TY - JOUR
T1 - Variability and anatomical specificity of the orbitofrontothalamic fibers of passage in the ventral capsule/ventral striatum (VC/VS)
T2 - precision care for patient-specific tractography-guided targeting of deep brain stimulation (DBS) in obsessive compulsive disorder (OCD)
AU - Makris, Nikolaos
AU - Rathi, Yogesh
AU - Mouradian, Palig
AU - Bonmassar, Giorgio
AU - Papadimitriou, George
AU - Ing, Wingkwai I.
AU - Yeterian, Edward H.
AU - Kubicki, Marek
AU - Eskandar, Emad N.
AU - Wald, Lawrence L.
AU - Fan, Qiuyun
AU - Nummenmaa, Aapo
AU - Widge, Alik S.
AU - Dougherty, Darin D.
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - 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.
AB - 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.
KW - Connectome
KW - Deep brain stimulation (DBS)
KW - Diffusion tensor imaging
KW - Diffusion tractography
KW - Obsessive-compulsive disorder (OCD)
KW - Tractography-guided DBS
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U2 - 10.1007/s11682-015-9462-9
DO - 10.1007/s11682-015-9462-9
M3 - Article
C2 - 26518214
AN - SCOPUS:84945569038
SN - 1931-7557
VL - 10
SP - 1054
EP - 1067
JO - Brain Imaging and Behavior
JF - Brain Imaging and Behavior
IS - 4
ER -
