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IJCRR - 8(23), December, 2016

Pages: 21-25

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CEREBRAL ASYMMETRY: A CADAVERIC STUDY

Author: Archana Rani, Rakesh Kumar Verma, Arvind Kumar Pankaj, Rakesh Kumar Diwan, Anita Rani, Deepshikha Kori

Category: Healthcare

Abstract:Objectives: Anatomical brain asymmetries in cadaveric human brains are not well defined in the literature. Therefore, the present study was undertaken to observe the variations in right and left cerebral hemispheres using various parameters. Methods: Twenty eight adult human brains irrespective of sex were taken for the present study. Various measurements of cerebral hemisphere including fronto-occipital length, cerebral width, Sylvian fissure length and distance between anterior Sylvian point to inferior Rolandic point were taken. These measurements were taken by Vernier calipers. Different configuration of the anterior ascending and anterior horizontal ramus of the Sylvian fissure were also examined as U-shaped, V-shaped and Y-shaped. The presence or absence of triangular sulcus located within pars triangularis was also observed.
Results: The fronto-occipital length was longer on right side while the cerebral width and Sylvian fissure length were more on left side. These values were significant statistically. The configuration of the anterior ascending and anterior horizontal ramus of the Sylvian fissure was V-shaped in maximum number of hemispheres followed by U-shaped. The triangular sulcus was noted in thirty hemispheres i.e. 16 right and 14 left.

Conclusions: Hemispheres of the brain are not identical and functional asymmetries have an underlying anatomical basis.

Keywords: Cerebrum, Morphometry, Sylvian fissure, Triangular sulcus

Full Text:

INTRODUCTION
Anatomical brain asymmetries are understated and still little studied in humans. The Sylvian fissure (SF) has long been shown to be an important indicator of the leftward cerebral asymmetry present in human language reception regions. The language ability and handedness are localized on the left side.

The two human cerebral hemispheres are not simply mirror image of each-other. Brain asymmetry has been observed in animals and humans in terms of structure, function and behavior. The evidence of lateralization was first provided in 1861, by Broca who described a case of expressive aphasia resulting from an infarction of the left posterior inferior frontal lobe, which became to be known as Broca’s area. The later discovery of Wernicke’s area in the left posterior temporal and inferior parietal lobes also provided unequivocal evidence of another lateralized function and demonstrated an asymmetry for language comprehension as well as for speech production. Association of language impairment with left hemisphere lesions led to the more general concept of a dominant left hemisphere and a minor right hemisphere.1

Speech and language are one of the most lateralized of all cerebral functions.2 Their cortical areas are also some of the most asymmetrical in the brain.3 These areas are located within pars opercularis and pars triangularis in the frontal lobe. They are bounded anatomically by the anterior horizontal and anterior ascending ramus of the SF. Sylvian fissure is a most commonly used landmark for neurosurgical interventions. The triangular sulcus, also known as the incisura capitis, separates the pars triangularis into an anterior and a posterior part.4

The present study was undertaken to note the morphometry, asymmetry and variations of the right and left cerebrum and SF using various parameters.

MATERIAL AND METHODS
28 adult human brains with no gross deformity preserved in formalin irrespective of sexes were obtained from the Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. The various measurements including fronto-occipital (FO) length, cerebral width, Sylvian fissure (SF) length and distance from anterior Sylvian point (ASP) to inferior Rolandic point (IRP) were taken. The sulcus (if present) located within the pars triangularis (PT) and pars opercularis (PO) was also evaluated. Identification of various sulci and gyri was done according to standard anatomy books. Confirmation was further strengthened by consensus of two authors. A tag with a specific number was attached to each specimen to avoid intermingling of brains.

Measurements were done by Vernier calipers. The fronto-occipital length was the maximum distance between the frontal and occipital poles measured from the inferior aspect of cerebrum (Figure 1). On superolateral surface of cerebral hemisphere, the lowermost point of central sulcus (Rolandic sulcus) which intersects with SF was referred as inferior Rolandic point (IRP). Lateral sulcus (Sylvian fissure) length was measured on the superolateral surface from anterior Sylvian point (ASP) i.e. most anterior point of SF where it divides into three rami (anterior horizontal, anterior ascending and posterior) to posterior Sylvian point (PSP) i.e. where the SF separates into ascending and descending posterior ramus (Figure 2). Width of cerebrum was measured by putting the two arms of Vernier calipers at the superomedial and inferolateral borders respectively at the level of IRP in midline. ASP to IRP distance and presence of the triangular sulcus (if present) located within the PT was also evaluated (Figure 3). Various pattern of division at ASP into anterior horizontal ramus (AHR) and anterior ascending ramus (AAR) of the Sylvian fissure as U, V and Y-shaped was also noted and analyzed (Figure 4).

