Tracing of Neuronal Connections in the Human Brain by Magnetic Resonance Imaging in vivo.

Axon degeneration after disruption of fibre tracts in the mammalian nervous system is accompanied by myelin breakdown which leads to changes in its magnetic resonance properties. In two patients with pure motor strokes due to small ischaemic lesions restricted to the internal capsule, magnetic resonance imaging disclosed a narrow band of pathological signal increase descending band-like into the brain stem and ascending to the precentral gyrus, which corresponded to the well-known path of the pyramidal tract. The findings suggest that in man anterograde and possibly retrograde fibre degeneration can be traced in vivo by conventional magnetic resonance imaging techniques. Critical conditions are the presence of small, strategically located lesions, appropriate choice of imaging plane, and the interval between time of lesion and of imaging. This demonstration may open a new era for functional neuroanatomy of man.