Healthy white matter in the brain and spinal cord is composed primarily of myelinated axons and glial cells. Myelinated axons transfer information between the peripheral nervous system and the central nervous system (CNS) as well as between centres within the CNS. Demyelination, a hallmark of neurodegenerative autoimmune diseases such as multiple sclerosis (MS), can cause nerve damage and degrade signal propagation. Magnetic resonance imaging (MRI) methods thought to assess myelin integrity and the structural integrity of axons are improving both the diagnosis and understanding of white matter diseases such as MS. Current methods, however, are sensitive to many different pathologies, making the interpretation of individual MRI results difficult. For this dissertation, several quantitative MRI methods were developed and compared, including single component T1 and T2 relaxometry, multicomponent T2 relaxometry, diffusion tensor imaging (DTI), and quantitative magnetization transfer imaging (qMTI). These methods were tested on agarose gels, fixed rat spinal cords, healthy control mice, and the cuprizone mouse model of demyelination. Quantitative MRI measurements were correlated to ultrastructural measurements of white matter to determine the influence myelin content and axonal structure have on different MRI methods. Cellular distributions measured in electron micrographs of the corpus callosum correlated strongly to several different quantitative MRI metrics. The largest Spearman correlation coefficient varied depending on cellular type: longitudinal relaxation rates (RA/T1) vs. the myelinated axon fraction ( r = 0.90/-0.90), the qMTI-derived bound pool fraction (f) vs. the myelin sheath fraction ( r = 0.93), and the DTI-derived axial diffusivity vs. the non-myelinated cell fraction (r = 0.92). Using Pearson’s correlation coefficient, f was strongly correlated to the myelin sheath fraction (r = 0.98) with a linear equation predicting myelin content (5.37f −0.25). Of the calculated MRI metrics, f was the strongest indicator of myelin content while longitudinal relaxation rates and diffusivity measurements were the strongest indicators of changes in tissue structure. Multiparametric MRI measurements of relaxation, diffusion, and magnetization transfer give a more complete picture of white matter integrity.

Le traumatisme crânien (TC) représente un des problèmes majeurs de santé publique, pour lequel à l’heure actuelle il n’existe aucun traitement. Le TC induit une neuro-inflammation délétère qui pourrait contribuer à l’apparition des lésions de la substance blanche (SB). Ces dernières sont à l’origine de lourdes conséquences neurologiques chez les patients victimes de TC. Néanmoins, très peu d’études se sont intéressées à ces lésions bien que plus sévères que les lésions de la substance grise. Ainsi une meilleure connaissance de leur évolution et des causes devient indispensable. L’hyperactivation de la poly(ADP ribose)polymérase (PARP) joue un rôle délétère dans les conséquences post-traumatiques, notamment sur la neuro-inflammation. Ainsi son inhibition pourrait être bénéfique le développement des lésions de la SB. Dans ce contexte, l’objectif de notre travail a été d’évaluer le rôle de la PARP dans les lésions de la SB dans un modèle expérimental de TC induit par impact cortical contrôlé chez la souris. Dans une première partie, nous avons étudié l’évolution de la démyélinisation dans le corps calleux, une structure riche en SB, entre 6 heures et 3 mois post-TC. Parallèlement, les évolutions de la lésion cérébrale, des déficits sensorimoteurs, de la neuro-inflammation et de l’œdème cérébral ont été étudiées. Le TC induit (1) une démyélinisation dès 7 jours et au moins jusqu’à 3 mois post-TC, précédée par (2) une lésion cérébrale entre 24 et 72 heures suivie par une cicatrisation, (3) une neuro-inflammation entre 6 heures et 7 jours et (4) un œdème cérébral entre 6 et 72 heures post-TC. De plus, le TC induit des déficits sensorimoteurs à 6 heures et 3 mois. Ces résultats montrent que ce modèle est adapté pour étudier les lésions de la SB post-TC, et que la neuro-inflammation et l’œdème cérébral pourrait être impliqués dans la démyélinisation. Dans une deuxième partie, nous avons étudié le rôle de la PARP dans les lésions de la SB suite à TC à l’aide de souris knockout (KO) et wild-type (WT) pour le gène de la PARP. Nous avons mis en évidence que les souris KO ne présentent pas de démyélinisation bilatérale du corps calleux après un TC par rapport aux souris WT à 7 jours post-TC, démontrant pour la première fois l’implication de cette enzyme dans les lésions de la SB consécutives à un TC. De plus, nous avons constaté que les souris KO non traumatisées présentent une diminution de myélinisation