scholarly journals The Accumbofrontal Fasciculus in the Human Brain: A Microsurgical Anatomical Study

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 1102-1111 ◽  
Author(s):  
Philippe Rigoard ◽  
Kévin Buffenoir ◽  
Nemhat Jaafari ◽  
Jean P. Giot ◽  
Jean L. Houeto ◽  
...  
Keyword(s):  
Human Brain ◽  
Anatomical Study ◽  
Obsessive Compulsive ◽  
Neural Connections ◽  
3 Dimensional ◽  
Compulsive Disorder ◽  
Orbital Gyrus ◽  
Fiber Dissection ◽  
Dissection Technique

Abstract BACKGROUND: The fiber-dissection technique provides unique 3-dimensional anatomic knowledge of the white matter. OBJECTIVE: To better identify the frontostriatal pathways in the human brain, we used a fiber-dissection technique to reconstruct neural connections between the frontal cortex and the nucleus accumbens (NAcc), which is the most ventral extent of the striatum. METHODS: Thirty previously frozen, formalin-fixed human brains were dissected under the operating microscope using a modified fiber-dissection technique, primarily reported by Klingler. RESULTS: Our serial dissections of 30 human brain specimens clearly demonstrated that projection fibers form a connection between the NAcc and the frontal lobe. We evidenced this newly described subcortical tract as an accumbofrontal fasciculus. This focal projection was concentrated at the level of the ventromedial part of the NAcc and characterized by an elective and specific projection from the orbitomedial prefrontal cortex, particularly the gyrus rectus and the medial orbital gyrus situated between the H-shaped and the medial orbital sulcus. CONCLUSION: The accumbofrontal fasciculus is an elective and specific projection from the orbitoprefrontal cortex. This fasciculus is part of a corticostriatothalamocortical loop and a putative target for deep-brain stimulation in the treatment of obsessive-compulsive disorder and major depression. The analysis of in vivo diffusion tractography, used today as a standard in the investigation of many brain disorders, could potentially take advantage of complementary anatomic correlations and functional extrapolations, as described in this study.

The claustrum and its projection system in the human brain: a microsurgical and tractographic anatomical study

2008 ◽  
Vol 108 (4) ◽  
pp. 764-774 ◽  
Author(s):  
Juan C. Fernández-Miranda ◽  
Albert L. Rhoton ◽  
Yukinari Kakizawa ◽  
Chanyoung Choi ◽  
Juan Álvarez-Linera
Keyword(s):  
Human Brain ◽  
Diffusion Tensor ◽  
Anatomical Study ◽  
Lower Surface ◽  
Ventral Part ◽  
Projection System ◽  
Brain Hemispheres ◽  
External Capsule ◽  
Fiber Dissection ◽  
Dissection Technique

Object The goal in this study was to examine the microsurgical and tractographic anatomy of the claustrum and its projection fibers, and to analyze the functional and surgical implications of the findings. Methods Fifteen formalin-fixed human brain hemispheres were dissected using the Klingler fiber dissection technique, with the aid of an operating microscope at × 6–40 magnification. Magnetic resonance imaging studies of 5 normal brains were analyzed using diffusion tensor (DT) imaging–based tractography software. Results Both the claustrum and external capsule have 2 parts: dorsal and ventral. The dorsal part of the external capsule is mainly composed of the claustrocortical fibers that converge into the gray matter of the dorsal claustrum. Results of the tractography studies coincided with the fiber dissection findings and showed that the claustrocortical fibers connect the claustrum with the superior frontal, precentral, postcentral, and posterior parietal cortices, and are topographically organized. The ventral part of the external capsule is formed by the uncinate and inferior occipitofrontal fascicles, which traverse the ventral part of the claustrum, connecting the orbitofrontal and prefrontal cortex with the amygdaloid, temporal, and occipital cortices. The relationship between the insular surface and the underlying fiber tracts, and between the medial lower surface of the claustrum and the lateral lenticulostriate arteries is described. Conclusions The combination of the fiber dissection technique and DT imaging–based tractography supports the presence of the claustrocortical system as an integrative network in humans and offers the potential to aid in understanding the diffusion of gliomas in the insula and other areas of the brain.

The Orbitofrontal Cortex

2019 ◽  
Author(s):  
Edmund T. Rolls
Keyword(s):  
Bipolar Disorder ◽  
Human Brain ◽  
Obsessive Compulsive Disorder ◽  
Orbitofrontal Cortex ◽  
Multidisciplinary Approach ◽  
Animal Behaviour ◽  
Obsessive Compulsive ◽  
Undergraduate Level ◽  
Compulsive Disorder

The book will be valuable for those in the fields of neuroscience, neurology, psychology, psychiatry, biology, animal behaviour, economics, and philosophy, from the undergraduate level upwards. The book is unique in providing a coherent multidisciplinary approach to understanding the functions of one of the most interesting regions of the human brain, in both health and in disease, including depression, bipolar disorder, autism, and obsessive-compulsive disorder. There is no competing book published in the last 10 years.

