METHODS: We performed probabilistic tractography in 7T diffusion MRI on 178 participants from the Human Connectome Project to validate the ZI\'s anatomical subdivisions and their respective tracts. K-means clustering segmented the ZI based on each voxel\'s connectivity profile. We further characterized the connections of each ZI subregion using probabilistic tractography with each subregion as a seed.
RESULTS: We identified 2 dominant clusters that delineated the whole ZI into rostral and caudal subregions. The caudal ZI primarily connected with motor regions, while the rostral ZI received a topographic distribution of projections from prefrontal areas, notably the anterior cingulate and medial prefrontal cortices. We generated a probabilistic ZI atlas that was registered to a patient-participant\'s magnetic resonance imaging scan for placement of stereoencephalographic leads for electrophysiology-guided deep brain stimulation to treat their obsessive-compulsive disorder. Rostral ZI stimulation improved the patient\'s core symptoms (mean improvement 21%).
CONCLUSIONS: We present a tractography-based atlas of the rostral and caudal ZI subregions constructed using high-resolution diffusion magnetic resonance imaging from 178 healthy participants. Our work provides an anatomical foundation to explore the rostral ZI as a novel target for deep brain stimulation to treat refractory obsessive-compulsive disorder and other disorders associated with dysfunctional reward circuitry.
方法:我们在7T中对人类Connectome项目的178名受试者进行了概率纤维束成像,以验证ZI的解剖细分及其各自的束。K-means聚类根据每个体素的连通性概况对ZI进行分割。我们使用概率示踪法进一步表征了每个ZI子区域的连接,每个子区域作为种子。
结果:我们确定了两个优势簇,将整个ZI划分为前端(ZIr)和尾(ZIc)亚区域。ZIc主要与电机区域相连,当ZIr接收到来自前额区的投影的地形分布时,特别是前扣带回和内侧前额皮质。我们生成了一个概率ZI图集,该图集已注册到患者-参与者的MRI中,用于放置立体脑电图导线,用于电生理学引导的DBS治疗强迫症。ZIr刺激改善了患者的核心症状(平均改善:21%)。
结论:我们提出了一个基于纤维束成像的头端和尾ZI亚区图集,使用高分辨率扩散MRI从178名健康受试者中构建。我们的工作为探索ZIr作为深部脑刺激治疗难治性强迫症和其他与功能失调的奖励电路相关的疾病的新目标提供了解剖学基础。