Tractography Activation Patterns in Dorsolateral Prefrontal Cortex Suggest Better Clinical Responses in OCD DBS

Frontiers in Neuroscience
Christian J HartmannIhtsham U Haq

Abstract

Medication resistant obsessive-compulsive disorder (OCD) patients can be successfully treated with Deep Brain Stimulation (DBS) which targets the anterior limb of the internal capsule (ALIC) and the nucleus accumbens (NA). Growing evidence suggests that in patients who respond to DBS, axonal fiber bundles surrounding the electrode are activated, but it is currently unknown which discrete pathways are critical for optimal benefit. Our aim was to identify axonal pathways mediating clinical effects of ALIC-NA DBS. We created computational models of ALIC-NA DBS to simulate the activation of fiber tracts and to identify connected cerebral regions. The pattern of activated axons and their cortical targets was investigated in six OCD patients who underwent ALIC-NA DBS. Modulation of the right anterior middle frontal gyrus (dorsolateral prefrontal cortex) was associated with an excellent response. In contrast, non-responders showed high activation in the orbital part of the right inferior frontal gyrus (lateral orbitofrontal cortex/anterior ventrolateral prefrontal cortex). Factor analysis followed by step-wise linear regression indicated that YBOCS improvement was inversely associated with factors that were predominantly determined by...Continue Reading

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Citations

May 6, 2016·Frontiers in Psychiatry·Rafael O'HalloranSophia Frangou
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Oct 9, 2021·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Alik S WidgeYogesh Rathi

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Methods Mentioned

BETA
imaging
pharmacotherapy
imaging techniques

Software Mentioned

COMSOL
Quantia
Prime
FSL
FSL toolbox
Linear Image Registration Tool ( FLIRT )
Brain Extraction Tool
Freesurfer
NEURON
probtrackX

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