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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Diffusion tensor imaging-based fibertracking of the medial forebrain bundle

Meeting Abstract

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  • Juergen Schlaier - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Judith Anthofer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Kathrin Steib - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Alexander Brawanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg
  • Claudia Fellner - Institut für Röntgendiagnostik, Universitätsklinikum Regensburg
  • Max Lange - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.06.08

doi: 10.3205/14dgnc313, urn:nbn:de:0183-14dgnc3137

Published: May 13, 2014

© 2014 Schlaier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) reduces symptoms in depression. The aim of our study was to find standardized parameters for diffusion tensor imaging (DTI)-based fibertracking to reliably visualize the MFB.

Method: 20 cerebral hemispheres in 10 patients were investigated. Three different regions of interest (ROI) were defined as seed regions for fiber tracking: the ipsi- and contralateral superior cerebellar peduncle (SCP) and the nucleus raphe dorsalis (NRD). From each seed region the fibers were followed seperately through the ventral tegmental area (VTA = second ROI). Their courses were documented and compared. Minimal fiber length was set at 30mm and the fractional anisotropy (FA) threshold at 0.12.

Results: The fiber tracts starting in the ipsilateral SCP and the NRD follow a similar course along the lateral wall of the third ventricle (hypothalamus) and the anterior limb of the internal capsule (ALIC) to the ventral striatum and the subcalossal area. Consistently, a branch leaves the main fiber tract laterally to take course through the capsula externa to the temporo-parietal cortex. These fibers are in accordance with the course of the MFB as described in various anatomical atlases. Fiber tracts starting from the contralateral SCP follow a more superior and lateral course, including the dentato-rubro-thalamic and the pyramidal tract.

Conclusions: Deterministic fiber tracking with standardized ROIs provides a robust and reproducable map of the medial forebrain bundle. Its visualization might help to adjust targeting in DBS for psychiatric disorders.