INDIVIDUALIZED SULCAL AND GYRAL CORTICAL ANATOMY: A NEGLECTED CONCEPT?

<p>Future unavoidable development of individualized brain anatomy as a part of personalized medicine requires large databases from a vast number of individual brains. The simple descriptions, important in the clinic, demonstrated the wide morphological and morphometric variability of the sulci and gyri. Today, it is no longer enough, like in traditional anatomy, to simply describe one single, several, or even "all" sulcal/gyral variations in one region of the brain. Potential problems in the comprehensive analysis of their patterns with attempts to suggest further research are briefly reviewed. The medial hemispheric surface is suitable for a morphological pilot study of complete sulcal and gyral variability. Sulcal patterns should be presented in simplified linear form rather than as detailed images, and one useful simplification for analyzing gyral patterns, the essential gyral line, is described. Simultaneous investigation of gyri and sulci is recommended, but the problem is combinations of specific patterns in different percentages. Sophisticated algorithms could recognize cortical patterns and calculate their possible combinations. Anatomical terminology is an unavoidable component of these studies. Big data about variations of sulci and gyri would be useful in personalized medicine but also in genetic studies of potential laws and inheritance of their associations.</p>