Using an Acceptance and Commitment Therapy Approach When Exposure and Cognitive Therapy Become Rituals in the Treatment of Obsessive-Compulsive Disorder

2019 ◽  
Vol 33 (3) ◽  
pp. 256-268 ◽  
Author(s):  
Jennifer L. Buchholz ◽  
Jonathan Abramowitz
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Acceptance And Commitment Therapy ◽  
Substantial Improvement ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Long Term Treatment

Exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) is often highly effective, yet some patients experience relapses following a seemingly successful course of treatment. In this article we describe the conceptual basis of ERP, and then present a client who relapsed after seemingly achieving substantial improvement following 11 sessions of ERP. Likely reasons for the relapse and strategies for enhancing ERP to achieve better long-term treatment outcomes are discussed from the perspective of acceptance and commitment therapy (ACT). These strategies mainly apply to the implementation of situational (in vivo) and imaginal exposure therapy, but also include suggestions for optimizing the use of cognitive therapy for OCD.

scholarly journals Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder

1995 ◽  
Vol 33 (4) ◽  
pp. 379-390 ◽  
Author(s):  
Patricia Van Oppen ◽  
Else De Haan ◽  
Anton J.L.M. Van Balkom ◽  
Philip Spinhoven ◽  
Kees Hoogduin ◽  
...  
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Exposure In Vivo

Three-Dimensional Topographic Fiber Tract Anatomy of the Cerebrum

2015 ◽  
Vol 11 (2) ◽  
pp. 274-305 ◽  
Author(s):  
Kaan Yagmurlu ◽  
Alexander L Vlasak ◽  
Albert L Rhoton
Keyword(s):  
Three Dimensional ◽  
Central Core ◽  
3 Dimensional ◽  
Fiber Tracts ◽  
Nuclear Masses ◽  
Fiber Dissection ◽  
Dissection Technique ◽  
Human Brains ◽  
The Brain ◽  
Formalin Fixed

Abstract BACKGROUND The fiber tracts of the cerebrum may be a more important determinant of resection limits than the cortex. Better knowledge of the 3-dimensional (3-D) anatomic organization of the fiber pathways is important in planning safe and accurate surgery for lesions within the cerebrum. OBJECTIVE To examine the topographic anatomy of fiber tracts and subcortical gray matter of the human cerebrum and their relationships with consistent cortical, ventricular, and nuclear landmarks. METHODS Twenty-five formalin-fixed human brains and 4 whole cadaveric heads were examined by fiber dissection technique and ×6 to ×40 magnification. The fiber tracts and central core structures, including the insula and basal ganglia, were examined and their relationships captured in 3-D photography. The depth between the surface of the cortical gyri and selected fiber tracts was measured. RESULTS The topographic relationships of the important association, projection, and commissural fasciculi within the cerebrum and superficial cortical landmarks were identified. Important landmarks with consistent relationships to the fiber tracts were the cortical gyri and sulci, limiting sulci of the insula, nuclear masses in the central core, and lateral ventricles. The fiber tracts were also organized in a consistent pattern in relation to each other. The anatomic findings are briefly compared with functional data from clinicoradiological analysis and intraoperative stimulation of fiber tracts. CONCLUSION An understanding of the 3-D anatomic organization of the fiber tracts of the brain is essential in planning safe and accurate cerebral surgery.

scholarly journals Histamine, Neuroinflammation and Neurodevelopment: A Review

2021 ◽  
Vol 15 ◽  
Author(s):  
Elliott Carthy ◽  
Tommas Ellender
Keyword(s):  
Brain Development ◽  
Neurodevelopmental Disorders ◽  
Histamine Receptor ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Inflammatory Processes ◽  
Preclinical And Clinical Studies

