J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.37.7.765 on 1 July 1974. Downloaded from Joutrnal of Neur)ology, Neurosurgery, and Psychiatry, 1974, 37, 765-789 Nucleus dorsalis superficialis (lateralis dorsalis) of the thalamus and the limbic system in man J. M. VAN BUREN AND R. C. BORKE Fr-om the Surgical Neurology Branch, National Institute of Neurological Diseases and Str-oke, National Institutes of Health, Bethesda, Maryland, U.S.A. SYNOPSIS Although the earlier supposition was that the n. dorsalis superficialis (n. lateralis dorsalis) of the thalamus projected to the parietal region, more recent evidence has linked it to the posterior cingulate gyrus and possibly adjacent regions near the splenium of the corpus callosum. An afferent supply from lower levels was in more doubt, although some report had been made of cell and fibre degeneration in the n. dorsalis superficialis after extensive temporal resections and section of the fornix in lower primates. The five human hemispheres of the present study all had lesions of long duration below the level of the splenium of the corpus callosum in the posteromedial temporal region. All showed marked degeneration in the fornix and n. dorsalis superficialis. In favourably Protected by copyright. stained cases, gliotic fascicles could be followed from the descending column of the fornix to the n. dorsalis superficialis via the region lateral to the stria medullaris thalami. The cell loss in the nucleus thus appeared to be an instance of anterograde transynaptic degeneration. These cases provided an interesting instance in which human infarctions provided natural lesions that would have been hard to duplicate in experimental animals. In man, the n. dorsalis superficialis (n. lateralis extent, to the cortex of areas 5 and 7.' Support dorsalis) lies on the superior surface of the for this concept was supplied by studies in the thalamus above the n. medialis (n. medialis macaque (Walker, 1938a), chimpanzee (Walker, dorsalis) and is contiguous with the pulvinar 1938b, c), and in man (Papez, 1939; Clark and posteriorly. Anteriorly, it extends a conical pro- Russell, 1940; Hartmann and Simma, 1952; cess medial to the posterior tapering extension Szabo, 1952). On the other hand, some dis- of the anterior nuclei. It is separated from the crepancies appeared. Ranson et al. (1941) re- http://jnnp.bmj.com/ thalamic surface and the adjacent nuclei by a ported a case of removal of the lateroposterior thin and somewhat variable medullated lamina. frontal, parietal, anterior occipital, and posterior In general, the background myelination of the temporal cerebral cortex including the opercula nucleus is very light, making it readily distin- and the cortex of the insula in the macaque that guishable by the naked eye on myelin prepara- had caused no degeneration in the n. lateralis tions. However, a variable pattern of fascicles dorsalis. may enter the nucleus from the stratum zonale Closer inspection of the positive material gives on September 24, 2021 by guest. lateral to the nucleus or the ventral myelinated some hint as to the basis for the discrepancy in lamina. This may lead to a parcellated or marbled results. Of Walker's three cases with degenera- appearance accounting for the designation, n. tion in LD, two (experiments 12L and 17) had disseminati dorsalis, used by Riley (1943). extension of the parietooccipital ablation to In the early work there was little to suggest include the medial surface down to the corpus that the nucleus belonged to the limbic system. callosum. In the remaining case (12R), the Walker (1938a, p. 185) concluded that, 'It is cortical removal extended down the midline only quite apparent that this nucleus [n. lateralis to the callosomarginal sulcus resulting in cell dorsalis] is largely related to the posterior part of loss in the inferior part of LD but leaving the the postcentral convolution and, to a lesser dorsal part intact. 765 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.37.7.765 on 1 July 1974. Downloaded from 766 J. M. Van Buren and R. C. Borke Some of the human material (Clark and hippocampal gyrus and anterior lingula (cases Russell, 1940; Sheps, 1945; Szabo, 1952; 149, 150, 151, 152). Simma, 1954) with degeneration in n. dorsalis The present report presents in detail the serial superficialis quite obviously had extension of the section reconstructions of five human hemi- lesion onto the medial aspect of the hemisphere. spheres, all of which had degeneration of the n. This was not so, however, in the cases of Papez dorsalis superficialis and fornix in association (1939) and Hartmann and Simma (1952). In with lesions in the medial posterior temporal these cases, however, the lesion extended down region below the level of the splenium of the to the wall of the cerebral ventricle and thus corpus callosum. The lesion was thus outside the would be in a position to interrupt thalamo- commonly accepted posterior limbic projection cortical fibres looping around