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Probabilistic mapping and automated segmentation of human brainstem white matter bundles.

February 10, 2026pubmed logopapers

Authors

Olchanyi MD,Schreier DR,Li J,Maffei C,Sorby-Adams A,Kinney HC,Healy BC,Freeman HJ,Shless J,Destrieux C,Tregidgo H,Iglesias JE,Brown EN,Edlow BL

Affiliations (13)

  • Neuroscience Statistics Research Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139.
  • Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114.
  • Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02142.
  • Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.
  • Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129.
  • Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.
  • Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115.
  • Department of Biostatistics, T.H Chan School of Public Health, Harvard University, Boston, MA 02115.
  • Imaging Brain and Neuropsychiatry iBraiN U1253, Université de Tours, INSERM, Tours 37032, France.
  • Centre Hospitalier Régional Universitaire de Tours, Tours 37044, France.
  • Hawkes Institute, University College London, London WC1V 6LJ, United Kingdom.
  • Computer Science and AI Laboratory, Massachusetts Institute of Technology, Cambridge, MA 02139.
  • The Picower Institute for Learning and Memory, Department of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, MA 02139.

Abstract

Brainstem white matter (WM) bundles are essential conduits for neural signals that modulate homeostasis and consciousness. Their architecture forms the anatomic basis for brainstem connectomics, subcortical circuit models, and deep brain navigation tools. However, their small size and complex morphology, compared to cerebral WM, makes mapping and segmentation challenging in neuroimaging. As a result, fundamental questions about brainstem modulation of human homeostasis and consciousness remain unanswered. We leverage diffusion MRI tractography to create BrainStem Bundle Tool (BSBT), which automatically segments eight WM bundles in the rostral brainstem. BSBT performs segmentation on a custom probabilistic fiber map using a convolutional neural network architecture tailored to detect small anatomic structures. We demonstrate BSBT's robustness across diffusion MRI acquisition protocols with in vivo scans of healthy subjects and ex vivo scans of human brain specimens with corresponding histology. BSBT also detected distinct brainstem bundle alterations in patients with Alzheimer's disease, Parkinson's disease, multiple sclerosis, and traumatic brain injury through tract-based analysis and classification tasks. Finally, we provide proof-of-principle evidence for the prognostic utility of BSBT in a longitudinal analysis of traumatic coma recovery. BSBT creates opportunities for scalable mapping of brainstem WM bundles and investigation of their role in a broad spectrum of neurological disorders.

Topics

White MatterBrain StemBrain MappingJournal Article

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