| Autor: |
Coenen, Volker Arnd, Schlaepfer, Thomas Eduard, Bewernick, Bettina H., Bostroem, Jan, Hattingen, Elke, Urbach, Horst, Meng Li |
| Zdroj: |
Stereotactic & Functional Neurosurgery; 2017 Supplement, Vol. 95, p12-12, 1p |
| Abstrakt: |
Introduction: The superolateral branch of the medial forebrain bundle (slMFB) is currently investigated as a putative DBS target for the treatment of major depression (MD) and OCD. DTI FT- assisted targeting is necessary. A total of 24 patients have been bilaterally implanted and stimulated for MD at our institutions in two IITs. We present a first analysis focusing on the effectively stimulated fiber tracts and their connections using probabilistic DTI FT. Methods: n=24, 9f, 47.3+/-10.5 years. Imaging data consisted of high-resolution anatomical T1W and T2W MRI sequences (3T, Philips Intera, Best, Netherlands) and 32-direction diffusion tensor imaging. Postoperative (after DTI assisted DBS (1)) helical CT scans were used to delineate electrode positions. A complex pipeline of Probabilistic streamline tractography was performed with MRtrix 3 (http://www.mrtrix.org/). Results: A total of 21 data sets had sufficient quality for further evaluation. In all cases only the slMFB and not the inferomedial branch of the medial forebrain bundle (imMFB) where included in the VAT, as expected. On the group level (not normalized), fibers that were affected by DBS connected bilaterally to the nucleus accumbens, the corpus callosum and the medial prefronal cortex (BA 24 and 32). The strongest connection was seen with the rostral prefrontal cortex (BA10) and BA46 (but only before normalizing data). Conclusion: The presented data supports the modulation of a widespread network containing the rostral prefrontal cortex and parts of the forceps minor and the medial prefrontal cortex in slMFB DBS together with subcortical structures of the reward system. BA10 is a unique part of the human brain. Involvement of this region has also been described before with cg25 as target regions (2). BA10 might represent a common denominator for antidepressant efficacy. A combined modulation of cortical and subcortical structures might explain the short and long-term clinical effects (2). [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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