Stephanie Forkel

Publications

Displaying 1 - 15 of 15
  • Nozais, V., Forkel, S. J., Petit, L., Talozzi, L., Corbetta, M., Thiebaut de Schotten, M., & Joliot, M. (2023). Atlasing white matter and grey matter joint contributions to resting-state networks in the human brain. Communications Biology, 6: 726. doi:10.1038/s42003-023-05107-3.

    Abstract

    Over the past two decades, the study of resting-state functional magnetic resonance imaging has revealed that functional connectivity within and between networks is linked to cognitive states and pathologies. However, the white matter connections supporting this connectivity remain only partially described. We developed a method to jointly map the white and grey matter contributing to each resting-state network (RSN). Using the Human Connectome Project, we generated an atlas of 30 RSNs. The method also highlighted the overlap between networks, which revealed that most of the brain’s white matter (89%) is shared between multiple RSNs, with 16% shared by at least 7 RSNs. These overlaps, especially the existence of regions shared by numerous networks, suggest that white matter lesions in these areas might strongly impact the communication within networks. We provide an atlas and an open-source software to explore the joint contribution of white and grey matter to RSNs and facilitate the study of the impact of white matter damage to these networks. In a first application of the software with clinical data, we were able to link stroke patients and impacted RSNs, showing that their symptoms aligned well with the estimated functions of the networks.
  • Parlatini, V., Itahashi, T., Lee, Y., Liu, S., Nguyen, T. T., Aoki, Y. Y., Forkel, S. J., Catani, M., Rubia, K., Zhou, J. H., Murphy, D. G., & Cortese, S. (2023). White matter alterations in Attention-Deficit/Hyperactivity Disorder (ADHD): a systematic review of 129 diffusion imaging studies with meta-analysis. Molecular Psychiatry, 28, 4098-4123. doi:10.1038/s41380-023-02173-1.

    Abstract

    Aberrant anatomical brain connections in attention-deficit/hyperactivity disorder (ADHD) are reported inconsistently across
    diffusion weighted imaging (DWI) studies. Based on a pre-registered protocol (Prospero: CRD42021259192), we searched PubMed,
    Ovid, and Web of Knowledge until 26/03/2022 to conduct a systematic review of DWI studies. We performed a quality assessment
    based on imaging acquisition, preprocessing, and analysis. Using signed differential mapping, we meta-analyzed a subset of the
    retrieved studies amenable to quantitative evidence synthesis, i.e., tract-based spatial statistics (TBSS) studies, in individuals of any
    age and, separately, in children, adults, and high-quality datasets. Finally, we conducted meta-regressions to test the effect of age,
    sex, and medication-naïvety. We included 129 studies (6739 ADHD participants and 6476 controls), of which 25 TBSS studies
    provided peak coordinates for case-control differences in fractional anisotropy (FA)(32 datasets) and 18 in mean diffusivity (MD)(23
    datasets). The systematic review highlighted white matter alterations (especially reduced FA) in projection, commissural and
    association pathways of individuals with ADHD, which were associated with symptom severity and cognitive deficits. The meta-
    analysis showed a consistent reduced FA in the splenium and body of the corpus callosum, extending to the cingulum. Lower FA
    was related to older age, and case-control differences did not survive in the pediatric meta-analysis. About 68% of studies were of
    low quality, mainly due to acquisitions with non-isotropic voxels or lack of motion correction; and the sensitivity analysis in high-
    quality datasets yielded no significant results. Findings suggest prominent alterations in posterior interhemispheric connections
    subserving cognitive and motor functions affected in ADHD, although these might be influenced by non-optimal acquisition
    parameters/preprocessing. Absence of findings in children may be related to the late development of callosal fibers, which may
    enhance case-control differences in adulthood. Clinicodemographic and methodological differences were major barriers to
    consistency and comparability among studies, and should be addressed in future investigations.
  • Barrett, R. L. C., Dawson, M., Dyrby, T. B., Krug, K., Ptito, M., D'Arceuil, H., Croxson, P. L., Johnson, P. J., Howells, H., Forkel, S. J., Dell'Acqua, F., & Catani, M. (2020). Differences in Frontal Network Anatomy Across Primate Species. The Journal of Neuroscience, 40(10), 2094-2107. doi:10.1523/JNEUROSCI.1650-18.2019.

