White matter anatomy of the human deep brain revisited with high resolution DTI fibre tracking

Background and Purpose: Deep white matter (WM) fascicles play a major, yet poorly understood, role in the overall connectivity of human brain. Better knowledge of their anatomy is requisite to understand the clinical correlates of their lesions and develop targeted treatments. We investigated whether MR-based diffusion tensor imaging (DTI) and fibre tracking could reveal in vivo, in explicit details, the 3D WM architecture within the subthalamic region and the internal capsule. Methods: High-resolution DTI images were acquired on six healthy volunteers on a three Tesla MR scanner. We studied using single-subject analysis WM fascicles within the subthalamic region and the internal capsule, as follows: DTI deterministic fibre tracking (FT) of fascicles; embedding fascicles in the volume-rendered brain coupled with a triplanar view; rigorous anatomic labelling of each fascicle according to classical knowledge as described by pioneer neuroanatomists. Deterministic FT effects were taken into account. Results: We charted most of WM fascicles of the deep brain, in particular large and complex fascicles such as the basal forebrain bundle and the ansa lenticularis. A topographic classification of subthalamic fascicles was proposed into three groups: the cerebellorubral, the reticulo-dorsal and the tegmento-peripheral one. Conclusions: Beyond to demonstrate the feasibility of imaging the deepest WM fascicles in vivo, our results pave the way for a better understanding of the brain connectivity and for developing targeted neuromodulation.