Statistical Analysis was done using Statistical Package for Social Sciences (SPSS), version 15.0. Continuous data was compared using paired‘t’-test. Categorical data was compared using chi-square test. A 'p' value less than 0.05 (<0.05) indicated a statistically significant difference.

RESULTS
Mean fronto-occipital length of right side (19.62 cm) was significantly greater than left side (18.83 cm). Mean cerebral width was significantly greater on left side (13.04 cm) as compared to right side (12.51 cm). Mean Sylvian fissure length of left side (6.43 cm) was more than that of right side (5.64 cm) and was statistically significant. Distance between anterior Sylvian point and inferior Rolandic point was greater on left side (3.36 cm) than right side (3.28 cm) but not significant. Triangular sulcus was present in 30 hemispheres (16 right and 14 left) out of 52 (26 right and 26 left). It was not well appreciated in one brain on right side, one brain on left side and bilaterally in one brain. It was noted more on right side (61.5%) as compared to left (53.8compared using chi-square test. A 'p' value less than 0.05). Out of 50 hemispheres (25 right and 25 left), V-shaped configuration of anterior ascending and anterior horizontal ramus was present in highest number of hemispheres i.e. 52% on right and 48% on left side followed by U and Y shaped. The various patterns of shapes were not properly demarcated bilaterally in two brains and unilaterally right and unilaterally left in one brain each (Table 1).

Table 1: Comparison of different parameters between right and left cerebral hemispheres

Parameters

Right (n=28)

Left (n=28)

t'

p'

Mean

SD

Mean

SD

Fronto-occipital length (cm)

19.62

1.92

18.83

1.79

4.191

<0.001*

Cerebral width (cm)

12.51

1.22

13.04

1.52

-3.583

0.001*

Sylvian fissure length (cm)

5.64

0.99

6.43

1.26

-5.147

<0.001*

ASP-IRP distance (cm)

3.28

0.86

3.36

0.94

-0.508

0.616

Presence of Triangular sulcus

16/26 (61.5%)

14/26 (53.8%)

c2=0.315; p=0.575

Various configuration of AAR / AHR of SF

Right (n=25)

Left (n=25)

 

U-shaped

10 (40%)

7 (28%)

c2=2.57; p=0.277

V-shaped

13 (52%)

12 (48%)

Y-shaped

2 (8%)

6 (24%)

p value<0.05* is highly significant

DISCUSSION
The gross anatomy and functional layout of the brain are organized asymmetrically, with hemispheric specializations for key aspects of language and motor function. These asymmetries are first observed around 29-31 weeks gestation. Various developmental programmes structure the two hemispheres well into childhood and beyond, leading to lateralized differences in maturational rates, dendritic arborization, metabolism, and functional activation.5 In humans, inbreeding (Markow and Martin, 1993)6, poor health conditions, and various neurological disorders, such as schizophrenia, attention deficit disorder, developmental delays in childhood and Down syndrome are positively associated with fluctuating asymmetries.7-11 Asymmetric areas have been reported to have less interhemispheric connections.12

The lateral sulcus (also called Sylvian fissure or lateral fissure) is one of the most prominent structures of the human brain. It begins on the inferior aspect of the cerebral hemisphere and runs laterally to reach the superolateral surface. There it divides into three rami i.e. anterior, ascending and posterior. The anterior and ascending rami are short and run into the frontal lobe while the posterior ramus begins near the temporal pole and runs backwards and slightly upwards. Its posterior most part curves sharply upwards. The sulcus divides both the frontal lobe and parietal lobe above from the temporal lobe below. It is present in both hemispheres of the brain but is longer in the left hemisphere in most people. It is one of the earliest-developing sulci of the human brain. It first appears around the fourteenth gestational week.13