    Abstract

    The frontal lobe is central to distinctive aspects of human cognition and behavior. Some comparative studies link this to a larger frontal cortex and even larger frontal white matter in humans compared with other primates, yet others dispute these findings. The discrepancies between studies could be explained by limitations of the methods used to quantify volume differences across species, especially when applied to white matter connections. In this study, we used a novel tractography approach to demonstrate that frontal lobe networks, extending within and beyond the frontal lobes, occupy 66% of total brain white matter in humans and 48% in three monkey species: vervets (Chlorocebus aethiops), rhesus macaque (Macaca mulatta) and cynomolgus macaque (Macaca fascicularis), all male. The simian–human differences in proportional frontal tract volume were significant for projection, commissural, and both intralobar and interlobar association tracts. Among the long association tracts, the greatest difference was found for tracts involved in motor planning, auditory memory, top-down control of sensory information, and visuospatial attention, with no significant differences in frontal limbic tracts important for emotional processing and social behaviour. In addition, we found that a nonfrontal tract, the anterior commissure, had a smaller volume fraction in humans, suggesting that the disproportionally large volume of human frontal lobe connections is accompanied by a reduction in the proportion of some nonfrontal connections. These findings support a hypothesis of an overall rearrangement of brain connections during human evolution.
  • Forkel, S. J., Rogalski, E., Drossinos Sancho, N., D'Anna, L., Luque Laguna, P., Sridhar, J., Dell'Acqua, F., Weintraub, S., Thompson, C., Mesulam, M.-M., & Catani, M. (2020). Anatomical evidence of an indirect pathway for word repetition. Neurology, 94, e594-e606. doi:10.1212/WNL.0000000000008746.

    Abstract



    Objective: To combine MRI-based cortical morphometry and diffusion white matter tractography to describe the anatomical correlates of repetition deficits in patients with primary progressive aphasia (PPA).

    Methods: The traditional anatomical model of language identifies a network for word repetition that includes Wernicke and Broca regions directly connected via the arcuate fasciculus. Recent tractography findings of an indirect pathway between Wernicke and Broca regions suggest a critical role of the inferior parietal lobe for repetition. To test whether repetition deficits are associated with damage to the direct or indirect pathway between both regions, tractography analysis was performed in 30 patients with PPA (64.27 ± 8.51 years) and 22 healthy controls. Cortical volume measurements were also extracted from 8 perisylvian language areas connected by the direct and indirect pathways.

    Results: Compared to healthy controls, patients with PPA presented with reduced performance in repetition tasks and increased damage to most of the perisylvian cortical regions and their connections through the indirect pathway. Repetition deficits were prominent in patients with cortical atrophy of the temporo-parietal region with volumetric reductions of the indirect pathway.

    Conclusions: The results suggest that in PPA, deficits in repetition are due to damage to the temporo-parietal cortex and its connections to Wernicke and Broca regions. We therefore propose a revised language model that also includes an indirect pathway for repetition, which has important clinical implications for the functional mapping and treatment of neurologic patients.
  • Forkel, S. J., & Thiebaut de Schotten, M. (2020). Towards metabolic disconnection – symptom mapping. Brain, 143(3), 718-721. doi:10.1093/brain/awaa060.

    Abstract

    This scientific commentary refers to ‘Metabolic lesion-deficit mapping of human cognition’ by Jha etal.
  • Friedrich, P., Forkel, S. J., & Thiebaut de Schotten, M. (2020). Mapping the principal gradient onto the corpus callosum. NeuroImage, 223: 117317. doi:10.1016/j.neuroimage.2020.117317.

    Abstract

    Gradients capture some of the variance of the resting-state functional magnetic resonance imaging (rsfMRI) signal. Amongst these, the principal gradient depicts a functional processing hierarchy that spans from sensory-motor cortices to regions of the default-mode network. While the cortex has been well characterised in terms of gradients little is known about its underlying white matter. For instance, comprehensive mapping of the principal gradient on the largest white matter tract, the corpus callosum, is still missing. Here, we mapped the principal gradient onto the midsection of the corpus callosum using the 7T human connectome project dataset. We further explored how quantitative measures and variability in callosal midsection connectivity relate to the principal gradient values. In so doing, we demonstrated that the extreme values of the principal gradient are located within the callosal genu and the posterior body, have lower connectivity variability but a larger spatial extent along the midsection of the corpus callosum than mid-range values. Our results shed light on the relationship between the brain's functional hierarchy and the corpus callosum. We further speculate about how these results may bridge the gap between functional hierarchy, brain asymmetries, and evolution.