The biogenic amine, histamine, has been shown to critically modulate inflammatory processes as well as the properties of neurons and synapses in the brain, and is also implicated in the emergence of neurodevelopmental disorders. Indeed, a reduction in the synthesis of this neuromodulator has been associated with the disorders Tourette’s syndrome and obsessive-compulsive disorder, with evidence that this may be through the disruption of the corticostriatal circuitry during development. Furthermore, neuroinflammation has been associated with alterations in brain development, e.g., impacting synaptic plasticity and synaptogenesis, and there are suggestions that histamine deficiency may leave the developing brain more vulnerable to proinflammatory insults. While most studies have focused on neuronal sources of histamine it remains unclear to what extent other (non-neuronal) sources of histamine, e.g., from mast cells and other sources, can impact brain development. The few studies that have started exploring this in vitro, and more limited in vivo, would indicate that non-neuronal released histamine and other preformed mediators can influence microglial-mediated neuroinflammation which can impact brain development. In this Review we will summarize the state of the field with regard to non-neuronal sources of histamine and its impact on both neuroinflammation and brain development in key neural circuits that underpin neurodevelopmental disorders. We will also discuss whether histamine receptor modulators have been efficacious in the treatment of neurodevelopmental disorders in both preclinical and clinical studies. This could represent an important area of future research as early modulation of histamine from neuronal as well as non-neuronal sources may provide novel therapeutic targets in these disorders.

Design and Validation of Virtual Environments for the Treatment of OCD related to fear to contamination (Preprint)

2020 ◽  
Author(s):  
Zoilo Emilio Garcia-Batista Sr ◽  
Kiero Guerra-Peña Sr ◽  
Ivan Alsina-Jurnet ◽  
Antonio Cano-Vindel ◽  
Adriana M. Álvarez-Hernández ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Virtual Environments ◽  
Clinical Group ◽  
Clinical Use ◽  
Obsessive Compulsive ◽  
Imaginal Exposure ◽  
Compulsive Disorder ◽  
Potential Alternative ◽  
Anxiety Levels

UNSTRUCTURED “Exposure therapy is highly effective to treat cleaning obsessive-compulsive disorder (OCD). However, traditional techniques, such as in vivo or imaginal exposure, show important limits that make the adherence to the treatment and/or the correct emotional activation difficult. Virtual Reality (VR) is a potential alternative to overcome such inconveniences. Therefore, the aim of this study was to develop virtual environments clinically relevant for patients with cleaning OCD and assess their efficiency to obtain emotionally significant responses. Based on this, two scenarios were developed, with progressive levels of dirtiness: a public restroom and a kitchen. Both were applied to a clinical group (18 patients with cleaning OCD) and to a control one (22 without OCD). Both scenarios produced anxiety levels significantly higher in the clinical group. This result is a valuable support for the clinical use of these environments”.

Empirically Supported Treatment for Obsessive-Compulsive Disorder

2021 ◽  
pp. 76-94
Author(s):  
Martin E. Franklin ◽  
Sarah G. Turk Karan
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Empirical Support ◽  
Response Prevention ◽  
Obsessive Compulsive ◽  
Empirically Supported Treatment ◽  
Therapist Experience ◽  
Compulsive Disorder ◽  
Empirically Supported

This chapter assesses which treatment should be chosen as the first-line intervention for obsessive-compulsive disorder (OCD). Cognitive Behavioral Therapy (CBT) involving Exposure Plus Response Prevention (ERP) is the treatment with the most empirical support, and its effects appear to be both robust and durable. The chapter then reviews the data on predictors and moderators of differential ERP outcomes. Contemporary ERP manuals emphasize the following core procedures: (1) psychoeducation; (2) hierarchy development; (3) in vivo and imaginal exposure; (4) response prevention; and (5) relapse prevention. The chapter looks at situations in which clinical circumstances dictate a deviation or modification of the protocol from the way these procedures are described in the manual or customarily implemented—being flexible while maintaining fidelity. Therapist experience appears to play a role in how comfortable clinicians are in being flexible, and how successful they are likely to be when they do so.

Obsessive-compulsive Disorder in Children and Adolescents

1995 ◽  
Vol 12 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Neville J. King ◽  
Thomas H. Ollendick ◽  
Iain M. Montgomery
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Mental Health Professionals ◽  
Antidepressant Medication ◽  
Behavioural Intervention ◽  
Obsessive Compulsive ◽  
Behavioural Treatment ◽  
Compulsive Disorder ◽  
Relationship Of ◽  
The Relationship

This selective review shows that childhood obsessive-compulsive disorder (OCD) is a serious condition that requires early identification and treatment. Initially, we examine the relationship of childhood rituals to OCD, and discuss recent findings on the epidemiology of childhood OCD. The DSM-IV criteria for OCD are presented, along with recent findings on psychopathology. Clinical management of childhood OCD is a challenging and difficult task for mental health professionals. We briefly describe and evaluate advances in behavioural treatment — mainly in vivo exposure and response prevention. The adjunctive use of antidepressant medication is also examined. Whilst these clinical innovations are promising, further controlled evaluations are necessary before the efficacy of behavioural intervention can be confidently asserted.

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