Anterior Limb Internal Capsule (ALIC)
Disorders Treated with Stimulation
- Primary indications: OCD
- Investigational applications: May be effective in treating depression and other mood disorders and well as Tourette syndrome, addiction, and chronic pain. [1,2]
Location
- This target is not a nucleus, rather white matter tracts coursing through the ALIC, which is between the caudate head and putamen
Associated Tracts
- STN Associative Tract: Part of the hyperdirect pathway, connecting the STN to the prefrontal cortex [3,4]
- STN Limbic Tract: Also part of the hyperdirect pathway, connecting the STN to limbic regions [3,4]
- The ALIC is made up of multiple white matter tracts connecting cortical and subcortical structures with topographical organization. Tracts relevant to DBS primarily include hyperdirect fibers from the STN coursing through the ALIC. General pathways associated with DBS include frontostriatal circuits and the cortico-striato-thalamo-cortical tracts [3] which play a large role in reward processing/habit formation [5] and cognitive, executive, and emotional functions, respectively. [6]
References
- van der Wal JM, Bergfeld IO, Lok A, Mantione M, Figee M, Notten P, Beute G, Horst F, van den Munckhof P, Schuurman PR, Denys D. Long-term deep brain stimulation of the ventral anterior limb of the internal capsule for treatment-resistant depression. J Neurol Neurosurg Psychiatry. 2020 Feb;91(2):189-195. doi: 10.1136/jnnp-2019-321758. Epub 2019 Dec 4. PMID: 31801845; PMCID: PMC6996094
- Lee DJ, Lozano CS, Dallapiazza RF, Lozano AM. Current and future directions of deep brain stimulation for neurological and psychiatric disorders. J Neurosurg. 2019 Aug 1;131(2):333-342. doi: 10.3171/2019.4.JNS181761. PMID: 31370011
- Middlebrooks EH, Domingo RA, Vivas-Buitrago T, Okromelidze L, Tsuboi T, Wong JK, Eisinger RS, Almeida L, Burns MR, Horn A, Uitti RJ, Wharen RE Jr, Holanda VM, Grewal SS. Neuroimaging Advances in Deep Brain Stimulation: Review of Indications, Anatomy, and Brain Connectomics. AJNR Am J Neuroradiol. 2020 Sep;41(9):1558-1568. doi: 10.3174/ajnr.A6693. Epub 2020 Aug 13. PMID: 32816768; PMCID: PMC7583111
- Zhang C, Kim SG, Li J, Zhang Y, Lv Q, Zeljic K, Gong H, Wei H, Liu W, Sun B, Wang Z, Voon V. Anterior limb of the internal capsule tractography: relationship with capsulotomy outcomes in obsessive-compulsive disorder. J Neurol Neurosurg Psychiatry. 2021 Jan 18;92(6):637–44. doi: 10.1136/jnnp-2020-323062. Epub ahead of print. PMID: 33461976; PMCID: PMC8142462
- Berner, L., & Marsh, R. (2014). Frontostriatal Circuits and the Development of Bulimia Nervosa. Frontiers in Behavioral Neuroscience, 8. https://doi.org/10.3389/fnbeh.2014.00395
- Zhu, Y., Jiang, X., & Ji, W. (2018). The Mechanism of Cortico-Striato-Thalamo-Cortical Neurocircuitry in Response Inhibition and Emotional Responding in Attention Deficit Hyperactivity Disorder with Comorbid Disruptive Behavior Disorder. Neuroscience Bulletin, 34, 566-572