    Additional information

    supplementary file
  • Friedrich, P., Thiebaut de Schotten, M., Forkel, S. J., Stacho, M., & Howells, H. (2020). An ancestral anatomical and spatial bias for visually guided behavior. Proceedings of the National Academy of Sciences of the United States of America, 117(5), 2251-2252. doi:10.1073/pnas.1918402117.

    Abstract

    Human behavioral asymmetries are commonly studied in the context of structural cortical and connectional asymmetries. Within this framework, Sreenivasan and Sridharan (1) provide intriguing evidence of a relationship between visual asymmetries and the lateralization of superior colliculi connections—a phylogenetically older mesencephalic structure. Specifically, response facilitation for cued locations (i.e., choice bias) in the contralateral hemifield was associated with differences in the connectivity of the superior colliculus. Given that the superior colliculus has a structural homolog—the optic tectum—which can be traced across all Vertebrata, these results may have meaningful evolutionary ramifications.
  • Howells, H., Puglisi, G., Leonetti, A., Vigano, L., Fornia, L., Simone, L., Forkel, S. J., Rossi, M., Riva, M., Cerri, G., & Bello, L. (2020). The role of left fronto-parietal tracts in hand selection: Evidence from neurosurgery. Cortex, 128, 297-311. doi:10.1016/j.cortex.2020.03.018.

    Abstract

    Strong right-hand preference on the population level is a uniquely human feature, although its neural basis is still not clearly defined. Recent behavioural and neuroimaging literature suggests that hand preference may be related to the orchestrated function and size of fronto-parietal white matter tracts bilaterally. Lesions to these tracts induced during tumour resection may provide an opportunity to test this hypothesis. In the present study, a cohort of seventeen neurosurgical patients with left hemisphere brain tumours were recruited to investigate whether resection of certain white matter tracts affects the choice of hand selected for the execution of a goal-directed task (assembly of jigsaw puzzles). Patients performed the puzzles, but also tests for basic motor ability, selective attention and visuo-constructional ability, preoperatively and one month after surgery. An atlas-based disconnectome analysis was conducted to evaluate whether resection of tracts was significantly associated with changes in hand selection. Diffusion tractography was also used to dissect fronto-parietal tracts (the superior longitudinal fasciculus) and the corticospinal tract. Results showed a shift in hand selection despite the absence of any motor or cognitive deficits, which was significantly associated with frontal and parietal resections rather than other lobes. In particular, the shift in hand selection was significantly associated with the resection of dorsal rather than ventral fronto-parietal white matter connections. Dorsal white matter pathways contribute bilaterally to control of goal-directed hand movements. We show that unilateral lesions, that may unbalance the cooperation of the two hemispheres, can alter the choice of hand selected to accomplish movements.
  • Milham, M., Petkov, C. I., Margulies, D. S., Schroeder, C. E., Basso, M. A., Belin, P., Fair, D. A., Fox, A., Kastner, S., Mars, R. B., Messinger, A., Poirier, C., Vanduffel, W., Van Essen, D. C., Alvand, A., Becker, Y., Ben Hamed, S., Benn, A., Bodin, C., Boretius, S. Milham, M., Petkov, C. I., Margulies, D. S., Schroeder, C. E., Basso, M. A., Belin, P., Fair, D. A., Fox, A., Kastner, S., Mars, R. B., Messinger, A., Poirier, C., Vanduffel, W., Van Essen, D. C., Alvand, A., Becker, Y., Ben Hamed, S., Benn, A., Bodin, C., Boretius, S., Cagna, B., Coulon, O., El-Gohary, S. H., Evrard, H., Forkel, S. J., Friedrich, P., Froudist-Walsh, S., Garza-Villarreal, E. A., Gao, Y., Gozzi, A., Grigis, A., Hartig, R., Hayashi, T., Heuer, K., Howells, H., Ardesch, D. J., Jarraya, B., Jarrett, W., Jedema, H. P., Kagan, I., Kelly, C., Kennedy, H., Klink, P. C., Kwok, S. C., Leech, R., Liu, X., Madan, C., Madushanka, W., Majka, P., Mallon, A.-M., Marche, K., Meguerditchian, A., Menon, R. S., Merchant, H., Mitchell, A., Nenning, K.-H., Nikolaidis, A., Ortiz-Rios, M., Pagani, M., Pareek, V., Prescott, M., Procyk, E., Rajimehr, R., Rautu, I.-S., Raz, A., Roe, A. W., Rossi-Pool, R., Roumazeilles, L., Sakai, T., Sallet, J., García-Saldivar, P., Sato, C., Sawiak, S., Schiffer, M., Schwiedrzik, C. M., Seidlitz, J., Sein, J., Shen, Z.-m., Shmuel, A., Silva, A. C., Simone, L., Sirmpilatze, N., Sliwa, J., Smallwood, J., Tasserie, J., Thiebaut de Schotten, M., Toro, R., Trapeau, R., Uhrig, L., Vezoli, J., Wang, Z., Wells, S., Williams, B., Xu, T., Xu, A. G., Yacoub, E., Zhan, M., Ai, L., Amiez, C., Balezeau, F., Baxter, M. G., Blezer, E. L., Brochier, T., Chen, A., Croxson, P. L., Damatac, C. G., Dehaene, S., Everling, S., Fleysher, L., Freiwald, W., Griffiths, T. D., Guedj, C., Hadj-Bouziane, F., Harel, N., Hiba, B., Jung, B., Koo, B., Laland, K. N., Leopold, D. A., Lindenfors, P., Meunier, M., Mok, K., Morrison, J. H., Nacef, J., Nagy, J., Pinsk, M., Reader, S. M., Roelfsema, P. R., Rudko, D. A., Rushworth, M. F., Russ, B. E., Schmid, M. C., Sullivan, E. L., Thiele, A., Todorov, O. S., Tsao, D., Ungerleider, L., Wilson, C. R., Ye, F. Q., Zarco, W., & Zhou, Y.-d. (2020). Accelerating the Evolution of Nonhuman Primate Neuroimaging. Neuron, 105(4), 600-603. doi:10.1016/j.neuron.2019.12.023.

