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DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions
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Subcaudate Tractotomy White Matter Anatomy and Variability: A Diffusion Tensor Imaging Study.

Kartik D Bhatia1, Luke A Henderson1, Eugene Hsu2

  • 1Department of Anatomy, University of Sydney, Camperdown, New South Wales, Australia.

Stereotactic and Functional Neurosurgery
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Subcaudate tractotomy targets white matter tracts for psychiatric conditions. Anatomical variability in these tracts, particularly the uncinate fasciculus and corticostriatal fibres, impacts treatment outcomes.

Keywords:
DepressionDiffusion tensor imagingSubcaudate tractotomy

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Area of Science:

  • Neurosurgery
  • Neuroanatomy
  • Psychiatric disease treatment

Background:

  • Subcaudate tractotomy is a surgical procedure for treatment-resistant psychiatric disorders.
  • It targets white matter tracts near the caudate nucleus.
  • Interindividual anatomical variability in this region may affect treatment efficacy.

Purpose of the Study:

  • To analyze the white matter tract anatomy and variability relevant to subcaudate tractotomy.
  • To understand the topographical variations in white matter tracts targeted by this procedure.

Main Methods:

  • Diffusion tensor imaging (DTI) and tractography were used on 74 healthy adult volunteers.
  • Individualized regions of interest were created in native space to simulate the surgical target.
  • Tract locations and variability were measured in both hemispheres.

Main Results:

  • The cingulum bundle, uncinate fasciculus, corticostriatal, and corticothalamic fibres were identified.
  • Cingulum bundle location was consistent across subjects.
  • Significant interindividual variability was observed in the topographic location of other targeted tracts.

Conclusions:

  • Detailed analysis reveals significant white matter tract variability underlying subcaudate tractotomy.
  • This anatomical variability has crucial implications for precise neurosurgical targeting.
  • Understanding this variability is key to optimizing treatment outcomes.