Central hub of fiber connection in the central front-back-abdominal fiber junction

The central front alcopic front alcopic fiber junction area (VPFIA) is an important white matter structure on the central front venteth side associated with language, movement, and advanced cognitive functionThe white fiber beams passed through in VPFIA include the bow-shaped beam (anterior segment of arcuate fasciculus, A-Arc), the bow-shaped beam (long segment of arcuate fasciculus, L-Arc) and the cone al-PathwayJuanMartinoof the University Hospital of Marqu?s de Valdecilla, Spain, and others studied the anatomical relationship between the central front-back-abdominal lateral fibrous junction and its surrounding structure by an autopsy combined with diffuse poop imaging (diffusion insor imaging, DTI) and electrostimulation in wake-up surgeryThe results were published in the September 2018 issue of the journal IneEronthe studythe study included eight side body brain hemispheric specimens for autopsy, dTI studies in the brain hemispheres of eight healthy subjects, and six patients with left-hand hemispheric gliomas, who were performed with wake-up surgery to remove gliomas, and the functional area was determined by cortical and subcortical electrical stimulationthe results of the studythe results show that the VPFIA fiber bundle is arranged back and forth: the cone body's abdominal side starts from the central front back to the front, the bow-shaped beam starts in the middle, and the bow-shaped beam starts at the rear (Figures 1-6)Figure 1The left-hand VPFIA white fiber beam is dissected, and the bow-beam beam is pulled up to show the deep bow-shaped bundle long beamVPFIA fiber bundles are arranged back and forthThe bow-shaped beam front starts at the rear of the central front ventral sideThe bow-shaped bundle is long and the head is headed to the top leaf at the deep part of the front bundle, i.eit walks to the front of the centerA-Arc: Bow-beam forearm; L-Arc: Bow beam long beam; SF: side split Figure 2. A Anatomy of VPFIA white fiber bundles in the left hemisphere of the brain The central front ventral side has been cut open to show the starting point of each fiber bundle: the bow-shaped beam front beam starts at the back of the VPFIA; B Another case of a left-hand hemispheric specimen of the brain, similar to Figure A CS: Central Groove; A-Arc: Bow Beam Forearm; L-Arc: Bow Beam Long Beam; P: Cone Beam Figure 3. A Side cracks in the left brain hemisphere, central front and central back B Left-hand VIFIA white fiber bundle A, B figure can be seen in the three fibers starting in the central front leather under the white area, arranged from front to back: the front is the cone beam (red), the middle is the bow beam long beam (blue), and finally the bow-shaped beam (orange) C.VPFIA white fiber beam diagram CS: Central Groove; A-Arc: Bow-beam forearm; L-Arc: Bow Beam; P: Cone Beam; PreCG: Central Forward; PostCG: Central Backback; SF: Side Split; UF: Near-Brain Back U Fiber Figure 4 A, B Diffuse exfoliation imaging 3D reconstruction VPFIA white fiber beam C, D Bow beam foreboding, bow beam long beam, cone beam dispersion mass imaging 3D reconstruction and MRI-T1 image fusion: VPFIA rear is a bow-beam forearm, the middle is a bow-shaped beam long beam, the front is a cone beam CS: Central Groove; A-Arc: Bow Beam Forehand; L-Arc: Bow Beam Long Beam; P: Cone Beam; PreCG: Center Forward; SF: Side Split Figure 5 VPFIA white fiber beam dispersion volume imaging 3D reconstruction The cone beam is located in the bow before the beam P: Cone beam; Arc: Bow beam Figure 6 VPFIA white fiber beam diagram D1: Minimum distance from the front-side split point to the back-of-the-back boundary of the bow-beam, D2: Minimum distance from the front-side split point to the bow-beam long beam backbound boundary, D3: minimum front-side split point to minimum hand-knot distance, D4: minimum distance from the bow-beam long beam lowerbound to bow-beam long beam back-back boundary CS: Central Groove; A-Arc: Bow Beam Forearm; L-Arc: Bow Beam Long Beam; P: Cone Beam VPFIA corresponding region softened speech dysfunction after electrostimulation (Figures 7 to 9) Figure 7 VpFIA in A-F.6 patients with sober open cranial VPFIA is sketched by a dotted line Stimulation of VPFIA leads to speech dysfunction 1 43-year-old male patient, right hand, left frontal loba glioblastoma; A Preoperative MRI-FLAIR phase with VPFIA and forehead beam white fiber DTI imaging 3D reconstruction fusion image The tumor is located in front of VPFIA, adjacent to the bow-shaped foreander and long beam B Postoperative MRI-FLAIR phase fusion image with fiber bundle Residual tumors are about 4.2mL C Midoperative cortical electrical stimulation found that the post-tumor cortex region developed language dysfunction after electrical stimulation, which corresponded to the VFPIA shown in the navigation The language area is represented by different flags After the cortical electrical stimulation, the Spanish flag 1, 2, 4, 5 areas of speech can not, the Spanish flag 3 area of the sound difficulties, the Spanish flag 6 area naming obstacles; D Post-stimulus area of tumor removal The Spanish flag 8 area semantic language confusion Pathology is diagnosed as glioblastoma Figure 9 1 41-year-old female patient with left frontal astrocyte glioma (WHOII); Preoperative examination did not reveal neurological dysfunction A Preoperative MRI-FLAIR phase fusion image with fiber bundle The tumor is located at the back of the forehead and lower part of the forehead, the upper upper part of VPFIA, adjacent to the bow-shaped foreander and long beam B Postoperative fusion image, tumor completely removed C Speech dysfunction after electrical stimulation of the cortical region of the posterior tumor during surgery, corresponding to the VPFIA shown in the navigation The Spanish flag 1 area cannot speak Red Mark 1 area thumb movement disorder D The ribbon is determined after the tumor is removed The final pathology is diffuse low-grade star-shaped glioma the conclusion
the authors point out that the central front-to-abdominal lateral fiber junction (VPFIA) is located between the language back-side pathway and the muscles that control pronunciation, such as the kinetic cortex of the tongue, lip and throat, and is an important language hub in the network around the side cracking network The study of fiber beam structure in this area has great value in understanding the principle of language production and the formulation of surgical strategy in this area, and can explain the phenomenon that cortical excision in Broca area does not affect language function to some extent.