期刊
JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY
卷 71, 期 6, 页码 531-546出版社
OXFORD UNIV PRESS INC
DOI: 10.1097/NEN.0b013e3182588293
关键词
Arousal; Ascending reticular activating system (ARAS); Brainstem; Consciousness; High angular resolution diffusion imaging (HARDI); Neuroanatomy; Tractography
资金
- National Institutes of Health [R25 NS065743, R01 HD20991, R21 HD069001, P41 RR14075]
- Center for Integration of Medicine & Innovative Technology
- Neuropathology Division, Department of Pathology, Brigham and Women's Hospital, Boston, MA
- National Center for Research Resources [1S10RR016811-01]
The ascending reticular activating system (ARAS) mediates arousal, an essential component of human consciousness. Lesions of the ARAS cause coma, the most severe disorder of consciousness. Because of current methodological limitations, including of postmortem tissue analysis, the neuroanatomic connectivity of the human ARAS is poorly understood. We applied the advanced imaging technique of high angular resolution diffusion imaging (HARDI) to elucidate the structural connectivity of the ARAS in 3 adult human brains, 2 of which were imaged postmortem. High angular resolution diffusion imaging tractography identified the ARAS connectivity previously described in animals and also revealed novel human pathways connecting the brainstem to the thalamus, the hypothalamus, and the basal forebrain. Each pathway contained different distributions of fiber tracts from known neurotransmitter-specific ARAS nuclei in the brainstem. The histologically guided tractography findings reported here provide initial evidence for human-specific pathways of the ARAS. The unique composition of neurotransmitter-specific fiber tracts within each ARAS pathway suggests structural specializations that subserve the different functional characteristics of human arousal. This ARAS connectivity analysis provides proof of principle that HARDI tractography may affect the study of human consciousness and its disorders, including in neuropathologic studies of patients dying in coma and the persistent vegetative state.
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