Stereotactic anatomy of the human nucleus accumbens: from applied mathematics to microsurgical accuracy

Abstract

We provide a stereotactic anatomic guide for some common targeting necessities of the NA stereotactic surgery, resulted from detailed analysis and careful combination of the measured data of our clinically oriented study. We hope that our work will be a really useful guide for neurosurgeons applying deep brain stimulation of the NA.

The Nucleus Accumbens: A Comprehensive Review

“…This inconsistency highlights the need for a uniform surgical procedure to produce comparable results. However, based on the reported targeted coordinates presented in table 1, coupled with the NAc localization work presented by Mavridis et al [41], placing the tip of the electrode at these coordinates, rather than the center of the deepest contact, would likely result in a more accurate placement in the NAc. The trajectory in most cases passes through the anterior limb of the internal capsule, entering just anterior to the coronal suture and slightly lateral to the mid-pupillary line (fig.…”

“…The presence of an age-based dimorphism is also contested, with some studies suggesting a decrease in volume with age [35,41,42], while others maintain that the NAc does not suffer any age-related atrophy [34]. …”

“…Morphometric studies examining dimorphisms based on location and sex have been controversial, with studies indicating the NAc is larger on the left [40], the right [34], in males [40], and with [41] or without [35,42] sexual or hemispheric differences. The presence of an age-based dimorphism is also contested, with some studies suggesting a decrease in volume with age [35,41,42], while others maintain that the NAc does not suffer any age-related atrophy [34].…”

“…A comprehensive anatomical examination has been done comparing both gross anatomical specimens and T2-weighted MR images in order to localize the NAc within the ventral striatum [41]. Pathological analysis of 32 cerebral hemispheres localized the NAc to a fairly variable area based upon hemisphere.…”

Surgical Anatomy of the Human Nucleus Accumbens: Mavridis' Area and Other Clarifications in Stereotactic Space

“…At first, I would like to thank Salgado and Kaplitt [1] for mentioning several results of my study regarding the stereotactic and microsurgical NA anatomy [2] in the Surgical Anatomy Section of their review article. However, there are some clarifications and corrections of unintended errors that should be made regarding a few points of their paper.…”