The spatial extent of anatomical connections within the thalamus varies across the cortical hierarchy in humans and macaques

Reviewer #1 (Public Review):

Summary:
The thalamus is a central subcortical structure that receives anatomical connections from various cortical areas, each displaying a unique pattern. Previous studies have suggested that certain cortical areas may establish more extensive connections within the thalamus, influencing distributed information flow. Despite these suggestions, a quantitative understanding of cortical areas' anatomical connectivity patterns within the thalamus is lacking. In this study, the researchers addressed this gap by employing diffusion magnetic resonance imaging (dMRI) on a large cohort of healthy adults from the Human Connectome Project. Using brain-wide probabilistic tractography, a framework was developed to measure the spatial extent of anatomical connections within the thalamus for each cortical area. Additionally, the researchers integrated resting-state functional MRI, cortical myelin, and human neural gene expression data to investigate potential variations in anatomical connections along the cortical hierarchy. The results unveiled two distinct cortico-thalamic tractography motifs: 1) a sensorimotor cortical motif featuring focused thalamic connections to the posterolateral thalamus, facilitating fast, feed-forward information flow; and 2) an associative cortical motif characterized by diffuse thalamic connections targeting the anteromedial thalamus, associated with slower, feed-back information flow. These motifs exhibited consistency across human subjects and were corroborated in macaques, underscoring cross-species generalizability. In summary, the study illuminates differences in the spatial extent of anatomical connections within the thalamus for sensorimotor and association cortical areas, potentially contributing to functionally distinct cortico-thalamic information flow.

Strengths:
* Quantitative Approach: The study employs diffusion magnetic resonance imaging (dMRI) and probabilistic tractography on a substantial sample size of 828 healthy adults, providing a robust quantitative analysis of anatomical connectivity patterns within the thalamus.

* Multi-Modal Integration: By incorporating resting-state functional MRI, cortical myelin, and human neural gene expression data, the study offers a comprehensive approach to understanding anatomical connections, enriching the interpretation of findings and enhancing the study's overall validity.

* Cross-Species Generalizability: The identification of consistent cortico-thalamic tractography motifs in both human subjects and macaques demonstrates the robustness and cross-species generalizability of the findings, strengthening the significance and broader applicability of the study.

* Supplementary Analyses: There are numerous, excellent examples of clear surrogates used to test the major claims of the paper. This is exemplary work.

Weaknesses:
* Indirect Estimates of White Matter Connections: While dMRI is a valuable tool, it inherently provides indirect and inferred information about neural pathways. The accuracy and specificity of tractography can be influenced by various factors, including fiber crossing, partial volume effects, and algorithmic assumptions. A potential limitation in the accuracy of indirect estimates might affect the precision of spatial extent measurements, introducing uncertainty in the interpretation of cortico-thalamic connectivity patterns. Addressing the methodological limitations associated with indirect estimates and considering complementary approaches could strengthen the overall robustness of the findings.

Reviewer #2 (Public Review):

Summary:
This paper by Howell and colleagues focuses on describing macro patterns of anatomical connections between cortical areas and the thalamus in the human brain. This research topic poses significant challenges due to the inability to apply the gold standard of mapping anatomical connections, and viral tracing, to humans. Moreover, when applied to animal models, viral tracing often has limited scope and resolution. As a result, the field has thus far lacked a comprehensive and validated description of thalamocortical anatomical connectivity in humans.

The paper focuses on an intriguing question: whether anatomical connections from the cortex to the thalamus exhibit a diffuse pattern, targeting multiple thalamic sub-regions, or a more focal pattern, selectively targeting specific thalamic subregions. This novel and significant question holds substantial implications for our understanding of thalamocortical information processing. The authors have developed a sophisticated and innovative quantitative metric to address this question. The study revealed two main patterns: a focal pattern originating from sensorimotor cortical regions to the posterior thalamus and a more diffuse pattern from associative cortical regions to the anterior-medial thalamus. These findings are then framed within the context of thalamocortical motifs involved in feedforward versus feedback processing.

While this paper has several strengths, including its significance and methodological sophistication, its extension to non-human primates, and other forms of data for testing hierarchy, there are important limitations. These limitations, discussed in more detail below, primarily concern tracking accuracy and the known limitations of using diffusion data to track thalamocortical connections in humans. These limitations may potentially introduce systematic biases into the results, weakening their support. Addressing these limitations through better validation is crucial, though some may remain unresolved due to the fundamental constraints of diffusion imaging.

Strengths:
This research holds significant basic, clinical, and translational importance as it contributes to our understanding of how thalamocortical anatomical connectivity is organized. Its relevance spans cognitive, systems, and clinical neuroscientists in various subfields.

