White-matter commissures: a clinically focused anatomical review

Area of Science:

• Neuroanatomy
• Radiology
• Neurology

Background:

• Brain commissures are white matter tracts facilitating interhemispheric communication.
• Key commissures include the telencephalic (anterior white commissure, hippocampal commissure, corpus callosum) and diencephalic (supramammilary, posterior, supraoptic, habenular) commissures.

Purpose of the Study:

• To provide a structured overview of major white matter commissures.
• To define their anatomy and radiological characteristics.
• To explore their implications in various diseases.

Main Methods:

• Literature review of the PubMed database and The JAMA Network.
• Search terms included specific commissure names and related conditions (e.g., agenesis of corpus callosum, Alzheimer's disease).
• 36 relevant papers were selected for analysis.

Main Results:

• The anterior white commissure (AWC) is involved in olfactory and non-visual communication.
• The hippocampal commissure is crucial for memory formation and consolidation.
• The corpus callosum (CC) is the largest commissure, vital for connecting hemispheres.
• Diencephalic commissures have largely unknown functions, possibly related to eye movements.
• Disorders include agenesis of commissures and diseases like Alzheimer's, where the hippocampal commissure may play a role in dissemination.

Conclusions:

• A thorough clinic-anatomic understanding of white matter commissures is essential.
• This knowledge improves diagnostic accuracy and treatment strategies for neurological disorders.
• Comprehensive understanding supports better patient management.