CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0044-1796649
Original Article

White Matter Dissection: Lessons from the United Kingdom National Neuroanatomy Undergraduate Competition 2023

1   Wolfson School of Medicine, Universiy of Glasgow, University Avenue, Glasgow, United Kingdom
,
2   Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
,
Sytske Lub
1   Wolfson School of Medicine, Universiy of Glasgow, University Avenue, Glasgow, United Kingdom
,
Mohammad Ashraf
2   Department of Neurosurgery, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
,
Hassan Ismahel
3   BHF Cardiovascular Research Centre, University of Glasgow, Universiity Avenue, Glasgow, United Kingdom
,
Attika Chaudhary
1   Wolfson School of Medicine, Universiy of Glasgow, University Avenue, Glasgow, United Kingdom
,
Laulwa Nasser Al-Salloum
1   Wolfson School of Medicine, Universiy of Glasgow, University Avenue, Glasgow, United Kingdom
3   BHF Cardiovascular Research Centre, University of Glasgow, Universiity Avenue, Glasgow, United Kingdom
,
Scott Border
1   Wolfson School of Medicine, Universiy of Glasgow, University Avenue, Glasgow, United Kingdom
› Author Affiliations
Funding None.

Abstract

Objective This narrative highlights a student-led initiative that explored white matter dissection techniques within the framework of the National Undergraduate Neuroanatomy Competition 2023.

Materials and Methods The project aimed to enhance neuroanatomical education by developing a novel approach to dissection that deviates from the traditional Klingler’s method. Instead, it incorporated contemporary techniques, including diffusion tensor imaging and other radiological tools, to ensure greater anatomical precision and enrich the learning experience.

Results The dissections focused on key white matter structures, such as the uncinate fasciculus and the inferior longitudinal fasciculus, and outlined a step-by-step methodology for creating high-quality specimens. These specimens are designed to serve as educational resources, particularly for students with limited access to formal neuroanatomy courses.

Conclusion This study emphasizes the critical role of hands-on dissection in neuroanatomy education, showcasing its ability to enhance student engagement, deepen anatomical understanding, and inspire interest in clinical neuroscience careers. By introducing innovative educational tools and methodologies, this initiative makes a meaningful contribution to addressing the issue of “neurophobia” in medical education.

Note

All dissections and data collection were performed with the approval of the University of Glasgow School of Medical, Veterinary and Life Sciences Ethics Review Board.


Authors' Contributions

A.G. contributed to conceptualization, writing the original draft, dissection, data analysis, figure production, editing, and reviewing. E.G. contributed to conceptualization and editing. S.L. contributed to editing and reviewing. M.A. contributed to conceptualization, editing, and reviewing. H.I. contributed to editing and reviewing. A.C. contributed to editing and reviewing. L.N.A-S. contributed to editing and reviewing. S.B. contributed to editing and reviewing.


