Mavridis I, Anagnostopoulou S
Department of Anatomy, Medical School, University of Athens, Athens, Greece.
Minim Invasive Neurosurg. 2009 Oct;52(5-6):212-5. doi: 10.1055/s-0029-1243240. Epub 2010 Jan 14.
The nucleus accumbens (NA), a "pleasure center", is the most inferior part of the ventral striatum. NA, related to the limbic and extrapyramidal motor system, is involved in some of the most common neuropsychiatric disorders. Nowadays it is a target for deep brain stimulation (DBS), in some carefully selected patients. Our purpose was to evaluate the accuracy of its position within the NA, in relation to the stereotactic target point that is today used.
We identified, studying 25 cerebral hemispheres, the target point of the NA DBS electrode, at a specific level that is important for its imaging. We also identified the stereotactic coordinates of the NA and made a statistical analysis and comparisons.
We found that in 3 out of 25 cases, the used stereotactic coordinates fail to offer a target point within the limits of the NA.
We present the first stereotactic anatomic study evaluating the precise position where the electrode for human NA DBS is to be placed and the only anatomic study of the human NA performed on such a large number of cases. The stereotactic coordinates used for NA DBS are accurate. However, we suggest that the electrode's final position should be considered to be slightly less deep.
伏隔核（NA）是腹侧纹状体最靠下的部分，是一个“愉悦中枢”。NA与边缘系统和锥体外系运动系统相关，参与一些最常见的神经精神疾病。如今，在一些经过精心挑选的患者中，它是深部脑刺激（DBS）的靶点。我们的目的是评估其在NA内的位置相对于当前使用的立体定向靶点的准确性。
我们通过研究25个大脑半球，确定了NA DBS电极在一个对其成像很重要的特定层面上的靶点。我们还确定了NA的立体定向坐标，并进行了统计分析和比较。
我们发现，在25例中有3例，所使用的立体定向坐标未能在NA的范围内提供靶点。
我们展示了第一项评估人类NA DBS电极放置精确位置的立体定向解剖学研究，也是在如此大量病例上进行的唯一一项人类NA解剖学研究。用于NA DBS的立体定向坐标是准确的。然而，我们建议电极的最终位置应被认为略浅一些。