comparativement aux souris WT non traumatisées, suggérant un rôle de la PARP dans le processus physiologique de la myélinisation.En conclusion, l’ensemble de ce travail expérimental a permis (1) une meilleure caractérisation de la démyélinisation post-TC et des mécanismes potentiellement impliqués dans cette dernière, et (2) de démontrer pour la première fois le rôle délétère de la PARP dans la démyélinisation induite par un TC. Nos travaux suggèrent le potentiel de l’inhibition de la PARP comme stratégie thérapeutique pour la prévention des lésions de la SB post-traumatiques. / Traumatic brain injury (TBI) is a leading cause of death and disability for which there is no neuroprotective treatment up to date. It results in neuroinflammation that may participate in lasting motor and cognitive impairments accompanied by changes in white matter (WM) tracts. WM lesions, evidenced by demyelination, are associated with neurological disorders and in clinical studies are common consequences in patients with chronic TBI. Several studies suggest a contribution of an overactivation of the poly(ADP-ribose) polymerase (PARP) to the neuroinflammatory response which may lead to demyelination. The first part of this study was dedicated to a detailed in vivo assessment of the evolution over time of neurological disorders, cerebral lesion and edema, neuroinflammation and white matter injury induced by controlled cortical impact (CCI) between 6 hours and 12 weeks post-TBI. Notably in the corpus callosum, a significant demyelination starting at 7 days appeared to be a major consequence to post-traumatic neuroinflammation associated with motor dysfunctions. The second part of this study was dedicated to the evaluation of PARP’s role in WM lesions post-TBI, using PARP knockout (KO) mice. Our main findings reveal a diminished demyelination in the corpus callosum of TBI PARP KO as opposed to TBI PARP wildtype specimens. Hence, these data suggest for the first time PARP’s deleterious role in post-traumatic demyelination. In conclusion, taken together these data give an overall view of motor/sensorimotor deficits, neuroinflammation and demyelination in a CCI model of TBI that could help to validate pharmacological strategy for preventing post-traumatic WM injury. Notably, PARP’s inhibition seems to be a valid candidate as this enzyme participates in the establishment of a demyelinating process.

No description available.

Healthy white matter in the brain and spinal cord is composed primarily of myelinated axons and glial cells. Myelinated axons transfer information between the peripheral nervous system and the central nervous system (CNS) as well as between centres within the CNS. Demyelination, a hallmark of neurodegenerative autoimmune diseases such as multiple sclerosis (MS), can cause nerve damage and degrade signal propagation. Magnetic resonance imaging (MRI) methods thought to assess myelin integrity and the structural integrity of axons are improving both the diagnosis and understanding of white matter diseases such as MS. Current methods, however, are sensitive to many different pathologies, making the interpretation of individual MRI results difficult. For this dissertation, several quantitative MRI methods were developed and compared, including single component T1 and T2 relaxometry, multicomponent T2 relaxometry, diffusion tensor imaging (DTI), and quantitative magnetization transfer imaging (qMTI). These methods were tested on agarose gels, fixed rat spinal cords, healthy control mice, and the cuprizone mouse model of demyelination. Quantitative MRI measurements were correlated to ultrastructural measurements of white matter to determine the influence myelin content and axonal structure have on different MRI methods. Cellular distributions measured in electron micrographs of the corpus callosum correlated strongly to several different quantitative MRI metrics. The largest Spearman correlation coefficient varied depending on cellular type: longitudinal relaxation rates (RA/T1) vs. the myelinated axon fraction ( r = 0.90/-0.90), the qMTI-derived bound pool fraction (f) vs. the myelin sheath fraction ( r = 0.93), and the DTI-derived axial diffusivity vs. the non-myelinated cell fraction (r = 0.92). Using Pearson’s correlation coefficient, f was strongly correlated to the myelin sheath fraction (r = 0.98) with a linear equation predicting myelin content (5.37f −0.25). Of the calculated MRI metrics, f was the strongest indicator of myelin content while longitudinal relaxation rates and diffusivity measurements were the strongest indicators of changes in tissue structure. Multiparametric MRI measurements of relaxation, diffusion, and magnetization transfer give a more complete picture of white matter integrity.