Supplementary Material



Publication History

Article published online:
02 December 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Jozefowicz RF. Neurophobia: the fear of neurology among medical students. Arch Neurol 1994; 51 (04) 328-329
  • 2 Han F, Zhang Y, Wang P, Wu D, Zhou L-X, Ni J. Neurophobia among medical students and resident trainees in a tertiary comprehensive hospital in China. BMC Med Educ 2023; 23 (01) 824
  • 3 Jukna Š, Puteikis K, Mameniškienė R. Perception of neurology among undergraduate medical students: what can be done to counter neurophobia during clinical studies?. BMC Med Educ 2023; 23 (01) 447
  • 4 Shiels L, Majmundar P, Zywot A, Sobotka J, Lau CSM, Jalonen TO. Medical student attitudes and educational interventions to prevent neurophobia: a longitudinal study. BMC Med Educ 2017; 17 (01) 225
  • 5 Youssef FF. Neurophobia and its implications: evidence from a Caribbean medical school. BMC Med Educ 2009; 9: 39
  • 6 Schon F, Hart P, Fernandez C. Is clinical neurology really so difficult?. J Neurol Neurosurg Psychiatry 2002; 72 (05) 557-559
  • 7 Feigin VL, Nichols E, Alam T. et al; GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18 (05) 459-480
  • 8 Hill CS, Dias L, Kitchen N. Perceptions of neurosurgery: a survey of medical students and foundation doctors. Br J Neurosurg 2011; 25 (02) 261-267
  • 9 McBride JM, Drake RL. National survey on anatomical sciences in medical education. Anat Sci Educ 2018; 11 (01) 7-14
  • 10 Neal MT, Lyons MK. Empowering qualities and skills for leaders in neurosurgery. Surg Neurol Int 2021; 12: 9
  • 11 Arantes M, Arantes J, Ferreira MA. Tools and resources for neuroanatomy education: a systematic review. BMC Med Educ 2018; 18 (01) 94
  • 12 Elnady FA. Innovative, simple models for teaching neuroanatomy using the Elnady technique. J Vet Med Educ 2019; 46 (02) 214-217
  • 13 López-Ojeda W, Hurley RA. Digital innovation in neuroanatomy: three-dimensional (3D) image processing and printing for medical curricula and health care. J Neuropsychiatry Clin Neurosci 2023; 35 (03) 206-209
  • 14 Hlavac RJ, Klaus R, Betts K, Smith SM, Stabio ME. Novel dissection of the central nervous system to bridge gross anatomy and neuroscience for an integrated medical curriculum. Anat Sci Educ 2018; 11 (02) 185-195
  • 15 Rae G, Cork RJ, Karpinski A, Farris H, Swartz W. Using the brains we have: dissection of the human brain assists the medical student in learning and retaining neuroanatomy. FASEB J 2015; 29: 565-574
  • 16 La Rocca G, Mazzucchi E, Pignotti F, Galieri G, Rinaldi P, Sabatino G. Advanced dissection lab for neuroanatomy training. Front Neuroanat 2022; 15: 778122
  • 17 Shell K, Holt E, Kington A. et al. Motivation to learn neuroanatomy by cadaveric dissection is correlated with academic performance. Clin Anat 2020; 33 (01) 128-135
  • 18 Smith CF, Freeman SK, Heylings D, Finn GM, Davies DC. Anatomy education for medical students in the United Kingdom and Republic of Ireland in 2019: a 20-year follow-up. Anat Sci Educ 2022; 15 (06) 993-1006
  • 19 Merzougui WH, Myers MA, Hall S. et al. Multiple-choice versus open-ended questions in advanced clinical neuroanatomy: using a national neuroanatomy assessment to investigate variability in performance using different question types. Anat Sci Educ 2021; 14 (03) 296-305
  • 20 Moxham B, McHanwell S, Plaisant O, Pais D. A core syllabus for the teaching of neuroanatomy to medical students. Clin Anat 2015; 28 (06) 706-716
  • 21 Silva SM, Andrade JP. Neuroanatomy: the added value of the Klingler method. Ann Anat 2016; 208: 187-193
  • 22 Agrawal A, Kapfhammer JP, Kress A. et al. Josef Klingler's models of white matter tracts: influences on neuroanatomy, neurosurgery, and neuroimaging. Neurosurgery 2011; 69 (02) 238-252 , discussion 252–254
  • 23 Dziedzic TA, Balasa A, Jeżewski MP, Michałowski Ł, Marchel A. White matter dissection with the Klingler technique: a literature review. Brain Struct Funct 2021; 226 (01) 13-47
  • 24 Matthias AT, Nagasingha P, Ranasinghe P, Gunatilake SB. Neurophobia among medical students and non-specialist doctors in Sri Lanka. BMC Med Educ 2013; 13: 164
  • 25 Pierpaoli C, Jezzard P, Basser PJ, Barnett A, Di Chiro G. Diffusion tensor MR imaging of the human brain. Radiology 1996; 201 (03) 637-648
  • 26 Borrelli M, Leung B, Morgan M, Saxena S, Hunter A. Should drawing be incorporated into the teaching of anatomy?. J Contemp Med Educ 2018; 6 (02) 34-48
  • 27 Papez JW. A proposed mechanism of emotion. Arch Neurol Psychiatry 1937; 38: 725
  • 28 Ferreira Jr TA, Middlebrooks EH, Tzu WH, Neto MR, Holanda VM. Postmortem dissections of the Papez circuit and nonmotor targets for functional neurosurgery. World Neurosurg 2020; 144: e866-e875
  • 29 Weininger J, Roman E, Tierney P. et al. Papez's forgotten tract: 80 years of unreconciled findings concerning the thalamocingulate tract. Front Neuroanat 2019; 13: 14
  • 30 Chowdhury F, Haque M, Sarkar M, Ara S, Islam M. White fiber dissection of brain; the internal capsule: a cadaveric study. Turk Neurosurg 2010; 20 (03) 314-322
  • 31 Catani M, Howard RJ, Pajevic S, Jones DK. Virtual in vivo interactive dissection of white matter fasciculi in the human brain. Neuroimage 2002; 17 (01) 77-94
  • 32 Guevara P. Inference of a Human Brain Fiber Bundle Atlas from High Angular Resolution Diffusion Imaging [dissertation]. Paris: University of Paris-Sud; 2011
  • 33 Rodríguez-Mena R, Piquer-Belloch J, Llácer-Ortega JL, Riesgo-Suárez P, Rovira-Lillo V. 3D microsurgical anatomy of the cortico-spinal tract and lemniscal pathway based on fiber microdissection and demonstration with tractography. Neurocirugia (Astur Engl Ed) 2018; 29 (06) 275-295
  • 34 Bozkurt B, Yagmurlu K, Middlebrooks EH. et al. Fiber connections of the supplementary motor area revisited: methodology of fiber dissection, DTI, and three dimensional documentation. J Vis Exp 2017; 123: 55681
  • 35 Gray H. Anatomy of the Human Body. Philadelphia, PA: Lea & Febiger; 1918
  • 36 Hau J, Sarubbo S, Houde JC. et al. Revisiting the human uncinate fasciculus, its subcomponents and asymmetries with stem-based tractography and microdissection validation. Brain Struct Funct 2017; 222 (04) 1645-1662
  • 37 Von Der Heide RJ, Skipper LM, Klobusicky E, Olson IR. Dissecting the uncinate fasciculus: disorders, controversies and a hypothesis. Brain 2013; 136 (Pt 6): 1692-1707
  • 38 Herbet G, Zemmoura I, Duffau H. Functional anatomy of the inferior longitudinal fasciculus: from historical reports to current hypotheses. Front Neuroanat 2018; 12: 77
  • 39 Latini F, Mårtensson J, Larsson E-M. et al. Segmentation of the inferior longitudinal fasciculus in the human brain: a white matter dissection and diffusion tensor tractography study. Brain Res 2017; 1675: 102-115