    Abstract

    Nonhuman primate neuroimaging is on the cusp of a transformation, much in the same way its human counterpart was in 2010, when the Human Connectome Project was launched to accelerate progress. Inspired by an open data-sharing initiative, the global community recently met and, in this article, breaks through obstacles to define its ambitions.

    Additional information

    supplementary information
  • Waymel, A., Friedrich, P., Bastian, P.-A., Forkel, S. J., & Thiebaut de Schotten, M. (2020). Anchoring the human olfactory system within a functional gradient. NeuroImage, 216: 116863. doi:10.1016/j.neuroimage.2020.116863.

    Abstract

    Margulies et al. (2016) demonstrated the existence of at least five independent functional connectivity gradients in the human brain. However, it is unclear how these functional gradients might link to anatomy. The dual origin theory proposes that differences in cortical cytoarchitecture originate from two trends of progressive differentiation between the different layers of the cortex, referred to as the hippocampocentric and olfactocentric systems. When conceptualising the functional connectivity gradients within the evolutionary framework of the Dual Origin theory, the first gradient likely represents the hippocampocentric system anatomically. Here we expand on this concept and demonstrate that the fifth gradient likely links to the olfactocentric system. We describe the anatomy of the latter as well as the evidence to support this hypothesis. Together, the first and fifth gradients might help to model the Dual Origin theory of the human brain and inform brain models and pathologies.
  • Besharati, S., Forkel, S. J., Kopelman, M., Solms, M., Jenkinson, P. M., & Fotopoulou, A. (2014). The affective modulation of motor awareness in anosognosia for hemiplegia: Behavioural and lesion evidence. Cortex, 61, 127-140. doi:10.1016/j.cortex.2014.08.016.

    Abstract

    The possible role of emotion in anosognosia for hemiplegia (i.e., denial of motor deficits contralateral to a brain lesion), has long been debated between psychodynamic and neurocognitive theories. However, there are only a handful of case studies focussing on this topic, and the precise role of emotion in anosognosia for hemiplegia requires empirical investigation. In the present study, we aimed to investigate how negative and positive emotions influence motor awareness in anosognosia. Positive and negative emotions were induced under carefully-controlled experimental conditions in right-hemisphere stroke patients with anosognosia for hemiplegia (n = 11) and controls with clinically normal awareness (n = 10). Only the negative, emotion induction condition resulted in a significant improvement of motor awareness in anosognosic patients compared to controls; the positive emotion induction did not. Using lesion overlay and voxel-based lesion-symptom mapping approaches, we also investigated the brain lesions associated with the diagnosis of anosognosia, as well as with performance on the experimental task. Anatomical areas that are commonly damaged in AHP included the right-hemisphere motor and sensory cortices, the inferior frontal cortex, and the insula. Additionally, the insula, putamen and anterior periventricular white matter were associated with less awareness change following the negative emotion induction. This study suggests that motor unawareness and the observed lack of negative emotions about one's disabilities cannot be adequately explained by either purely motivational or neurocognitive accounts. Instead, we propose an integrative account in which insular and striatal lesions result in weak interoceptive and motivational signals. These deficits lead to faulty inferences about the self, involving a difficulty to personalise new sensorimotor information, and an abnormal adherence to premorbid beliefs about the body.

