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Journal of Neurosurgical Sciences 2021 May 03

DOI: 10.23736/S0390-5616.21.05391-1


language: English

The inferior longitudinal fasciculus: anatomy, function and surgical considerations

Ilyess ZEMMOURA 1, 2 , Eléonor BURKHARDT 3, Guillaume HERBET 4, 5

1 UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; 2 CHRU de Tours, Neurosurgery Department, Tours, France; 3 Praxiling, CNRS UMR 5267, Paul Valéry Montpellier 3 University, Montpellier, France; 4 Institute of Functional Genomics, University of Montpellier, CNRS UMR5203, INSERM U1191, Montpellier, France; 5 Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France


The inferior longitudinal fasciculus (ILF) is a large association white matter tract that interconnects, in a bidirectional manner, the occipital cortex to anterior temporal structures. In view of both its pattern of cortical projections and its recently evidenced multilayered anatomical organization, the ILF has been supposed to be vital for maintaining a wide range of cognitive and affective processes operating on the visual modality. As tumors commonly damage the temporal cortex, an updated knowledge of the functional anatomy of this ventral tract is needed to better map and monitor online its potential functions and thus to improve surgical outcomes. In this review, we first describe the gross anatomy of the ILF, its array of cortical terminations and its different layers. We then provide a comprehensive review of the functions that have been assigned to the tract. We successively address its role in object and face recognition, visual emotion recognition, language and semantic, including reading, and memory. It is especially shown that the ILF is critically involved in visually-guided behaviors, as its breakdown, both in sudden neurosurgical and progressive neurodegenerative diseases, is commonly associated with visual-specific neuropsychological syndromes (e.g. prosopagnosia and pure alexia, and so on). In the last section, we discuss the extent to which the ILF can reorganize in response to glioma infiltration and to surgery, and provide some reflections on how its intra-operative mapping may be refined.

KEY WORDS: Inferior longitudinal fasciculus; Ventral pathway; Visual agnosia; Semantics; Reading; Emotion recognition; Lexical retrieval; Prosopagnosia; Low grade glioma; Awake surgery; Brain plasticity

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