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Related Experiment Video

Updated: Jan 19, 2026

Measuring Connectivity in the Primary Visual Pathway in Human Albinism Using Diffusion Tensor Imaging and Tractography
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Understanding gamma ventral capsulotomy: Potential implications of diffusion tensor image tractography on target

Bruno Fernandes de Oliveira Santos1,2, Alessandra Gorgulho1,2, Crystian W C Saraiva1

  • 1Department of Neurosurgery and Radiotherapy, Hospital do Coracao (HCOR Neurosciences), Gamma Knife.

Surgical Neurology International
|September 19, 2019
PubMed
Summary

Tractography reveals distinct medial and lateral orbitofrontal cortex (OFC) fiber distributions in the anterior limb of the internal capsule (ALIC). These OFC fiber tract volumes differ significantly between patients with obsessive-compulsive disorder (OCD) and those with Parkinson's disease or morbid obesity.

Keywords:
CapsulotomyFunctional stereotactic neurosurgeryGamma knifeObsessive-compulsive disorderTractography and anisotropy

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Area of Science:

  • Neurosurgery
  • Neuroimaging
  • Computational Neuroscience

Background:

  • The utility of tractography in gamma ventral capsulotomy (GVC) planning remains under investigation.
  • Understanding the spatial arrangement of orbitofrontal cortex (OFC) fibers within the anterior limb of the internal capsule (ALIC) is crucial for precise surgical targeting.

Purpose of the Study:

  • To delineate the spatial distribution of medial and lateral OFC fibers traversing the ALIC.
  • To identify quantitative tractography parameters that distinguish patients with obsessive-compulsive disorder (OCD) from those with Parkinson's disease (PD) or morbid obesity undergoing functional neurosurgery.

Main Methods:

  • Diffusion tensor image tractography was performed on 20 patients (5 OCD, 9 PD, 6 morbid obesity) between 2013 and 2016.
  • OCD patients underwent GVC, while PD and morbid obesity patients received deep brain stimulation implants.
  • Tracts were reconstructed using Brainlab Elements software.

Main Results:

  • Medial OFC fibers were consistently located inferior to lateral OFC fibers within the ALIC, though individual variations in topography were observed.
  • Fiber tract volumes for both medial and lateral OFC were significantly lower in PD and morbid obesity patients compared to OCD patients.
  • Patient demographics (age) differed significantly across the three groups (P < 0.001).

Conclusions:

  • A general topographical standard for medial and lateral OFC fibers exists within the ALIC, with lateral OFC fibers positioned higher than medial OFC fibers.
  • Quantitative tractography reveals significant differences in OFC fiber tract statistics among patients with OCD, PD, and morbid obesity, suggesting potential utility in surgical planning.