Department of Neurosurgery, Üsküdar State Hospital, Istanbul, Turkey.
Department of Neurology, Üsküdar State Hospital, Istanbul, Turkey.
World Neurosurg. 2018 Feb;110:133-144. doi: 10.1016/j.wneu.2017.10.168. Epub 2017 Nov 10.
Recently, neuromodulation through deep brain stimulation (DBS) has appeared as a new surgical procedure in the treatment of some types of dementia and epilepsy. The mammillothalamic and mammillotegmental tracts are involved among the new targets. To our knowledge, a review article focused specifically on these mammillary body efferents is lacking in the medical literature. Their contribution to memory is, regrettably, often overlooked.
A review of the relevant literature was conducted.
There is evidence that mammillary bodies can contribute to memory independently from hippocampal formation, but the mechanism is not yet known. Recent studies in animals have provided evidence for the specific roles of these mammillary body efferents in regulating memory independently. In animal studies, it has been shown that the disruption of the mammillothalamic tract inhibits seizures and that electrical stimulation of the mammillary body or mammillothalamic tract raises the seizure threshold. In humans, DBS targeting the mammillary body through the mammillothalamic tract or the stimulation of the anterior thalamic nucleus, especially in the areas closely related to the mammillothalamic tract, has been found effective in patients with medically refractory epilepsy. Nonetheless, little knowledge exists on the functional anatomy of the mammillary body efferents, and their role in the exact mechanism of epileptogenic activity and in the memory function of the human brain.
A comprehensive knowledge of the white matter anatomy of the mammillothalamic and mammillotegmental tracts is crucial since they have emerged as new DBS targets in the treatment of various disorders including dementia and epilepsy.
最近，通过深部脑刺激（DBS）进行神经调节已作为治疗某些类型痴呆症和癫痫的新手术出现。新的治疗靶点包括乳头丘脑束和乳头体被盖束。据我们所知，医学文献中缺乏专门针对这些乳头体传出束的综述文章。它们对记忆的贡献常常被忽视。
对相关文献进行了回顾。
有证据表明，乳头体可以独立于海马体参与记忆，但机制尚不清楚。最近的动物研究为这些乳头体传出束在独立调节记忆方面的特定作用提供了证据。在动物研究中，已经表明破坏乳头丘脑束可以抑制癫痫发作，并且刺激乳头体或乳头丘脑束可以提高癫痫发作阈值。在人类中，通过乳头丘脑束或刺激前丘脑核靶向乳头体的 DBS 已被发现对药物难治性癫痫患者有效，特别是在与乳头丘脑束密切相关的区域。尽管如此，对于乳头体传出束的功能解剖及其在致痫活动的确切机制和人类大脑的记忆功能中的作用知之甚少。
全面了解乳头丘脑束和乳头体被盖束的白质解剖结构至关重要，因为它们已成为治疗包括痴呆症和癫痫在内的各种疾病的新 DBS 靶点。