Eberstaller (1890) reported that the posterior horizontal ramus of the left lateral fissure was longer than the right in 63% of a large series of adult brains. The difference averaged 0.64 cm.14 This asymmetry was confirmed by Cunningham (1892) who also pointed out that the right lateral fissure (the posterior horizontal portion) courses posteriorly at a slightly greater upward angle than the left with a mean difference of 4 degrees.15 Rubens et al. (1976) noted a characteristic pattern of divergence of posterior regions of the lateral fissures in 25 of 36 adult brains. He found that after pursuing similar courses, the right lateral fissure angulated sharply upward into the inferior parietal area while the left one continued posteriorly.16 Sylvian fissure was significantly longer on the left side as compared to right in our study. In a study done by Boni et al. (2007) on 42 postmortem adult brains, the lateral sulcus in the right hemisphere had a median of65.11mm and in left hemisphere 79.94mm (16.6% higher in left hemisphere).17 The left SF was significantly longer than the right and both were positively correlated in various other studies.18-20 Ono et al. (1990) detected the absence of anterior ascending rami in 86.66% (13/15) of the right hemispheres and in 93.33% of the (14/15) left hemispheres.21 In our study and the study conducted on 62 hemispheres by Idowu et al.(2014),19 the anterior ascending ramus was present in all the hemispheres. The anterior horizontal and anterior ascending rami of the SF had three major configurations. In a study done by Idowu et al. (2014), the U and V-shaped configuration of branching of anterior ascending and anterior horizontal ramus was seen in 70% According to him, the anterior ascending and anterior horizontal rami of the SF was U-shaped in 37.1% (23/62), V-shaped in 32.3% (20/62) and Y-shaped in 30.65% (19/62) hemispheres.19  Chakrabarti and Vijayalakshmi (2015) also found the U-shaped configuration in maximum number of specimens.20 While in the present study, maximum hemispheres 50% (25/50) depicted V-shaped configuration followed by U-shaped 34% (17/50) and Y-shaped 16% (8/50). In six hemispheres, the shape could not be appreciated well. Ayberk et al. (2012) observed Y-shaped configuration in 39.3% (11/28) and 28.6% (8/28) each with V-shaped and U-shaped configuration which is again contradictory to the findings of our study.22 He noted the triangularis sulcus in 49 hemispheres (79%) i.e. 26 right and 23 left side while we observed it in 30 hemispheres (57.69%) i.e. 16 right and 14 left side. Fronto-occipital length of right side was significantly greater on right side (19.62 cm) than left (18.83 cm) in our study. Cerebral width of left side was significantly greater on left side (13.04 cm) as compared to right (12.51 cm) in the present study. While Idowu et al (2014) found the mean value of FO length to be similar on both sides and the mean value of cerebral width to be 6.71 cm and 6.99 cm respectively on right and left side.19 ASP-IRP distance was more on left side but the values was not significant in the present study. This finding is in concordance with the study of Idowu et al. (2014).19

Anatomical asymmetries may help to explain the range of human talents, recovery from acquired disorders of language function, certain childhood learning disabilities, and some dementing illnesses of middle life (Galaburda et al., 1978).23

The surgeon’s knowledge of the structure and a better appreciation of the range of their variation in the human brain, is vital to interpret functional imaging studies and during intra-operative dissection.24,25

CONCLUSION
Significant difference in fronto-occipital length, cerebral width and Sylvian fissure length indicates that the two brain hemispheres differ structurally and it can be speculated that some morphological asymmetries could be related to other functional hemispheric specialization. To correlate this anatomical asymmetry with the functional aspects, further studies are required.

ACKNOWLEDGEMENTS
I express my gratitude to the staff of the Department of Anatomy for assistance in providing infrastructure facilities and necessary help. Authors are indebted to the residents of the Department especially Dr. Aruna Arya who have helped in measuring the various parameters used in the present study.

Authors acknowledge the immense help received from the scholars whose articles are cited and included in references of this manuscript. The authors are also grateful to authors / editors / publishers of all those articles, journals and books from where the literature for this article has been reviewed and discussed.

Source of Funding: Nil

Conflict of interest: All authors have none to declare.

ABBREVIATIONS USED: SF- Sylvian fissure, PO- Pars opercularis, PO- Pars triangularis, FO- Fronto-occipital, ASP- Anterior Sylvian point, PSP- Posterior Sylvian point, IRP- Inferior Rolandic point, SPSS- Statistical Package for Social Sciences, AHR- Anterior horizontal ramus, AAR- Anterior ascending ramus

References:

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2. Knaus TA, Corey DM, Bollich AM, Lemen LC, Foundas AL. Anatomical asymmetries of anterior perisylvian speech-language regions. Cortex. 2007;43:499–510.

