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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 Behav. 2016 12; 10(4):1054-1067.BI

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.

Authors+Show Affiliations

Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA. nikos@cma.mgh.harvard.edu. Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. nikos@cma.mgh.harvard.edu. McLean Imaging Center, McLean Hospital, Harvard Medical School, Boston, MA, USA. nikos@cma.mgh.harvard.edu. Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA. nikos@cma.mgh.harvard.edu.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA. Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Department of Psychology, Colby College, Waterville, ME, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA. Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA. Picower Institute for Learning & Memory, Massachusetts Institute of Technology, Cambridge, MA, USA.Departments of Psychiatry, Neurology, Neurosurgery and Radiology, Center for Morphometric Analysis, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Building 149, 13th Street, Charlestown, MA, 02129, USA.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26518214

Citation

Makris, Nikolaos, 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, vol. 10, no. 4, 2016, pp. 1054-1067.
Makris N, Rathi Y, Mouradian P, 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 Behav. 2016;10(4):1054-1067.
Makris, N., Rathi, Y., Mouradian, P., Bonmassar, G., Papadimitriou, G., Ing, W. I., Yeterian, E. H., Kubicki, M., Eskandar, E. N., Wald, L. L., Fan, Q., Nummenmaa, A., Widge, A. S., & Dougherty, D. D. (2016). 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, 10(4), 1054-1067.
Makris N, 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 Behav. 2016;10(4):1054-1067. PubMed PMID: 26518214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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). 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, PY - 2015/11/1/pubmed PY - 2017/10/17/medline PY - 2015/11/1/entrez KW - Connectome KW - Deep brain stimulation (DBS) KW - Diffusion tensor imaging KW - Diffusion tractography KW - Obsessive-compulsive disorder (OCD) KW - Tractography-guided DBS SP - 1054 EP - 1067 JF - Brain imaging and behavior JO - Brain Imaging Behav VL - 10 IS - 4 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. SN - 1931-7565 UR - https://www.unboundmedicine.com/medline/citation/26518214/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__ L2 - https://dx.doi.org/10.1007/s11682-015-9462-9 DB - PRIME DP - Unbound Medicine ER -