<p>In recent years, the emergence of diffusion tensor imaging (DTI) has provided a unique means via water diffusional characteristics to investigate the white matter integrity in the human brain, and its impact on neuronal functions. However, since the characterization of white matter integrity using DTI often lacks tissue specificity, most research studies report changes in anisotropy that are not explicitly correlated with particular cellular origins. To improve the utility of DTI in translational neuroimaging, it is critical to develop DTI acquisition techniques that are quantitative and tissue specific.</p><p>There are, nevertheless, existing methods for tissue specificity. For example, myelin water images can be generated using multiple echo time (TE) or magnetization transfer techniques. These techniques can detect changes in the concentration of myelin associated markers, but not in their spatial organization. Most white matter pathologies however start with early microstructural changes in the myelin sheaths during which the tissue contents remain similar and are thus not differentiable on a conventional MR image. Thus, the ability to construct a diffusion tensor that is myelin specific can have an immediate impact on our better understanding myelin physiology and pathophysiology during brain development. </p><p>Unfortunately, the myelin water signal decays rapidly because of its short transverse relaxation time constant (T2 < 50 ms), especially in DTI experiments where the echo time (TE) can be as large as 100ms. Even in special cases where the TE is shorter, the lack of myelin selectivity in conventional DTI techniques makes assessment of myelin microstructure extremely challenging. Thus we need to develop a DTI methodology that will greatly shorten the TE and allow myelin selectivity.</p><p>To address these challenges we have developed innovative DTI acquisition methodologies that can specifically assess myelin microstructural changes in white matter. To preserve more signal from myelin water we used a stimulated echo DTI implementation. In our initial approach we integrated this sequence with a magnetization transfer preparation to achieve additional differentiating sensitization to myelin water and derive a myelin water weighted (MWW) diffusion tensor. Our results indicate that, compared to the conventional DTI, myelin water diffuses along the axis of the fiber, but has the same has larger fractional anisotropy (FA) due to significantly smaller radial diffusivity. The limited specificity of MT and high radio frequency power deposition of MT-DTI restrict its applicability in clinical studies. </p><p>To obtain increased myelin specificity we implemented a robust stimulated echo DTI sequence with segmented spiral-out readout trajectory for achieving minimal TE on clinical MRI scanners. To ensure high spatial accuracy throughout the DTI scan we further develop a methodology for inherently and dynamically correcting both motion induced phase errors and off-resonance effects due to magnetic field inhomogeneities (including eddy currents) in the reconstructed image. We the used this technique to conduct an unprecedented experiment in which we collected DTI images at multiple echo times (as short as 18ms) and characterized the dependence of anisotropy on the T2 components including myelin water. The results confirmed the anisotropy characteristics of myelin water found with our initial previous approach. </p><p>Building on this new information, we designed a MWW-DTI method based on the simultaneous acquisition of DTI images at two different echo times within clinical practical durations. It is hoped that this new DTI technique sensitized myelin microanatomy will find wide applications in monitoring healthy brain development in pediatric populations, as many developmental brain disorders start with microstructural changes in white matter.</p> / Dissertation

This thesis first explored the effects of concurrent spatial attention and working memory task performance on over-ground gait in healthy young and older adults. It then compared over-ground gait parameters and working memory performance in mild Alzheimer’s Disease (AD) and normal controls (NC) and investigated costs of dual-tasking on working memory performance and cadence during treadmill walking at preferred walking speed in the two groups. Furthermore, it explored these differences in AD and NC groups in relation to their subcortical hyperintensities (SH) that were rated using standardized scales on MRI. Reaction times and accuracy on working memory performance measures were collected under single and dual task conditions. Over-ground gait parameters were measured on an automated walkway. Costs of dual-tasking on gait parameters and working memory performance were measured at a constant velocity on a treadmill. The hypotheses that working memory influences gait performance and that a higher SH burden negatively influences over-ground gait and costs of dual-task conditions, were supported in a series of experiments. Gait slowed down while performing working memory and spatial attention tasks in young and older adults. Patients with mild AD, compared to NC, had a slower gait velocity, shorter stride length and lower cadence on the walkway. When the two groups were subdivided into higher and lower SH groups based on their median SH score, the NC group with lower SH burden walked significantly faster with a higher cadence and a longer stride length than the other three groups. Lastly, a higher SH burden negatively influenced working memory performance in NC while in mild AD patients, it had negative influences on adaptive changes in gait while dual-tasking. These results suggest that, in dual-task condition, SH interfere with processing speed in NC and on gait in AD. These findings provide new insights in to tradeoffs during dual tasking in relation to cerebrovascular disease. This has ecological implications because of the prevalence of small vessel disease in aging and dementia, may impact on predicting falls in AD.

