Sunnybrook Research Institute, Toronto, Ontario, Canada.
Sunnybrook Research Institute, Toronto, Ontario, Canada.
Behav Brain Res. 2020 Jun 1;387:112588. doi: 10.1016/j.bbr.2020.112588. Epub 2020 Mar 14.
The last two decades have seen a re-emergence of neurosurgery for severe, refractory psychiatric diseases, largely due to the advent of more precise and safe operative techniques. Nevertheless, the optimal targets for these surgeries remain a matter of debate, and are often grandfathered from experiences in the late 20th century. To better explore the rationale for one target in particular - the anterior limb of the internal capsule (ALIC) - we comprehensively reviewed all available literature on its role in the pathophysiology and treatment of mental illness. We first provide an overview of its functional anatomy, followed by a discussion on its role in several prevalent psychiatric diseases. Given its structural integration into the limbic system and involvement in a number of cognitive and emotional processes, the ALIC is a robust target for surgical treatment of refractory psychiatric diseases. The advent of novel neuroimaging techniques, coupled with image-guided therapeutics and neuromodulatory treatments, will continue to enable study on the ALIC in mental illness.
在过去的二十年中,由于更精确和安全的手术技术的出现,神经外科治疗严重、难治性精神疾病再次出现。然而,这些手术的最佳靶点仍然存在争议,并且通常是从 20 世纪末的经验中传承下来的。为了更好地探讨特别是一个靶点的原理 - 内囊前肢(ALIC) - 我们全面回顾了其在精神疾病的病理生理学和治疗中的所有可用文献。我们首先概述了其功能解剖结构,然后讨论了它在几种常见精神疾病中的作用。鉴于其结构整合到边缘系统中,并涉及许多认知和情绪过程,ALIC 是治疗难治性精神疾病的有效靶点。新型神经影像学技术的出现,加上图像引导治疗和神经调节治疗,将继续使 ALIC 能够在精神疾病中进行研究。