the superolateral area of the nucleus. aspect of the ventricle to reach the medial aspect of the As is often the case with human material, hemisphere. lesions tend to be multiple. In the present study, The likelihood that the n. dorsalis superficialis the associated infarcts of the lingula and n. has important efferent connections to the medial ventralis caudalis thalami were the most trouble- aspect of the parietal region-that is, cortex some. The importance of these extraneous bordering the interhemispheral sulcus-receives lesions has been discounted by the authors on support from studies in the macaque. Krieg the basis of the appearance of degeneration in n. (1963) reported that after lesions in the retro- and dorsalis superficialis when these regions were suprasplenial cortex (areas 23 and 31) there was intact and experience with other cases (VanProtected by copyright. cell degeneration in LD (n. lateralis dorsalis or Buren and Borke, 1972a) which serve as control n. dorsalis superficialis). Locke et al. (1964) con- material. firmed this in cases of posterior cingulate abla- tions. Niimi and Tsutsui's (1962) observations in a single animal were similar. Both Krieg and METHODS Locke et al. noted lack of complete degeneration The five hemispheres had been prepared with immer- in LD after lesions of the posterior cingulate sion fixation, total embedding in celloidin and serial region, suggesting the possibility of additional section at 35 ,um. Adjacent sections at 20 section areas of projection. intervals were stained respectively with cresyl violet and for myelin (Loyez method) and mounted on Afferent connections to the n. dorsalis super- large glass slides. ficialis have also been found from the posterior Reconstruction work was begun by making prints cingulate region. With the Marchi technique, of every 100th section of the myelin series at about Larson (1962) noted a sparse but definite projec- 4 x and every 40th section through the thalamus at http://jnnp.bmj.com/ tion to the nucleus from area 23 in the macaque. 12 x of the cresyl violet series on Kodak Photo- With similar preparations, Krieg (1963, p. 223, mechanical T paper. The 10 second processor avail- 230) reported fibres from both the retro- and able for this paper was a great convenience. On these suprasplenial cortex (areas 23 and 31) to the n. prints the areas of damage and degeneration were dorsalis superficialis. Domesick (1969) in the rat marked with a soft pencil after inspection with a traced fibre degeneration from lesions in the stereomicroscope (10-40 diameter magnification). dorsal part of the posterior cingulate region Thus the term 'neuronal degeneration' used here refers quite simply to loss of neuronal population of on September 24, 2021 by guest. (Rose's agranular retrosplenial cortex) to LD. varying degree. No attempt was made to evaluate A final interesting observation has been made intrinsic cell change-for example, chromatolysis. by Pasik et al. (1960) and Siqueira (1965) in the Postmortem autolytic changes made such evaluations monkey. After extensive temporal lobectomies, of doubtful value. 'Gliosis' refers to areas of definite degeneration was apparent in the n. dorsalis increase in glial nuclei giving the region a darker background than adjacent areas. 'Myelin loss' was superficialis which they felt was proportional in likewise a designation made on low power observa- intensity to the degree of damage to the hippo- tion. The cardinal concept applied to the studies was campal formation. One may remember that that the changes were of three-dimensional nature Krieg (1963) found no Marchi evidence of and thus must be visible in sequential sections of the corticothalamic projection from the posterior series. Adherence to this principle tended to mini- J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.37.7.765 on 1 July 1974. Downloaded from Nucleus dorsalis superficialis in man 767 TABLE 1 macaque, Olszewski (1952) was forced to add a PRESENT HUMAN THALAMIC AND 'nucleus X' in this area. HYPOTHALAMIC NOMENCLATURE* The present system essentially follows that of Vogt and Vogt (1941) including a few of the many A pr N. anteroprincipalis (combined n. anteromedialis and n. modifications introduced by Hassler (1959). In the anteroventralis) authors' experience many of the smaller divisions of Ce N. centralis (n. centrum medianum) Co N. commissuralis (n. centralis medialis) Hassler did not hold up well in a considerable series D c N. dorsocaudalis (n. lateralis posterior) of serial section reconstructions of the human D o N. dorsooralis (n. ventralis lateralis, dorsal part) D sf N. dorsalis superficialis (n. lateralis dorsalis) thalamus. They thus appeared more as features of a Fa N. fasciculosus (n. ventralis anterior, medial part) particular specimen brain rather than the general G I Corpus geniculatum laterale human thalamus. The details and justification for G m Corpus geniculatum mediale H Habenula this system are given elsewhere (Van Buren and H m N.