Doctor of Philosophy (PhD) / Schizophrenia is a severe mental illness that affects approximately 1% of the population worldwide, and which typically has a devastating effect on the lives of its sufferers. The characteristic symptoms of the disease include hallucinations, delusions, disorganized thought and reduced emotional expression. While many of the early theories of schizophrenia focused on its psychosocial foundations, more recent theories have focused on the neurobiological underpinnings of the disease. This thesis has four primary aims: 1) to use magnetic resonance imaging (MRI) to identify the structural brain abnormalities present in patients suffering from their first episode of schizophrenia (FES), 2) to elucidate whether these abnormalities were static or progressive over the first 2-3 years of patients’ illness, 3) to identify the relationship between these neuroanatomical abnormalities and patients’ clinical profile, and 4) to identify the normative relationship between longitudinal changes in neuroanatomy and electrophysiology in healthy participants, and to compare this to the relationship observed between these two indices in patients with FES. The aim of Chapter 2 was to use MRI to identify the neuroanatomical changes that occur over adolescence in healthy participants, and to identify the normative relationship between the neuroanatomical changes and electrophysiological changes associated with healthy periadolescent brain maturation. MRI and electroencephalographic (EEG) scans were acquired from 138 healthy participants between the ages of 10 and 30 years. The MRI scans were segmented into grey matter (GM) and white matter (WM) images, before being parcellated into the frontal, temporal, parietal and occipital lobes. Absolute EEG power was calculated for the slow-wave, alpha and beta frequency bands, for the corresponding cortical regions. The age-related changes in regional tissue volumes and regional EEG power were inferred with a regression model. The results indicated that the healthy participants experienced accelerated GM loss, EEG power loss and WM gain in the frontal and parietal lobes between the ages of 10 and 20 years, which decelerated between the ages of 20 and 30 years. A linear relationship was also observed between the maturational changes in regional GM volumes and EEG power in the frontal and parietal lobes. These results indicate that the periadolescent period is a time of great structural and electrophysiological change in the healthy human brain. The aim of Chapter 3 was to identify the GM abnormalities present in patients with FES, both at the time of their first presentation to mental health services (baseline), and over the first 2-3 years of their illness (follow-up). MRI scans were acquired from 41 patients with FES at baseline, and 47 matched healthy control subjects. Of these participants, 25 FES patients and 26 controls returned 2-3 years later for a follow-up scan. The analysis technique of voxel-based morphometry (VBM) was used in conjunction with the Statistical Parametric Mapping (SPM) software package in order to identify the regions of GM difference between the groups at baseline. The related analysis technique of tensor-based morphometry (TBM) was used to identify subjects’ longitudinal GM change over the follow-up interval. Relative to the healthy controls, the FES patients were observed to exhibit widespread GM reductions in the frontal, parietal and temporal cortices and cerebellum at baseline, as well as more circumscribed regions of GM increase, particularly in the occipital lobe. Furthermore, the FES patients lost considerably more GM over the follow-up interval than the controls, particularly in the parietal and temporal cortices. These results indicate that patients with FES exhibit significant structural brain abnormalities very early in the course of their illness, and that these abnormalities progress over the first few years of their illness. Chapter 4 employed the same methodology to investigate the white matter abnormalities exhibited by the FES subjects relative to the controls, both at baseline and over the follow-up interval. Compared to controls, the FES patients