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Neurology 1999;53:1260
© 1999 American Academy of Neurology


Articles

Structural and functional brain asymmetries in human situs inversus totalis

D. N. Kennedy, PhD, K. M. O’Craven, PhD, B. S. Ticho, MD, A. M. Goldstein, MD, N. Makris, MD, PhD and J. W. Henson, MD

From the Center for Morphometric Analysis (Drs. Kennedy and Makris), Neuroscience Center (Drs. Kennedy, Makris, and Henson), NMR Center (Dr. O’Craven), Cardiovascular Research Center (Drs. Ticho and Goldstein), and Departments of Pediatrics (Dr. Ticho) and Surgery (Dr. Goldstein), Massachusetts General Hospital; and Harvard Medical School (Drs. Kennedy, O’Craven, Ticho, Makris, and Henson), Boston, MA.

Address correspondence and reprint requests to Dr. John W. Henson and Dr. David N. Kennedy, Center for Morphometric Analysis, Massachusetts General Hospital-East, 149 13th Street, Charlestown, MA 02129.

OBJECTIVE: To determine whether individuals with situs inversus totalis (SI), a condition in which there is a mirror-image reversal of asymmetric visceral organs, have alterations in brain asymmetries.

BACKGROUND: The human brain is asymmetric in structure and function. Although correlations between anatomic asymmetries and functional lateralization in human brain have been demonstrated, it has been difficult to further analyze them. Characterization of asymmetries of brain structure and function in SI might advance the understanding of these relationships.

METHODS: Using anatomic and functional MRI techniques, we analyzed asymmetries in the brains of three individuals with SI.

RESULTS: Two major anatomic asymmetries of the cerebral hemispheres, the frontal and occipital petalia, were reversed in individuals with SI. In contrast, SI subjects had left cerebral hemisphere language dominance on functional MRI analysis as well as strong right-handedness.

CONCLUSION: These observations suggest that the developmental factors determining anatomic asymmetry of the cerebral petalia and viscera are distinct from those producing the functional lateralization of language.

Key words: Situs inversus totalis—Cerebral lateralization—Asymmetry—Functional MRI—Language lateralization.




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