gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

Deep brain stimulation: Targeting the medial forebrain bundle in obsessive compulsive disorder?

Meeting Abstract

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

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 105

doi: 10.3205/15dgnc503, urn:nbn:de:0183-15dgnc5034

Published: June 2, 2015

© 2015 Schlaier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: The aim of our study was to compare the course of the medial forebrain bundle (MFB) with the courses of the fibers running through the activated tissue of effective and non-effective contacts of the electrodes in a patient with obsessive compulsive disorder (OCD).

Method: Deterministic fiber tracking of the MFB was performed by setting 2 regions of interest (ROIs) in each hemisphere: in the nucleus raphe dorsalis and in the ventral tegmental area. Fibers running through the activated tissue around each contact of the electrodes were tracked based on ROIs, which were constructed as a sphere with a diameter of 2mm centered on the midpoint of each contact. The fiber tracts running through the ROIs of the electrode contacts are referred to as "contact-fibers". The courses of the contact-fibers were documented and compared to the course of the MFB. Minimal fiber length was set at 30mm and the FA threshold at 0.12.

Results: 7 of 8 contacts were located immediately medial to the MFB. Anterior to the contacts, the contact-fibers of effective contacts, concerning the alleviation of OCD symptoms, joined the course of the MFB. Contact-fibers of ineffective contacts were located inferior to the MFB. Posteriorly, the fibers of effective contacts followed the MFB to the brain stem on a slightly more anterior path. The fibers of most ineffective contacts did not accompany the MFB to the mesencephalon. Fibertracking of all contact-fibers depicted an additional superior branch to the medial-posterior thalamus, superior to the MFB. In some cases these fibers continued their course between the posterior horns of the lateral ventricles to the splenium corporis callosi and terminated in the superior parietal lobulus.

Conclusions: The medial forebrain bundle, as defined with deterministic fiber tracking, might help to refine atlas based targeting in deep brain stimulation for obsessive compulsive disorders.