exhibited volumetric WM deficits in the frontal and temporal lobes at baseline, as well as volumetric increases at the fronto-parietal junction bilaterally. Furthermore, the FES patients lost considerably more WM over the follow-up interval than did the controls in the middle and inferior temporal cortex bilaterally. While there is substantial evidence indicating that abnormalities in the maturational processes of myelination play a significant role in the development of WM abnormalities in FES, the observed longitudinal reductions in WM were consistent with the death of a select population of temporal lobe neurons over the follow-up interval. The aim of Chapter 5 was to investigate the clinical correlates of the GM abnormalities exhibited by the FES patients at baseline. The volumes of four distinct cerebral regions where 31 patients with FES exhibited reduced GM volumes relative to 30 matched controls were calculated and correlated with patients’ scores on three primary symptom dimensions: Disorganization, Reality Distortion and Psychomotor Poverty. The results indicated that the greater the degree of atrophy exhibited by the FES patients in three of these four ‘regions-of-reduction’, the less severe their degree of Reality Distortion. These results suggest that an excessive amount of GM atrophy may in fact preclude the formation of hallucinations or highly systematized delusions in patients with FES. The aim of Chapter 6 was to identify the relationship between the longitudinal changes in brain structure and brain electrophysiology exhibited by 19 FES patients over the first 2-3 years of their illness, and to compare it to the normative relationship between the two indices reported in Chapter 2. The methodology employed for the parcellation of the MRI and EEG data was identical to Chapter 2. The results indicated that, in contrast to the healthy controls, the longitudinal reduction in GM volume exhibited by the FES patients was not associated with a corresponding reduction in EEG power in any brain lobe. In contrast, EEG power was observed to be maintained or even to increase over the follow-up interval in these patients. These results were consistent with the FES patients experiencing an abnormal elevation of neural synchrony. Such an abnormality in neural synchrony could potentially form the basis of the dysfunctional neural connectivity that has been widely proposed to underlie the functional deficits present in patients with schizophrenia. The primary aim of Chapter 7 was to assimilate the findings from the preceding empirical chapters with the theoretical framework provided in the literature, into an integrated and testable model of schizophrenia. The model emphasized dysfunctions in brain maturation, specifically in the normative processes of synaptic ‘pruning’ and axonal myelination, as playing a key role in the development of disintegrated neural activity and the subsequent onset of schizophrenic symptoms. The model concluded with the novel proposal that disintegrated neural activity arises from abnormal elevations in the synchrony of synaptic activity in patients with first-episode schizophrenia.

The present study characterized two fiber pathways important for language, the superior longitudinal fasciculus/arcuate fasciculus (SLF/AF) and the frontal aslant tract (FAT), and related these tracts to speech, language, and literacy skill in children five to eight years old. We used Diffusion Tensor Imaging (DTI) to characterize the fiber pathways and administered several language assessments. The FAT was identified for the first time in children. Results showed no age-related change in integrity of the FAT, but did show age-related change in the left (but not right) SLF/AF. Moreover, only the integrity of the right FAT was related to phonology but not audiovisual speech perception, articulation, language, or literacy. Both the left and right SLF/AF related to language measures, specifically receptive and expressive language, and language content. These findings are important for understanding the neurobiology of language in the developing brain, and can be incorporated within contemporary dorsal-ventral-motor models for language.

