Abstract
The structure of the human brain has been studied extensively. Despite all the knowledge accrued, direct information about connections, from origin to termination, in the human brain is extremely limited. Yet there is a widespread misperception that human connectional neuroanatomy is well-established and validated. In this article, we consider what is known directly about human structural and connectional neuroanatomy. Information on neuroanatomical connections in the human brain is derived largely from studies in non-human experimental models in which the entire connectional pathway, including origins, course, and terminations, is directly visualized. Techniques to examine structural connectivity in the human brain are progressing rapidly; nevertheless, our present understanding of such connectivity is limited largely to data derived from homological comparisons, particularly with non-human primates. We take the position that an in-depth and more precise understanding of human connectional neuroanatomy will be obtained by a systematic application of this homological approach.
Introduction
Understanding the structure of the human brain remains one of the most challenging issues in human neuroscience. While the fundamental architecture of most other organ systems has been determined and the structural organization of their underlying tissues established in great detail, this is not the case in the human brain. The fundamental structure of the human central nervous system, in particular structural brain connectivity, is still not completely delineated.
Different parts of the human central nervous system have been delineated and described using gross anatomical and histological approaches, and according to regional differences in cellular or fibrous composition (e.g., Dejerine and Dejerine-Klumpke, ; Vogt and Vogt, ; Bailey and von Bonin, ; Cajal, ; Brodmann, ; von Economo et al., 2008). Since the 19th century, the optimal method for dividing the central nervous system into discrete regions has been an object of study and debate. The regional organization of the human brain has been extensively described using post-mortem material and is generally agreed upon. This line of investigation continues using non-invasive brain imaging techniques such as magnetic resonance imaging (MRI), which provides both post-mortem and in vivo data (e.g., Toga and Mazziotta, ; Walters et al., ; Eickhoff et al., ).
One essential aspect of the human central nervous system structure is virtually unknown: precisely where a specific connection originates and terminates in the brain. Surprising as it may seem, this realization arises from an evaluation of our knowledge of human neuroanatomy. Even among the most studied neuroanatomical systems, e.g., the connections between the lateral geniculate nucleus and the primary visual cortex (PVC), what direct evidence do we have in the human? Axonal fibers such as the optic radiations can be observed through microdissection of white matter, e.g., the Klingler technique (Ludwig and Kingler, ; Rubino et al., ), or inferred from a pattern of degeneration in fibers and cells after a stroke or other localized damage (e.g., Dejerine and Dejerine-Klumpke, ). The course of the pathways can also be inferred by tracking the flow of water molecules within axonal bundles using diffusion-based MRI (dMRI) imaging tractography (e.g., Conturo et al., ; Mori et al., ; Basser et al., ; Poupon et al., ; Lori et al., ). However, none of these methods can directly visualize cellular origins or terminal fields of axons (Figure 1). Both microdissection and dMRI-based methods have difficulties in evaluating branch points or determining trajectories as groups of axons approach each other (Maier-Hein et al., ). More problematic is that these methods are unable to determine the trajectory of axons when they enter gray matter and whether they pass through a structure on their way to a deeper layer or region, stop at a proximal point, or branch and turn upon entering a structure (Makris et al., ; Schmahmann and Pandya, ; Zemmoura et al., ; Maier-Hein et al., ).
Figure 1
How Human Is Human Connectional Neuroanatomy?
Given this situation, from where does our information on human neuroanatomy, in particular structural brain connectivity, emerge? To address this question, we examined two classic human neuroanatomy texts: Carpenter and Sutin (
Figure 2

Primary literature in classic human neuroanatomy textbooks according to species. Upper left: percentages derived from primary literature citations found in Carpenter and Sutin (
In the Carpenter text, of the primary literature listed in the references section, 37% (781) of studies were performed in cats. Studies in monkeys (mostly macaque species) accounted for 24% (509), while rodents comprised 19% (363). Only 13% (275) of the investigations listed used human material, with the vast majority describing aspects of the human nervous system readily accessible to study such as vascular supply, peripheral nerves, or architectonics. Many of the human investigations described neurological symptoms or neurosurgical approaches and interventions in clinical cases. Several examined post-mortem brain histology in neurological cases to infer the trajectories and termination patterns of degenerated fibers after damage such as that caused by stroke (e.g., Dejerine and Dejerine-Klumpke,
In the more recent Nieuwenhuys text, the proportions of non-human vs. human studies were slightly different. Studies in cats accounted for 17% (576), whereas studies in monkeys and rodents each represented 32% (monkey = 1,098, rodent = 1,122) of the primary literature. Human studies accounted for 16% (543) of the total primary sources. As before, the vast majority of human studies were based on post-mortem analyses, and to this were added non-invasive imaging studies (e.g., positron emission tomography, MRI-based studies, magnetoencephalography) and non-invasive brain stimulation studies (e.g., transcranial magnetic stimulation). A similar analysis of Schmahmann and Pandya (
The human studies cited in these texts do not show precise origins or terminations of fiber pathways. Collectively, these studies provide little direct evidence of structural brain connectivity in humans, except the following approaches. In one, a tracer is applied to slices of the human brain collected quickly after death and kept alive as long as possible (Dai et al.,
Thus, the bulk of knowledge that forms the basis of human connectional neuroanatomy is drawn from a variety of non-human species. This fact is not surprising; the homological approach has been and remains a cornerstone of neuroanatomy, including that of the human brain (e.g., Crick and Jones,
Although gross anatomical and histological features have been well studied in the human brain, precise knowledge of structural connections between specific areas, from origins to terminations, is quite limited. This has been the case since the classic neuroanatomical studies of the 19th century (e.g., Reil,
In parallel, experimental neuroanatomists since the 19th century have focused on brain connections in non-human species with the primary aim of describing fundamental aspects of brain organization rather than clinical relevance. This research has used invasive methods that provide a high level of microscopic detail and employ systematic methodologies aimed at charting connections. Like the clinico-anatomical approach in humans, early studies in animals entailed making lesions in specific parts of the neuraxis, with connectivity inferred based on patterns of degeneration (e.g., Glees,
In the 1970s degeneration techniques were largely superseded as novel pathway tracing techniques were developed to obviate the limitations of earlier methods. These new techniques involved the intracerebral injection of tracers taken up and transported by neurons (e.g., Cowan et al.,
Indeed, human connectional neuroanatomy is based partly on human clinico-anatomical and fiber microdissection studies (and a few studies of very short connections), but largely on homologies generated from anatomical studies in non-human species. The former provides information principally on pathway stems, while the latter comprises the vast majority of information on origins and terminations of brain pathways (Figure 1). Thus, there is scant direct evidence regarding human connectional neuroanatomy, and the data that exist are largely incomplete. Yet there is a widespread misperception that human connectional neuroanatomy is well-established and validated.