The central question addressed in this study, concerning whether cortico-thalamic projections are focal or diffuse, is both novel and previously unexplored to the best of my knowledge. It offers valuable insights into the potential capabilities of the thalamocortical system in terms of parallel or integrative processing.

The development of quantitative metrics to analyze anatomical connectivity is highly innovative and suitable for addressing the research questions at hand.

The findings are not only interesting but also robust, aligning with data from other sources that suggest a hierarchical organization in the brain.

Using PCA to integrate results across a range of thresholds is innovative.

The study's sophisticated integration of a diverse range of data and methods provides strong, converging support for its main findings, enhancing the overall credibility of the research.

Weaknesses:
Structural thalamocortical connectivity was estimated from diffusion imaging data obtained from the HCP dataset. Consequently, the robustness and accuracy of the results depend on the suitability of this data for such a purpose. Conducting tractography on the cortical-thalamic system is recognized as a challenging endeavor for several reasons. First, diffusion directions lose their clearly defined principal orientations once they reach the deep thalamic nuclei, rendering the tracking of structures on the medial side, such as the medial dorsal (MD) and pulvinar nuclei difficult. Somewhat concerning is those are regions that authors found to show diffuse connectivity patterns. Second, the thalamic radiata diverge into several directions, and routes to the lateral surface often lack the clarity necessary for successful tracking. It is unclear if all cortical regions have similar levels of accuracy, and some of the lateral associative regions might have less accurate tracking, making them appear to be more diffuse, biasing the results.

While the methodology employed by the authors appears to be state-of-the-art, there exists uncertainty regarding its appropriateness for validation, given the well-documented issues of false positives and false negatives in probabilistic diffusion tractography, as discussed by Thomas et al. 2014 PNAS. Although replicating the results in both humans and non-human primates strengthens the study, a more compelling validation approach would involve demonstrating the method's ability to accurately trace known tracts from established tracing studies or, even better, employing phantom track data. Many of the control analyses the authors presented, such as track density, do not speak to accuracy.

Because the authors included data from all thresholds, it seems likely that false positive tracks were included in the results. The methodology described seems to unavoidably include anatomically implausible pathways in the spatial extent analyses.

If tracking the medial thalamus is indeed less accurate, characterized by higher false positives and false negatives, it could potentially lead to increased variability among individual subjects. In cases where results are averaged across subjects, as the authors have apparently done, this could inadvertently contribute to the emergence of the "diffuse" motif, as described in the context of the associative cortex. This presents a critical issue that requires a more thorough control analysis and validation process to ensure that the main results are not artifacts resulting from limitations in tractography.

The thresholding approach taken in the manuscript aimed to control for inter-areal differences in anatomical connection strength that could confound the ED estimates. Here I am not quite clear why inter-areal differences in anatomical connection strength have to be controlled. A global threshold applied on all thalamic voxels might kill some connections that are weak but do exist. Those weak pathways are less likely to survive at high thresholds. In the meantime, the mean ED is weighted, with more conservative thresholds having higher weights. That being said, isn't it possible that more robust pathways might contribute more to the mean ED than weaker pathways?

Reviewer #3 (Public Review):

Summary:
In the current work, Howell et al studied the connectivity between the cortex and thalamus using DTI tractorgraphy per parcel to all voxels in the thalamus. Following they performed various dimensional reduction techniques to uncover how differences in connectivity to the thalamus vary across cortical parcels. Following they explore the spatial correlation of these variations with cortical myelin and functional organization, thalamic nuclei, gene expression derived core-matrix cell differentiation, and extend the model towards macaques. Overall, the authors find a differentiation between sensory and association areas in terms of the association with the thalamus, which reflects differences in cortical microstructure and function, and links to core-matrix differences and can be replicated in macaques.

Strengths:
A clear strength of the current work is the combination of different models and approaches to study the link between the cortex and the thalamus. This approach nicely bridges different approaches to describe the role of the thalamus in cortical organisation using a diffusion-based approach. Especially the extension of the model to the macaque is quite nice.

Weaknesses:
Potential weaknesses of the study are that it seems to largely integrate aspects of the thalamus that have been already described before. The differentiation between sensory and association systems across thalamic subregions is something that has been described before (see: Oldham and Ball, 2023; Zheng et al., 2023; Yang et al., 2020 Mueller, 2020; Behrens, 2003).

Appraisal:
However, the aim of the study: 'to investigate the spatial extent of anatomical connectivity patterns within the thalamus in both humans and non-human primates and determine if such patterns differ between sensorimotor and association cortical areas' has been met.

Discussion:
Overall, I think the study is a nice addition to the growing literature studying the anatomical connectivity between the thalamus and cortex and its functional implications.