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Three dimensional anatomy of the human nucleus accumbens

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Abstract

Background

The Nucleus accumbens (Acc) is the main structure of the ventral striatum. It acts as a motor-limbic interface, being involved in emotional and psychomotor functions, frequently disturbed in neuropsychiatric disorders such as obsessive compulsive disorder and addiction. Most of the studies concerning the Acc were made in animals and those performed in humans are contradictory. Nevertheless, it has become a target for stereotactic deep brain stimulation for some of those diseases, when refractory to medical treatment. Previous studies performed by our group have established the localization, limits and dimensions of the human Acc and its stereotactic coordinates. Now it is our purpose to perform the Acc anatomical three-dimensional (3D) reconstruction in order to clarify its shape and topography and to render this nucleus a safer target for stereotactic procedures.

Methods

Anatomical coronal slicing of ten Acc from human brains was performed, perpendicular to the anterior commissure-posterior commissure line and to the midline; then the Acc contours were traced and its dimensions and 3D stereotactic coordinates measured, on each slice. Finally a 3D computerized model was created.

Results

The human Acc was identified as a distinct brain structure, with clear-cut limits on its posterior half. It lies parallel to the midline, descends caudally, and progresses from a globose to a flattened and dorsolateral concave shape. Its main expression is subcomissural.

Conclusion

This study defined more accurately the 3D anatomy of the human Acc, providing new tools for stereotactic procedures.

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Conflicts of interest

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Author information

Correspondence to L. Lucas-Neto.

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Comments

The nucleus accumbens definitely plays a pivotal role in the “reward” circuitry. Operations in this circuit are based on actions of two essential neurotransmitters: dopamine, which promotes desire, and serotonin, whose effects include satiety and inhibition. Furthermore, many animal studies have shown that all drugs increase the production of dopamine in the nucleus accumbens, while reducing that of serotonin. Deep bain stimulation (DBS) of the nucleus accumbens has been, therefore, investigated for the treatment of several psychiatric conditions including obsessive–compulsive disorder, treatment-resistant depression and, more recently, to modulate substance-induced dysfunction and to promote reversal of addictive behavior. This study, from the experienced group of Lisbon, will be a fundamental reference for DBS of the nucleus accumbens, a treatment that is increasingly offered to patients for psychiatric conditions. The limitation of this study is the same as that of traditional stereotactic atlases based on cadaver specimen, namely the potential spatial errors due to “post-mortem” structural changes and fixation and histological sectioning. Nonetheless, by using multiple specimens the authors offset this source of inaccuracy. The best stereotactic target coordinates within the nucleus accumbens, as delineated in this study, will come in the next future by integrating intraoperative neuroelectrophysiology, pre- and intraoperative neuroimaging, and postoperative neurological assessment.

Alfredo Conti

Messina, ITALY

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Lucas-Neto, L., Neto, D., Oliveira, E. et al. Three dimensional anatomy of the human nucleus accumbens. Acta Neurochir 155, 2389–2398 (2013). https://doi.org/10.1007/s00701-013-1820-z

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Keywords

  • Nucleus accumbens
  • Deep brain stimulation
  • Three-dimensional anatomy
  • Stereotaxy