    Additional information

    supplementary file
  • Forkel, S. J., Thiebaut de Schotten, M., Dell’Acqua, F., Kalra, L., Murphy, D. G. M., Williams, S. C. R., & Catani, M. (2014). Anatomical predictors of aphasia recovery: a tractography study of bilateral perisylvian language networks. Brain, 137, 2027-2039. doi:10.1093/brain/awu113.

    Abstract

    Stroke-induced aphasia is associated with adverse effects on quality of life and the ability to return to work. For patients and clinicians the possibility of relying on valid predictors of recovery is an important asset in the clinical management of stroke-related impairment. Age, level of education, type and severity of initial symptoms are established predictors of recovery. However, anatomical predictors are still poorly understood. In this prospective longitudinal study, we intended to assess anatomical predictors of recovery derived from diffusion tractography of the perisylvian language networks. Our study focused on the arcuate fasciculus, a language pathway composed of three segments connecting Wernicke’s to Broca’s region (i.e. long segment), Wernicke’s to Geschwind’s region (i.e. posterior segment) and Broca’s to Geschwind’s region (i.e. anterior segment). In our study we were particularly interested in understanding how lateralization of the arcuate fasciculus impacts on severity of symptoms and their recovery. Sixteen patients (10 males; mean age 60 ± 17 years, range 28–87 years) underwent post stroke language assessment with the Revised Western Aphasia Battery and neuroimaging scanning within a fortnight from symptoms onset. Language assessment was repeated at 6 months. Backward elimination analysis identified a subset of predictor variables (age, sex, lesion size) to be introduced to further regression analyses. A hierarchical regression was conducted with the longitudinal aphasia severity as the dependent variable. The first model included the subset of variables as previously defined. The second model additionally introduced the left and right arcuate fasciculus (separate analysis for each segment). Lesion size was identified as the only independent predictor of longitudinal aphasia severity in the left hemisphere [beta = −0.630, t(−3.129), P = 0.011]. For the right hemisphere, age [beta = −0.678, t(–3.087), P = 0.010] and volume of the long segment of the arcuate fasciculus [beta = 0.730, t(2.732), P = 0.020] were predictors of longitudinal aphasia severity. Adding the volume of the right long segment to the first-level model increased the overall predictive power of the model from 28% to 57% [F(1,11) = 7.46, P = 0.02]. These findings suggest that different predictors of recovery are at play in the left and right hemisphere. The right hemisphere language network seems to be important in aphasia recovery after left hemispheric stroke.

    Additional information

    supplementary information
  • Forkel, S. J. (2014). Identification of anatomical predictors of language recovery after stroke with diffusion tensor imaging. PhD Thesis, King's College London, London.

    Abstract

    Background Stroke-induced aphasia is associated with adverse effects on quality of life and the ability to return to work. However, the predictors of recovery are still poorly understood. Anatomical variability of the arcuate fasciculus, connecting Broca’s and Wernicke’s areas, has been reported in the healthy population using diffusion tensor imaging tractography. In about 40% of the population the arcuate fasciculus is bilateral and this pattern is advantageous for certain language related functions, such as auditory verbal learning (Catani et al. 2007). Methods In this prospective longitudinal study, anatomical predictors of post-stroke aphasia recovery were investigated using diffusion tractography and arterial spin labelling. Patients An 18-subject strong aphasia cohort with first-ever unilateral left hemispheric middle cerebral artery infarcts underwent post stroke language (mean 5±5 days) and neuroimaging (mean 10±6 days) assessments and neuropsychological follow-up at six months. Ten of these patients were available for reassessment one year after symptom onset. Aphasia was assessed with the Western Aphasia Battery, which provides a global measure of severity (Aphasia Quotient, AQ). Results Better recover from aphasia was observed in patients with a right arcuate fasciculus [beta=.730, t(2.732), p=.020] (tractography) and increased fractional anisotropy in the right hemisphere (p<0.05) (Tract-based spatial statistics). Further, an increase in left hemisphere perfusion was observed after one year (p<0.01) (perfusion). Lesion analysis identified maximal overlay in the periinsular white matter (WM). Lesion-symptom mapping identified damage to periinsular structure as predictive for overall aphasia severity and damage to frontal lobe white matter as predictive of repetition deficits. Conclusion These findings suggest an important role for the right hemisphere language network in recovery from aphasia after left hemispheric stroke.

