired datasets of different ages and health conditions (including neonates and patients with space-occupying brain tumors). Compared to several state-of-the-art methods, SupWMA obtains highly consistent and accurate SWM parcellation results on all datasets, showing good generalization across the lifespan in health and disease. In addition, the computational speed of SupWMA is much faster than other methods.Comment: 12 pages, 7 figures. Extension of our ISBI 2022 paper (arXiv:2201.12528) (Best Paper Award Finalist