The Accumbofrontal Fasciculus in the Human Brain: A Microsurgical Anatomical Study

Abstract

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.

The use of a cerebral perfusion and immersion–fixation process for subsequent white matter dissection

“…It should come as no surprise then that some recent papers describing new WM pathways was first described with anatomical dissection (Rigoard et al, 2011). These authors applied some modifications to the classical Klingler protocol for specimen preparation.…”

“…These authors applied some modifications to the classical Klingler protocol for specimen preparation. After the initial immersion-fixation process (24 h) the brains were refrigerated and thawed in a 24-h cycle, 4 times (total of 5-6 days) (Rigoard et al, 2011). After this relatively short amount of time for preparation, the authors were able to dissect one of the most complex and deep fibre bundles, the accumbo-frontal fasciculus.…”

“…Some authors reported modifications of the classic protocol for specimen preparation or the dissection technique, with a preserved high quality of the anatomical details (Martino et al, 2011;Rigoard et al, 2011;Latini, 2015).…”

“…The accumbo-frontal fasciculus (AFF), which connects the Nucleus accumbens (NAcc) region and orbito-frontal cortices (Rigoard et al, 2011), was exposed in the basal ganglia region ( Fig. 4A and B).…”

“…The grey matter, for instance, which is the first layer to be fixed, can easily be removed en bloc, but this results in the destruction of intra-cortical WM terminations. According to the literature, very deep bundles such as the accumbo-frontal fasciculus (AFF) (Rigoard et al, 2011) are better described with modifications of the Klingler technique for specimen preparation. Furthermore WM vasculature, which has been more often studied with transparent specimens and radiological enhancement of thin histological sections, has been difficult to describe during dissection of classical Klingler fixed brains.…”