Human Brainstem: Cytoarchitecture, Chemoarchitecture, Myeloarchitecture

Human Brainstem

Cytoarchitecture, Chemoarchitecture, Myeloarchitecture

Revised Edition

George Paxinos¹

Teri M. Furlong¹

Charles Watson¹,²

¹Neuroscience Research Australia and The University of New South Wales, Sydney, NSW, 2031

²University of Western Australia, Crawley, WA, 6009

Table of Contents

Cover image

Title page

Copyright

The Memorandum

Preface

Source of Tissue

Histology

Photography/Imaging

Diagrams and Labeled Photographs

In Vivo MRI

Stereotaxic Grid

Nomenclature and abbreviations

Caudal hindbrain

The basis of delineation of structures

Efferent and afferent nuclei of the cranial nerves

List of structures

Index of abbreviations

The Figures Title page

Figures

Figures

Copyright

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First edition: 2019

Revised edition: 2020

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The Memorandum

Preface

Olszewski and Baxter (1954) constructed the first comprehensive study of the cell groups in the human brainstem. Using Nissl and myelin stains, they produced a high-quality atlas which formed a starting point for the work of Paxinos and Huang (1995) who employed, in addition, histochemical staining (acetylcholinesterase, AChE). In turn the work of Paxinos and Huang formed the basis of the present atlas. It was known from our early work in mapping the rat brain (Paxinos and Watson, 1982) that acetylcholinesterase (AChE) staining reveals features not visible in Nissl-stained sections. Beyond this, because nuclei tend to have similar AChE staining across mammals, AChE reveals homologous structures.

The Paxinos and Huang (1995) atlas of the human brainstem consisted of 64 photographic plates and 64 accompanying schematic diagrams. However, in that atlas only a fraction of the sections available from that brain were presented; we have taken advantage of the additional (unused) sections in the construction of the present atlas.

We thoroughly updated the original 64 diagrams of Paxinos and Huang and added another 128 labelled plates. Further, we added a myeloarchitectonic atlas of 31 labelled plates.

Our aim was to construct an atlas of sufficient accuracy, comprehensiveness, and convenience for students, researchers, and pathologists.

The key features of the present atlas are:

•The atlas is based on a single brain obtained from a 59-year old Caucasian male with no medical history of neurologic or psychiatric illness.

•Thorough updating of the 64 original diagrams first published 24 years ago by Paxinos and Huang, juxtaposed with their Nissl and AChE plates in color.

•128 additional Nissl and AChE color plates fully labelled

•The sections presented are at 0.5-mm intervals in a plane transverse to the longitudinal axis of the brainstem.

•The atlas systematically establishes the human homologs of nearly all nuclei previously identified in the brainstem of the rat.

•In addition to the above, we present 31 labelled plates of sections stained for myelin based on tissue from the Latham collection.

•Electronic diagrams available to purchasers of this book via a password-protected website.

Reproduction of atlas figures in other publications. As authors, we give permission for the reproduction of any figure from the atlas in other publications, provided the atlas is cited. Formal permission from the publisher should be sought directly on-line via the Elsevier homepage (http://elsevier.com/locate/permissions) or from Elsevier Global Rights Department in Oxford, UK: phone: (+ 44) 1865843830, fax: (+ 44) 1865 853333, email: permissions@elsevier.com.

How to cite this atlas: Paxinos G, Furlong TM and Watson C, Human Brainstem: Cytoarchitecture, Chemoarchitecture, Myeloarchitecture, Revised Edition. San Diego, Elsevier Academic Press, 2020.

Acknowledgements

We thank Xu-Feng Huang whose work on the 1995 book Atlas of the Human Brainstem gave us most of the basic material for the present atlas. We thank Mark Schira for his elegant work with MR images that indicate the location of the section and for the accurate match of the transverse MRIs to the plates. We thank Steve Kassem for brilliance and commitment in organizing the layout of the pages. We thank Gulgun Sengul for the literature review in the updating of the diagrams of the original atlas. A special thanks to Keira McLoskey, our enthusiastic lab assistant. We thank Christodoulos Skliros and Katerina Arvanitakis for technical help. Yvette Paxinos (http://www.paxifilm.com/) was responsible for the cover design and Daniel Binks for the index. We acknowledge the help of the talented staff at Academic Press Elsevier (Natalie Farra, Kathy Padilla, and Andrew Riley). This work was supported by NHMRC grants (APP1086083, APP1086643) and in part by ARC Centre of Excellence for Integrative Brain Function (CE140100007) to G. Paxinos who is an NHMRC Senior Principal Research Fellow.

Introduction

A detailed atlas is vital to clinical and research studies on the human brain, more so in the age of MRI. The Olszewski and Baxter (1954) human brainstem atlas has been very influential, but a number of its organizational schemes have been superseded. Additionally, the Olsewski and Baxter atlas presents only 19 levels of the brainstem, an insufficient sampling frequency for present needs. That atlas was recently republished by Büttner-Enever and Horne (2014a), with virtually unchanged diagrams, but with a scholarly literature review by the contemporary editors.

Nissl substance stains have been widely accepted as the standard guide to brain organization. But while Nissl stains display each neuron and glial cell, they do not reveal other levels of organization. Chemoarchitectonic stains can give an overview of the organization of regions at a glance. We have found that AChE is the best overall chemical stain for subcortical structures because of its widespread and differential distribution. Because we are familiar with the AChE signature of nuclei of the brainstem of the rat, mouse, rhesus monkey, and marmoset (Paxinos and Watson, 1986; Paxinos and Franklin, 2019; Paxinos et al, 2009; Paxinos et al, 2012), we were able to use AChE as a kind of Rosetta stone for interpretation of human brainstem structures.

Source of Tissue

The brainstem used was obtained from a 59-year-old Caucasian male who died suddenly from a heart attack. The individual had no medical history of neurologic or psychiatric disease.

The brainstem used for the atlas stained for myelin displays Weigert stained sections prepared by Dr Aubrey Latham in a psychiatric hospital in Sydney in 1905. This section set was donated to the School of Anatomy of The University of New South Wales by the widow of Latham’s protégé, Dr Brian Turner, in 1995. There are no available details of the age, sex, or health history of the person from whom this brain was taken. The Latham brain sections were photographed by Huang and Paxinos on 4x5-inch negatives and these negatives were scanned to produce the myeloarchitectonic atlas (Fig. 129-159).

Histology

For the primary atlas (Nissl and AChE plates and diagrams), the brain was removed from the skull 4 hours post-mortem and kept in phosphate buffered saline, pH 7.4 at 4oC for another 6 hours, resulting in a 10-hour post-mortem delay before it was frozen. The unfixed brainstem was placed into an aluminium mould which was made following the construction of an endocast of a skull (see Procrustes brain mould photograph). The main purpose of placing the brain in the Procrustes mould was to avoid the distortion that would have occurred if the brain was frozen on a flat surface. An additional aim was to block the brain at diencephalic levels on a plane perpendicular to the long axis of the medulla and pons and to make a fiducial mark by inserting a needle perpendicular to that surface (right-hand probe in