Made available in DSpace on 2014-07-29T15:29:05Z (GMT). No. of bitstreams: 1 TESE MARIA CAROLINA.pdf: 402792 bytes, checksum: 8d8bc54ccfec33d3f62e4107f1060beb (MD5) Previous issue date: 2009-08-03 / In the twentieth century, it was believed that the injury cortical was the substrate of cerebral dysfunction neuropathological. Studies of dementia were primarily focused on disorders of the cerebral cortex and sub cortical gray region, which originated the concepts of cortical and subcortical dementia respectively. The report of dementia mainly involving the white brain received less attention. The aim of this study was to achieve a profile of changes in language and cognitive processes involved in changes in the white sub cortical dementia (DSB) and dementia sub cortical gray (DSC) and then compared with the control group and among themselves. Thus 15 patients were evaluated with DSB, 8 with DSC and 14 control subjects. We applied the following tests: Boston for Diagnostic of Aphasia Examination (BDAE), the Boston Naming Test (BNT), Token Test, Verbal fluency - semantic category and board Theft of biscuits. The results showed that the subcortical group showed worse performance with the control group, showing significant differences in the Boston Naming Test and on the evidence of comprehension and oral production and graphics for the Boston Diagnostic Test of Aphasia. The DSB group showed more significant changes when compared with the control group than in the comparison between DSC X control group. Despite the language is related to cortical involvement, our study showed that such changes are found in subcortical dementia and receiving influence of cognitive processes involved in language. Symptoms of changes in language were similar between groups subcortical, but in greater or lesser degree of commitment. The DSB group showed more impairment of comprehension and oral apraxia and DSC group is highlighted by changes in prosody and the presence of hyperkinetic dysarthria. / No século vinte acreditava-se que o prejuízo cortical era o maior substrato neuropatológico da disfunção cerebral. Os estudos de demência foram primeiramente focados nas desordens do córtex cerebral e região subcortical cinzenta, o que originou os conceitos de demência cortical e subcortical respectivamente. O relato de demência principalmente envolvendo substância branca cerebral recebeu menos atenção. O objetivo desse estudo foi traçar um perfil das alterações de linguagem e os processos cognitivos envolvidos nessas alterações com seu substrato neurobiológico na demência subcortical branca (DSB) e demência subcortical cinzenta (DSC) e em seguida estabelecer uma comparação intra e inter grupos. Para tanto foram avaliados 15 pacientes com DSB, 8 com DSC e 14 sujeitos-controle. Foram aplicados os seguintes testes: Teste Boston para Diagnóstico das Afasias (TBDA), Teste de Nomeação de Boston (TNB), Teste Token, Fluência Verbal - categoria semântica e a prancha Roubo dos Biscoitos. Os resultados mostraram que os grupos subcorticais apresentaram pior desempenho com relação ao grupo controle, apresentando diferenças significativas no teste de Nomeação de Boston e nas provas de compreensão e produção oral e gráfica do Teste Boston para Diagnóstico das Afasias. O grupo DSB apresentou mais alterações significativas quando comparado com o grupo controle, do que na comparação entre DSC X grupo controle. Não obstante as alterações de linguagem estarem tradicionalmente relacionadas ao comprometimento cortical, nosso estudo mostrou que tais alterações estão presentes nas demências subcorticais. Os sintomas de alteração de linguagem foram semelhantes entre os grupos subcorticias, porém em maior ou menor grau de comprometimento. O grupo DSB apresentou mais comprometimento de compreensão oral e apraxia buço-facial e o grupo DSC se destacou pela alteração na prosódia e pela presença de disartria hipercinética.

