The accumbofrontal fasciculus in the human brain: a microsurgical anatomical study.
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.


CONCLUSIONS
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.
Department of Neurosurgery and Anatomy, Poitiers University School of Medicine, Poitiers, France. p.rigoard@chu-poitiers.fr
Philippe
P
Rigoard
Kévin
K
Buffenoir
Nemhat
N
Jaafari
Jean P
JP
Giot
Jean L
JL
Houeto
Patrick
P
Mertens
Stéphane
S
Velut
Benoit
B
Bataille
D005625:Frontal Lobe / Q000033:anatomy & histology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D009434:Neural Pathways / Q000033:anatomy & histology; D009714:Nucleus Accumbens / Q000033:anatomy & histology*