OBJECTIVE Stereotactic ablation (cingulotomy) and subcallosal cingulate deep brain stimulation (SCC DBS) of different regions of the cingulum bundle (CB) have been successfully used to treat psychiatric disorders, such as depression and bipolar disorder. They are hypothesized to work by disrupting white matter pathways involved in the clinical manifestation of these disorders. This study aims to compare the connectivity of different CB subregions using tractography to evaluate stereotactic targets for the treatment of mood disorders. METHODS Fourteen healthy volunteers underwent 3T-MR imaging followed by connectivity analysis using probabilistic tractography. Twenty-one anatomic regions of interest were defined for each subject: 10 CB subregions (including the classical cingulotomy and SCC DBS targets) and 11 cortical/subcortical structures implicated in mood disorders. Connectivity results were compared using Friedman and Bonferroni-corrected post-hoc Wilcoxon tests. RESULTS CB connectivity showed a high degree of regional specificity. Both of the traditional stereotactic targets had widespread connectivity with discrete topology. The cingulotomy target connected primarily to the dorsomedial frontal, dorsal anterior cingulate, and posterior cingulate cortices, whereas the SCC DBS target connected mostly to the subgenual anterior cingulate and medial/central orbitofrontal cortices. However, a region of the rostral dorsal CB, lying between these surgical targets, encompassed statistically equivalent connections to all five cortical regions. CONCLUSIONS The CB is associated with brain structures involved in affective disorders, and the rostral dorsal CB demonstrates connectivity that is comparable to the combined connectivity of cingulotomy and SCC DBS neurosurgical interventions. The rostral dorsal CB represents a surgical target worthy of clinical exploration for mood disorders.

中文翻译：

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基于连接性的情绪障碍潜在神经外科手术目标识别。

目的立体定向消融（切开环切开术）和call突束（CB）不同区域的call骨扣带回深部脑刺激（SCC DBS）已成功用于治疗精神疾病，例如抑郁症和双相情感障碍。假设它们通过破坏与这些疾病的临床表现有关的白质途径而起作用。这项研究的目的是比较不同的CB子区域的连通性，使用射线照相术评估用于治疗情绪障碍的立体定向目标。方法对14名健康志愿者进行3T-MR成像，然后使用概率束摄影术进行连通性分析。为每个受试者定义了21个感兴趣的解剖区域：涉及情绪障碍的10个CB子区域（包括经典的切带切开术和SCC DBS靶标）和11个皮质/皮质下结构。使用Friedman和Bonferroni校正的事后Wilcoxon测试比较了连通性结果。结果CB连通性显示出高度的区域特异性。两个传统的立体定向目标都具有离散拓扑的广泛连通性。扣带切开术的靶标主要连接到背侧额叶，背侧前扣带回和后扣带回皮质，而SCC DBS靶标主要连接到下属前扣带回和内侧/中央眶额皮质。但是，位于这些手术目标之间的延髓背侧CB区域在统计上等同于所有五个皮质区域的连接。结论CB与涉及情感障碍的大脑结构有关，而延髓背侧CB表现出的连通性可媲美环切切开术和SCC DBS神经外科干预的综合连通性。鼻背CB代表值得临床探索情绪障碍的外科手术目标。