A New Pathway for the Decussation of Corticospinal Tracts

Each brain hemisphere controls the movements of the opposite side of the body because the motor axons cross the midline, known as CST decussation. The current theory on CST decussation suggests CSTs decussate as a single tract at the junction between medulla and spinal cord. Although this theory is widely accepted, this theory is based on selective analyses and is therefore incomplete. Here, we employed new approaches, including the horizontal analyses and a non-invasive anterograde tracing method to examine CST decussation thoroughly. We analyzed all CS axons in 3 planes. These approaches led to the discovery of a new pathway for CST decussation. We found CSTs turned back to medulla, moving anteriorly and decussated in an oval structure. In this structure, each CST split into 4 fascicle groups and interdigitated with the corresponding groups from the opposite CST to cross the midline. The significance of this pathway was apparent after decussation where these 4 groups reversed direction, moving posteriorly toward spinal cord. While moving, the motor axons gradually separated at different locations and subsequently turned and occupied the correct positions in the dorsal funiculus for proper limb control. In addition to CSTs, we also characterized several components in the oval structure.