3. Greve DN, Van der Haegen L, Cai Q, Stuffle beam S, Sabuncu MR, Fischl B, et al. A surface-based analysis of language lateralization and cortical asymmetry. J Cogn Neurosci. 2013;25:1477– 92.

4. Petrides M. Neuroanatomy of Language Regions of the Human Brain. 1sted, In: Morphological features of the core language regions: The Sulci and Gyri. Amsterdam, Boston: Elsevier, 2013: 21-22.

5. Toga AW, Thompson PM. Mapping Brain Asymmetry. Nat. Rev. Neurosci. 2003; 4: 37.

6. Markow TA, Martin JF. Inbreeding and developmental stability in a small human-population. Annals of Human Biology. 1993; 20: 389-94.

7. Mellor C. Dermatoglyphic evidence of fluctuating asymmetry in schizophrenia. Br Jpsychiatry. 1992;160: 467–72.

8. Burton C, Stevenson JC, Williams DC, Everson PM, Mahoney ER. Attention DeficitDisorder (ADD) and fluctuating asymmetry (FA) in a college sample. Am. J. Hum. Biol. 2002; 14: 7.

9. Burton C, Stevenson JC, Williams DC, Everson PM, Mahoney ER, Trimble JE. Attention deficit hyperactivity disorder (AD/ HD) and fluctuating asymmetry in a college sample: An exploratory study. Am. J. Hum. Biol. 2003; 15: 601–19.

10. Naugler CT, Ludman MD. Fluctuating asymmetry and disorders of developmental origins. Am. J. Med. Genet. 1996; 66: 15–20.

11. Barden HS. Fluctuating dental asymmetry: A measure of developmental instability in Down syndrome. Am. J. Phys. Anthropol. 1980; 52: 169–73.

12. Galaburda AM, Rosen GD, Sherman GF. Individual variability in cortical organization: its relationship to brain laterality and implications to function. Neuropsychologia. 1990; 28: 529– 46.

13. Chi JG, Dooling EC, Gilles FH. Gyral development of the human brain. Annals of Neurology. 1977; 1 (1): 86-93.

14. Eberstaller O, Das Stimhim. Ein Beitragzur Anatomie der oberflache des Gehirns. Urban and Schwarzenberg, Vienna, Austria, 1890.

15. Cunningham DJ. Contribution to the surface anatomy of the cerebral hemispheres. Dublin, Royal Irish Academy, 1892.

16. Rubens AB, Mahowald MW, Hutton JT. Asymmetry of the lateral (sylvian) fissures in man. Neurology. 1976; 26: 620-24.

17. Boni RC, Prodoscimi FC, Bonsi AB, Almeida TM, Ribeiro LAM. Asymmetries ofthe left and right temporal lobes. Int. J. Morphol. 2007; 25(1):117-20.

18. Foundas AL, Faulhaber JR, Kulynych JJ, Browning CA, Weinberger DR. Hemispheric and sex-linked differences in Sylvian fissure morphology: a quantitative approach using volumetric magnetic resonance imaging. Neuropsychiatry Neuropsychol Behav Neurol. 1999; 12 (1):1–10.

19. Idowu OE, Soyemi S, Atobatele K. Morphometry, asymmetry and variations of the Sylvian fissure and sulci bordering and within the pars triangularis and pars opercularis: An autopsy study. J Clin Diagn Res 2014;8(11): AC11-AC14.

20. Chakrabarti S, Vijayalakshmi S. Interhemispheric variation of Sylvian fissure: A Cadaveric brain study. Int J Anat Res. 2015;3(2):1143-48.

21. Ono M, Kubik S, Abernathy CD. Atlas of the cerebral sulci. New York: Georg Thieme Verlag. 1990; 62-74.

22. Ayberk G, Yagli OE, Comert A, Esmer AF, Canturk N, Tekdemir I, et al. Anatomic relationship between the anterior sylvian point and the pars triangularis. Clin. Anat. 2012;25:429–36.

23. Galaburda AM, LeMay M, Kemper TL, Geschwind N. Rightleft asymmetrics in the brain.Science.1978; 199(4331): 852-6.

24. Rumeau C, Tzourio N, Murayama N, Peretti-Viton P, Levrier O, Joliot M, et al. Location of hand function in the sensorimotor cortex: MR and functional correlation. Am J Neuroradiol. 1994; 15:567–72.

25. Sanes JN, Donoghue JP, Thangaraj V, Edelman RR, Warach S. Shared neural substrates controlling hand movements in human motor cortex. Science. 1995; 268:1775–77.

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A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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