Magnetic Resonance anatomy of the pedunculopontine nucleus in normal subjects.
DOI:
https://doi.org/10.47924/neurotarget2016188Keywords:
Pedunculopontine, Anatomy, MRN, Mesensephalic locomotor region, Pontomesencephalic reticular formationAbstract
Introduction: The pedunculopontine nucleus (PPN) is a target for functional neurosurgery in parkinsonian patients with severe gait disorders. It is related to the superior cerebellar peduncle (SCP), the central tegmental tract (CTT) and the lemniscal system (LS). Previous works had studied the PPN nucleus in small groups of parkinsonian patients, employing special MRI protocols. Being the NPP an island of gray matter surrounded by white matter bundles, it should be visible with conventional MRI.
Objective: To identify the NPP in MRI studies in normal subjects.
Methods: We analyzed retrospectively 100 normal brain MRI. We chose axial slices in T2, parallel to the bicommissural line of midbrain and pons, from the superior colliculi to the middle cerebellar peduncle.
Results: The NPP was identified in 81 % of subjects. The bundles of white matter surrounding the NPP are hyperintense on axial T2. The mesencephalic PPN was observed as an intermediate signal region bounded by the SL anterolaterally, anteromedially by the decussation of the SCP and posteromedially by the TTC and the periaqueductal gray matter. At the pontine level, LS and SCP were seen as two hyperintense bands, between them the NPP showed an iso- hypointense signal.
Conclusions: The NPP can be identified directly on axial MRI, taking into account the white matter bundles that surround it both in midbrain and in pons. Direct anatomical visualization allows greater precision than that obtained only through atlas coordinates, considering also individual anatomic characteristics of each patient.
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Copyright (c) 2016 Mariana Bendersky
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