Variability and anatomical specificity of the orbitofrontothalamic fibers of passage in the ventral capsule/ventral striatum (VC/VS): precision care for patient-specific tractography-guided targeting of deep brain stimulation (DBS) in obsessive compulsive disorder (OCD)
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Author(s) • • • • • • • • •
Makris, Nikolaos
Rathi, Yogesh
Mouradian, Palig
Bonmassar, Giorgio
Papadimitriou, George
Kubicki, Marek
Fan, Qiuyun
Nummenmaa, Aapo
Ing, Wingkwai I.
Yeterian, Edward H.
Date Issued
October 2015
Journal
Brain Imaging and Behavior
Publisher
Springer US
Citation
Makris, Nikolaos, Yogesh Rathi, Palig Mouradian, Giorgio Bonmassar, George Papadimitriou, Wingkwai I. Ing, Edward H. Yeterian, et al. “Variability and Anatomical Specificity of the Orbitofrontothalamic Fibers of Passage in the Ventral Capsule/ventral Striatum (VC/VS): Precision Care for Patient-Specific Tractography-Guided Targeting of Deep Brain Stimulation (DBS) in Obsessive Compulsive Disorder (OCD).” Brain Imaging and Behavior (October 30, 2015).
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Author's final manuscript
Abstract
Deep Brain Stimulation (DBS) is a neurosurgical procedure that can reduce symptoms in medically intractable obsessive-compulsive disorder (OCD). Conceptually, DBS of the ventral capsule/ventral striatum (VC/VS) region targets reciprocal excitatory connections between the orbitofrontal cortex (OFC) and thalamus, decreasing abnormal reverberant activity within the OFC-caudate-pallidal-thalamic circuit. In this study, we investigated these connections using diffusion magnetic resonance imaging (dMRI) on human connectome datasets of twenty-nine healthy young-adult volunteers with two-tensor unscented Kalman filter based tractography. We studied the morphology of the lateral and medial orbitofrontothalamic connections and estimated their topographic variability within the VC/VS region. Our results showed that the morphology of the individual orbitofrontothalamic fibers of passage in the VC/VS region is complex and inter-individual variability in their topography is high. We applied this method to an example OCD patient case who underwent DBS surgery, formulating an initial proof of concept for a tractography-guided patient-specific approach in DBS for medically intractable OCD. This may improve on current surgical practice, which involves implanting all patients at identical stereotactic coordinates within the VC/VS region.
MIT Department
Picower Institute for Learning and Memory
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Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
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DOI of Published Version
https://doi.org/10.1007/s11682-015-9462-9