Clinical effects of deep brain stimulation are largely mediated by the activation of myelinated axons. Hence, increasing attention has been paid in the past on targeting white matter tracts in addition to gray matter. Aims of the present study were: (i) visualization of discrete afferences and efferences of the nucleus accumbens (NAc), supposed to be a major hub of neural networks relating to mental disorders, using probabilistic fiber tractography and a data driven approach, and (ii) validation of the applied methodology for standardized routine clinical applications. MR-data from 11 healthy subjects and 7 measurement sessions each were acquired on a 3T MRI-scanner. For probabilistic fiber tracking the NAc as a seed region and the medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), amygdala (AMY), hippocampus (HPC), dorsomedial thalamus (dmT) and ventral tegmental area (VTA) as target regions were segmented for each subject and both hemispheres. To quantitatively assess the reliability and stability of the reconstructions, we filtered and clustered the individual fiber-tracts (NAc to target) for each session and subject and performed a point-by-point calculation of the maximum cluster distances for intra-subject comparison. The connectivity patterns formed by the obtained fibers were in good concordance with published data from tracer and/or fiber-dissection studies. Furthermore, the reliability assessment of the (NAc to target)-fiber-tracts yielded to high correlations between the obtained clustered-tracts. Using DBS with directional lead technology, the workflow elaborated in this study may guide selective electrical stimulation of NAc projections.

中文翻译：

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伏隔核预测：基于高分辨率弥散加权 MRI 的纤维重建的有效性和可靠性

深部脑刺激的临床效果主要由有髓轴突的激活介导。因此，除了灰质之外，过去人们越来越关注针对白质束。本研究的目的是：（i）使用概率纤维束成像和数据驱动方法可视化伏隔核（NAc）的离散影响和影响，它应该是与精神障碍相关的神经网络的主要枢纽，以及（ ii) 验证标准化常规临床应用的应用方法。来自 11 名健康受试者和 7 次测量会话的 MR 数据均在 3T MRI 扫描仪上获得。对于概率纤维跟踪作为种子​​区域的 NAc 和内侧前额叶皮层 (mPFC)、前扣带皮层 (ACC)、杏仁核 (AMY)、海马体 (HPC)、背内侧丘脑 (dmT) 和腹侧被盖区 (VTA) 作为目标区域被分割为每个受试者和两个半球。为了定量评估重建的可靠性和稳定性，我们对每个会话和受试者的单个纤维束（NAc 到目标）进行过滤和聚类，并对受试者内比较的最大聚类距离进行逐点计算。由获得的纤维形成的连接模式与示踪剂和/或纤维解剖研究的已发表数据具有良好的一致性。此外，（NAc 到目标）纤维束的可靠性评估产生了所获得的集群束之间的高度相关性。使用带有定向引线技术的 DBS，本研究中阐述的工作流程可以指导 NAc 投射的选择性电刺激。