Section of Neurosurgery, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA.
Department of Neurosurgery, National and Kapodistrian University of Athens Medical School, Evangelismos General Hospital, Athens 10676, Greece.
Brain. 2024 Sep 3;147(9):3083-3098. doi: 10.1093/brain/awae173.
Comprehensive understanding of the neural circuits involving the ventral tegmental area is essential for elucidating the anatomofunctional mechanisms governing human behaviour, in addition to the therapeutic and adverse effects of deep brain stimulation for neuropsychiatric diseases. Although the ventral tegmental area has been targeted successfully with deep brain stimulation for different neuropsychiatric diseases, the axonal connectivity of the region is not fully understood. Here, using fibre microdissections in human cadaveric hemispheres, population-based high-definition fibre tractography and previously reported deep brain stimulation hotspots, we find that the ventral tegmental area participates in an intricate network involving the serotonergic pontine nuclei, basal ganglia, limbic system, basal forebrain and prefrontal cortex, which is implicated in the treatment of obsessive-compulsive disorder, major depressive disorder, Alzheimer's disease, cluster headaches and aggressive behaviours.
全面了解腹侧被盖区涉及的神经回路,对于阐明调控人类行为的解剖功能机制,以及深脑刺激治疗神经精神疾病的治疗效果和不良反应至关重要。尽管深脑刺激已成功应用于不同的神经精神疾病,但腹侧被盖区的轴突连接仍不完全清楚。在这里,我们使用人类尸检大脑半球中的纤维微分离、基于人群的高清纤维束追踪和先前报道的深脑刺激热点,发现腹侧被盖区参与了一个复杂的网络,涉及 5-羟色胺能脑桥核、基底节、边缘系统、基底前脑和前额叶皮层,这与强迫症、重度抑郁症、阿尔茨海默病、丛集性头痛和攻击性行为的治疗有关。