INTRODUÇÃO: O acesso cirúrgico ao corno temporal do ventrículo lateral (CTVL) é realizado para tratamento de lesões temporais mediais, dentre as quais se destaca a esclerose hipocampal que leva à epilepsia, e pode ser realizado através das superfícies lateral ou inferior do lobo temporal ou pelo sulco lateral do cérebro (fissura silviana). O parênquima cerebral subcortical localizado entre o sulco limitante inferior da ínsula (SLI) e o CTVL é composto por importantes feixes de fibras brancas, os quais podem eventualmente ser lesionados nos acessos cirúrgicos trans-silvianos. OBJETIVO: Descrever a localização dos principais feixes de fibras brancas na região entre o SLI e o CTVL. MÉTODOS: Os principais feixes de fibras brancas subcorticais foram examinados em 14 hemisférios cerebrais cadavéricos adultos utilizando a técnica de dissecção de Klingler, sendo possível descrever suas posições em relação à extremidade anterior do SLI (nomeado de Ponto Temporal do Límen - PTL). RESULTADOS: Os principais feixes de fibras identificados profundamente ao SLI formam um arranjo multilaminar e podem ser divididos de acordo com a profundidade em que são encontrados. As fibras de associação curta da cápsula extrema, que continuam em direção aos opérculos, formam a camada subcortical mais superficial e foram encontradas sob todo o SLI. As fibras da cápsula externa são encontradas mais profundamente, em uma camada formada por três principais feixes em uma disposição anteroposterior sequencial: o fascículo uncinado (encontrado desde o PTL até 10,0 ± 2.2 mm posteriormente), o fascículo fronto-occipital inferior (encontrado entre 10,0 ± 2,2 mm e 35,5 ± 2,7 mm posterior ao PTL) e fibras claustro-corticais (encontradas desde 35,5 ± 2,7 mm posterior ao PTL até o final desse sulco). A extensão lateral da comissura anterior está logo abaixo dessa camada e suas fibras foram encontradas entre 8,4 ± 1,8 mm e 22,0 ± 6,8 mm posterior ao PTL. A camada mais profunda é formada pelas fibras da cápsula interna/corona radiata, onde se destacam as radiações ópticas cujas fibras foram encontradas entre 10,6 ± 3,4 mm e 34,5 ± 3,5 mm posterior ao PTL. CONCLUSÕES: O fascículo uncinado é aproximadamente encontrado sob o terço anterior do segmento anterior do SLI (entre o PTL e o corpo geniculado lateral), enquanto o fascículo fronto-occipital inferior e as fibras da radiação óptica são encontrados sob os dois terços posteriores deste segmento. Os resultados sugerem que na abordagem trans-silviana transinsular, uma incisão através do SLI, começando no PTL e se estendendo até 6 mm posteriormente, irá atravessar o fascículo uncinado, mas não o fascículo fronto-occipital inferior e as radiações ópticas / INTRODUCTION: The surgical approach to the temporal horn of the lateral ventricle (CTVL) is performed for treatment of medial temporal lesions, among which hippocampal sclerosis leading to epilepsy is emphasized, and can be performed through the lateral or inferior surfaces of the temporal lobe or through the sylvian fissure. The subcortical cerebral parenchyma located between the inferior limiting sulcus of the insula (SLI) and the CTVL is composed of important white matter fiber bundles, which may eventually be injured in transsylvian surgical approaches. OBJECTIVES: To describe the location of the main white matter fiber bundles in the region between SLI and CTVL. METHODS: The main subcortical white matter fiber bundles were examined in 14 adult cadaveric cerebral hemispheres using the Klingler dissection technique, and it was possible to describe their positions in relation to the anterior end of the SLI (named Temporal Limen Point - PTL). RESULTS: The main white matter fiber bundles identified deeply to the SLI form a multi-laminar arrangement that can be understood according to the depth in which they are found. The short association fibers of the extreme capsule, which continue toward the opercula, form the most superficial subcortical layer and were found underneath all the SLI. The external capsule fibers were found more deeply, in a layer formed by three main fiber bundles organized in a sequential anterior-posterior disposition: the uncinate fascicle (found from the PTL to 10.0 ± 2.2 mm posteriorly), the inferior fronto-occipital fascicle (found between 10.0 ± 2.2 mm and 35.5 ± 2.7 mm posterior to the PTL) and claustrocortical fibers (found from 35.5 ± 2.7 mm posterior to PTL to the end of this sulcus). The lateral extension of the anterior commissure was below this layer and its fibers were found between 8.4 ± 1.8 mm and 22.0 ± 6.8 mm posterior to the PTL. The deepest layer is formed by the fibers of the internal capsule/corona radiata, where the optical radiation fibers were distinguished and found between 10.6 ± 3.4 mm and 34.5 ± 3.5 mm posterior to the PTL. CONCLUSIONS: The uncinate fascicle is approximately found under the anterior third of the anterior SLI segment (between the PTL and the lateral geniculate body), while the inferior fronto-occipital fascicle and fibers of the optical radiation are found under the posterior two thirds of this segment. The results suggest that at the transsylvian-transinsular approach, an incision at the SLI, from the PTL to 6 mm posteriorly, will cross the uncinate fascicle, but not the inferior fronto-occipital fascicle and optical radiation fibers