Anatomy Department, Lisbon Medical School, Lisbon, Portugal,
Acta Neurochir (Wien). 2013 Dec;155(12):2389-98. doi: 10.1007/s00701-013-1820-z. Epub 2013 Aug 3.
The Nucleus accumbens (Acc) is the main structure of the ventral striatum. It acts as a motor-limbic interface, being involved in emotional and psychomotor functions, frequently disturbed in neuropsychiatric disorders such as obsessive compulsive disorder and addiction. Most of the studies concerning the Acc were made in animals and those performed in humans are contradictory. Nevertheless, it has become a target for stereotactic deep brain stimulation for some of those diseases, when refractory to medical treatment. Previous studies performed by our group have established the localization, limits and dimensions of the human Acc and its stereotactic coordinates. Now it is our purpose to perform the Acc anatomical three-dimensional (3D) reconstruction in order to clarify its shape and topography and to render this nucleus a safer target for stereotactic procedures.
Anatomical coronal slicing of ten Acc from human brains was performed, perpendicular to the anterior commissure-posterior commissure line and to the midline; then the Acc contours were traced and its dimensions and 3D stereotactic coordinates measured, on each slice. Finally a 3D computerized model was created.
The human Acc was identified as a distinct brain structure, with clear-cut limits on its posterior half. It lies parallel to the midline, descends caudally, and progresses from a globose to a flattened and dorsolateral concave shape. Its main expression is subcomissural.
This study defined more accurately the 3D anatomy of the human Acc, providing new tools for stereotactic procedures.
伏隔核（Acc）是腹侧纹状体的主要结构。它作为运动边缘接口，参与情感和精神运动功能，在神经精神障碍如强迫症和成瘾中经常受到干扰。大多数关于 Acc 的研究都是在动物身上进行的，而在人类身上进行的研究则存在矛盾。然而，当这些疾病对药物治疗无效时，它已成为立体定向深部脑刺激的目标之一。我们小组之前的研究已经确定了人类 Acc 的定位、界限和尺寸及其立体定向坐标。现在，我们的目的是对 Acc 进行解剖三维（3D）重建，以阐明其形状和拓扑结构，并使该核成为立体定向手术更安全的目标。
对十个人类大脑的 Acc 进行了垂直于前连合-后连合线和中线的冠状解剖切片；然后在每个切片上追踪 Acc 轮廓并测量其尺寸和 3D 立体定向坐标。最后创建了一个 3D 计算机模型。
人类 Acc 被确定为一个独特的脑结构，在后半部分有明确的界限。它与中线平行，向尾侧下降，并从球形变为扁平且背外侧凹陷的形状。它的主要表现形式是亚连合的。
这项研究更准确地定义了人类 Acc 的 3D 解剖结构，为立体定向手术提供了新的工具。