The Importance of Validation and Ground Truth
Awareness of the strong reliance of human neuroanatomy on findings from non-human species is important in the context of current human neuroimaging. The recent advent of non-invasive imaging techniques and the adoption of computer science-based analytical tools has led to a resurgence of human neuroanatomical study and has contributed to the emergence of new fields such as computational neuroanatomy. Non-invasive approaches to neuroanatomy in the human brain have been adopted that use diffusion-based techniques to infer the presence and orientation of fiber bundles in vivo (e.g., Conturo et al.,
Although human fiber stems have been validated and are well established using diffusion-based techniques, it is much more difficult for these techniques to define the trajectory of fibers in a voxel when these fibers have a broader range of orientations (e.g., Dauguet et al.,
Connectional ground truth comprises the complete structure of fiber bundles, including origins and terminations as well as stems (Figure 1). For the human brain, ground truth for origins and terminations is extremely limited, and, in most instances, does not exist. Consequently, the validity of results from dMRI-based tract-tracing algorithms cannot be compared against ground truth and confirmed. Moreover, the fiber tract structure as inferred from diffusion-based imaging techniques against ground truth cannot be used as feedback to guide the development of better algorithms. The absence of ground truth is thus a major impediment to defining the complete pattern of structural connections in the human brain from origin to termination and represents a barrier that cannot be directly overcome using available technology.
What are the implications of the absence of ground truth for human structural brain connectivity? One important implication is that depending on the acquisition parameters and tractographic analysis tools, the anatomical results provided by diffusion-based tractography can be markedly different for the same structure in the same subject (Makris et al.,
Ground truth exists for the non-human primate, several species of which have been used in conjunction with invasive tract-tracing methods to comprehensively chart pathways at high resolution (e.g., Schmahmann and Pandya,
One approach to compare connections across species that has particular promise is the creation of a connectional fingerprint (e.g., Mars et al., 2018). In this work, the authors use known correspondence in the white matter bundles across species (e.g., human and non-human primates) and diffusion MRI based connectivity profiles of these white matter fiber bundles with gray matter areas to determine homologies between human and primate gray matter areas. Therefore, prior knowledge of white matter correspondence is the key to the determination of gray matter homologies in this work. Nevertheless, the incorporation of tract-tracing data derived from experimental animals into these models could provide a stronger and more direct link between connectional ground truth data and diffusion-based tractographic data that could then be extrapolated to humans.
Other studies relating experimental neuroanatomical data in non-human primates to diffusion-based data have been carried out (van den Heuvel et al.,
More studies are needed to better establish homological comparisons between a non-human primate and human connectional neuroanatomy. These comparisons are essential to translate ground truth connectional knowledge based on tract-tracing experiments in non-human primates to the human brain. However, data from extant neuroanatomical tract-tracing in multiple non-human primate species are underutilized and need to be leveraged and used more fully, taking into account the limitations of the methods (e.g., variability in tracer injections, tracer uptake by fibers of passage; Jbabdi et al.,
Conclusion
Although differences in brain structure, connectivity, and function have been documented between non-human primates and human (e.g., Jbabdi et al.,
Statements
Data availability statement
The datasets generated for this study are available on request to the corresponding author.
Author contributions
RR, NM, and EY wrote the first draft of the manuscript. All authors contributed to manuscript revision, read and approved the submitted version.
Funding
The authors acknowledge support from the National Institutes of Health (NIH; R01 MH112748). NM was a EURIAS Fellow at the Hanse-Wissenschaftskolleg Institute for Advanced Study, Delmenhorst, Germany while working on this study.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
neuroanatomy, homology, human, monkey, cat, rat, axons, DTI
Citation
Rushmore RJ, Bouix S, Kubicki M, Rathi Y, Yeterian EH and Makris N (2020) How Human Is Human Connectional Neuroanatomy?. Front. Neuroanat. 14:18. doi: 10.3389/fnana.2020.00018
Received
23 December 2019
Accepted
23 March 2020
Published
15 April 2020
Volume
14 - 2020
Edited by
Marcello Rosa, Monash University, Australia
Reviewed by
Alexandros Goulas, Universitätsklinikum Hamburg-Eppendorf, Germany; Stefan Everling, University of Western Ontario, Canada
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Copyright
© 2020 Rushmore, Bouix, Kubicki, Rathi, Yeterian and Makris.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Nikos Makris nikos@cma.mgh.harvard.edu
†These authors have contributed equally to this work
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