Anatomy and White Matter Connections of the Lingual Gyrus and Cuneus

ABSTRACT Background The medial occipital lobe, comprised of the lingual gyrus and cuneus, is necessary for both basic and higher-level visual processing as well as facilitates cross-modal, non-visual functions following the loss of visual senses, such as linguistic processing and verbal memory. A detailed cortical model elucidating the white matter connectivity associated with this area may improve our understanding of the interacting brain networks that underlie complex human processes and post-operative outcomes related to vision and language. Methods Generalized q-sampling imaging (GQI) tractography validated by gross anatomic dissection for qualitative visual agreement performed on 10 healthy adult controls obtained from the Human Connectome Project (HCP). Results Major white matter connections were identified on tractography and validated by gross-dissection which connect the medial occipital lobe with itself as well as with adjacent cortices, especially the temporal lobe. Short and long range connections identified consisted mainly of U-shaped association fibers, intra-cuneal fibers, the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, middle longitudinal fasciculus, and lingual-fusiform connections. Conclusion The medial occipital lobe is an extremely interconnected system supporting its ability to perform coordinated basic visual processing, but also serves as a hub of many long-range association fibers which also implicates its importance in non-visual functions, such as language and memory. Data presented in this manuscript represents clinically actionable anatomic information which can be utilized in multimodal navigation of white matter lesions in the medial occipital lobe to prevent neurologic deficit and improve patient quality of life following cerebral surgery.