    Additional information

    Link to repository
  • Forkel, S. J., Thiebaut de Schotten, M., Kawadler, J. M., Dell'Acqua, F., Danek, A., & Catani, M. (2014). The anatomy of fronto-occipital connections from early blunt dissections to contemporary tractography. Cortex, 56, 73-84. doi:10.1016/j.cortex.2012.09.005.

    Abstract

    The occipital and frontal lobes are anatomically distant yet functionally highly integrated to generate some of the most complex behaviour. A series of long associative fibres, such as the fronto-occipital networks, mediate this integration via rapid feed-forward propagation of visual input to anterior frontal regions and direct top–down modulation of early visual processing.

    Despite the vast number of anatomical investigations a general consensus on the anatomy of fronto-occipital connections is not forthcoming. For example, in the monkey the existence of a human equivalent of the ‘inferior fronto-occipital fasciculus’ (iFOF) has not been demonstrated. Conversely, a ‘superior fronto-occipital fasciculus’ (sFOF), also referred to as ‘subcallosal bundle’ by some authors, is reported in monkey axonal tracing studies but not in human dissections.

    In this study our aim is twofold. First, we use diffusion tractography to delineate the in vivo anatomy of the sFOF and the iFOF in 30 healthy subjects and three acallosal brains. Second, we provide a comprehensive review of the post-mortem and neuroimaging studies of the fronto-occipital connections published over the last two centuries, together with the first integral translation of Onufrowicz's original description of a human fronto-occipital fasciculus (1887) and Muratoff's report of the ‘subcallosal bundle’ in animals (1893).

    Our tractography dissections suggest that in the human brain (i) the iFOF is a bilateral association pathway connecting ventro-medial occipital cortex to orbital and polar frontal cortex, (ii) the sFOF overlaps with branches of the superior longitudinal fasciculus (SLF) and probably represents an ‘occipital extension’ of the SLF, (iii) the subcallosal bundle of Muratoff is probably a complex tract encompassing ascending thalamo-frontal and descending fronto-caudate connections and is therefore a projection rather than an associative tract.

    In conclusion, our experimental findings and review of the literature suggest that a ventral pathway in humans, namely the iFOF, mediates a direct communication between occipital and frontal lobes. Whether the iFOF represents a unique human pathway awaits further ad hoc investigations in animals.
  • Vergani, F., Mahmood, S., Morris, C., Mitchell, P., & Forkel, S. J. (2014). Intralobar fibres of the occipital lobe: A post mortem dissection study. Cortex, 56, 145-156. doi:10.1016/j.cortex.2014.03.002.

    Abstract

    Introduction

    The atlas by Heinrich Sachs (1892) provided an accurate description of the intralobar fibres of the occipital lobe, with a detailed representation of the short associative tracts connecting different parts of the lobe. Little attention has been paid to the work of Sachs since its publication. In this study, we present the results of the dissection of three hemispheres, performed according to the Klingler technique (1935). Our anatomical findings are then compared to the original description of the occipital fibres anatomy as detailed by Sachs.
    Methods

    Three hemispheres were dissected according to Klingler's technique (1935). Specimens were fixed in 10% formalin and frozen at −15 °C for two weeks. After defreezing, dissection of the white matter fibres was performed with blunt dissectors. Coronal sections were obtained according to the cuts originally described by Sachs. In addition, medial to lateral and lateral to medial dissection of the white matter of the occipital lobe was also performed.

    Results

    A network of short association fibres was demonstrated in the occipital lobe, comprising intralobar association fibres and U-shaped fibres, which are connecting neighbouring gyri. Lateral to the ventricles, longitudinal fibres of the stratum sagittale were also identified that are arranged as external and internal layers. Fibres of the forceps major were also found to be in direct contact with the ventricular walls. We were able to replicate all tracts originally described by Sachs. In addition, a previously unrecognised tract, connecting the cuneus to the lingual gyrus, was identified. This tract corresponds to the “sledge runner”, described in tractography studies.

    Conclusions

    The occipital lobe shows a rich network of intralobar fibres, arranged around the ventricular wall. Good concordance was observed between the Klingler dissection technique and the histological preparations of Sachs.

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