Brain, Vol. 122, No. 12, 2416-2417,
December 1999
© 1999 Oxford University Press
Book reviews |
CD-ROM: NEUROFUNCTIONAL SYSTEMS.3D RECONSTRUCTIONS WITH CORRELATED NEUROIMAGING.
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Cardiff School of Biosciences, Cardiff, UK
This CD-ROM is more than the `film of the book', as it compliments and extends the authors' hardback publication of 1998. It enables the user to play with brightly coloured images of the human brain, turn them around, view them from whichever angle is chosen and put labels on them. It also enables the user to superimpose 3D reconstructions of individual neuronal systems on serial MRI images of the brain with the intention that a clinical neurologist can `accurately localize the systems in relation to neighbouring structures'—a particularly reassuring aim for those undergoing an invasive intracerebral procedure. Indeed one of the stated aims of the authors is to enable a clinician to formulate a `mental reconstruction' of a region of the brain or indeed of a particular neural system. Given that it is also possible to combine into a single image afferent systems such as the medial lemniscus, auditory and visual with efferent systems such as the corticospinal, and visualize them together with the ventricular system, this provides a considerable challenge to the `mental reconstructor'!
The subject matter is a `simulated brain for neurosurgeons and neuroradiologists', and indeed for those learning neuroanatomy for the first time. The 3D reconstructions are derived from cadaveric brains that were fixed in situ and embedded in agar prior to sectioning at 2-mm thickness with a macrovibratome. This innovative method is extremely important as the shrinkage of the brain that occurs during tissue processing is only ~5%, far less than the 30–50% shrinkage that occurs when brain tissue is embedded in paraffin or celloidin. As a result, the sections from which the reconstructions were made very closely represent the actual dimensions of the living brain, greatly aiding the accuracy of the spatial representation of neuranatomical features.
The CD-ROM package is accompanied by two pairs of stereoglasses and a very clear User's Manual. It starts automatically and is a pleasure to use. Your reviewer is by no stretch of the imagination the most computer-literate neuroscientist in Britain, but he metaphorically jumped onto this CD-ROM and played around with it with the greatest of ease! It has so many attractive features, which are explained in the excellent `Notes for Users' section in the accompanying text, which is very clear and not at all too detailed: `eye' symbols that with a mouse-click impose an arrow on the appropriate feature of the image; rotation of the image so that it can be viewed from 16 different angles; perspective projection such that the images are seen as if they are 80 cm away, thus giving much better spatial perception; clear expositions of the terminology used in describing axes used for 3D reference; a list of abbreviations used; an extremely useful reference section which is also represented in the text by `book' icons on which one clicks to reveal references germane to the subject matter of the sentence. The images themselves portray the individual neural systems in distinctive colours that are brighter on the computer screen than they are in the book and consequently are of superior quality. The 3D reconstructions are breathtaking when viewed with the stereoglasses and they can be transiently labelled as the cursor is moved over the image. This is an excellent feature for the student who wants to indulge in some revision or indeed in self-directed learning. Exposing the entire image on the screen by altering the size of the window, as is frequently necessary to view a system in its entirety or the complete territory of the anterior cerebral artery, for example, and rotating it in more than one plane is again an easy operation.
Each of the brain structures or neurofunctional systems in the contents list is accompanied by a variable number of appropriate icons that amplify the topic: `Description' is a written commentry; `Demarcation' adds an overview of the structure/system on brain sections; `Neuronal connections' provides a simple diagram of the main connections (which can be labelled using the cursor) superimposed on a light background; `Clinical notes' are exactly what one would expect of this CD-ROM—concise and apposite; `References' are generally from relevant textbooks and reviews as well as original articles. The sectional images opened up by Demarcation contained one very disappointing feature in that the images of the brainstem were far too small for any meaningful detail to be made out. Whilst appreciating that this is not a brainstem atlas, the representation of neurofunctional systems such as the medial lemniscus and corticospinal systems really do require that good images of the brainstem are available so that the system can be presented in its entirety. This is the one aspect of this CD-ROM in which there is room for improvement. The brain structures that are included in the contents list are cerebral sulci and gyri; ventricular system and thalamus; and under Neurofunctional Systems we find medial lemniscus, auditory, visual, corticospinal, limbic systems, motor systems and basal ganglia, and cerebral arteries.
For me the most striking images and perhaps the most instructive were those of the basal ganglia and their relationship to the lateral ventricles. The ability to rotate them both horizontally and vertically really made it possible to grasp their 3D arrangement within the depths of the cerebral hemispheres. At a time when it is becoming increasingly difficult to obtain sufficient numbers of human brains for increasing numbers of medical students to dissect thoroughly, this CD-ROM will be of undoubted value in helping students understand the anatomy of the hemispheres and to build up their own `mental reconstructions'.
The third section of the contents list contains `Methods for Visualisation', which is not too technical but does not include any mention of possible errors that can occur during sampling, morphometry and reconstruction that are present in detail in the authors' book); `Matching MR and CT images'; `Outlook' (for brain imaging in the future); `Tables' (of data and measurements of the brains used in the reconstructions); and `References'. The programme also has a very useful index of all the terms used; this can either be used to find a specific term in the text or to look up a specific feature.
All in all, Professors Kretschmann and Weinrich and their collaborators are to be congratulated on the production of this impressive and user-friendly CD-ROM. It will be used with pleasure by many undergraduate and postgraduate medical students alike and they will gain much from it.
Notes
By Hans-Joachim Kretschmann and Wolfgang Weinrich.1998. Stuttgart: Georg Thieme Verlag. Price DM 179. ISBN 3-13-115281-8.
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