Premortem and postmortem measurement to study structure with function: a human brain collection

Basic issues concerning structure-function relationships in the normal human brain remain unresolved. For example, it is not known what structural basis may underlie the functional specialization of the two cerebral hemispheres or the variation in cognitive ability among people. The study of the general principles of gross and microscopic brain structure in relation to behavior requires direct postmortem study of samples of brain specimens from cognitively normal people for whom quantitative measures on neuropsychological scales are available. No such work has been reported. Although conceptually simple, such research is administratively complex. We present here an approach to the study of structure-function relationships involving postmortem measurements of the human brain. Our subjects were cancer patients who were ambulatory but had a poor prognosis. They agreed to participate in research involving both premortem neuropsychological testing on prospectively selected measures, and, in the event of death, an autopsy and subsequent neuroanatomical study. We describe the essential features of our method including the neuropsychological testing and processing of brain specimens, document the method's feasibility by reporting the number of subjects recruited and autopsies obtained, and discuss the possible usefulness of such research as a prototype for other studies and the various issues such research raises. The present collection of brain specimens and associated medical and neuropsychological documentation is a unique resource and, accordingly, tissue and associated documentation will be made available as a resource to neuroscientists for use in other basic research or as control cases in studies of neuropsychiatric disease.