PMID- 35901682
OWN - NLM
STAT- MEDLINE
DCOM- 20230203
LR  - 20230203
IS  - 1933-0693 (Electronic)
IS  - 0022-3085 (Linking)
VI  - 138
IP  - 2
DP  - 2023 Feb 1
TI  - Nucleus accumbens: a systematic review of neural circuitry and clinical studies 
      in healthy and pathological states.
PG  - 337-346
LID - 10.3171/2022.5.JNS212548 [doi]
AB  - OBJECTIVE: The nucleus accumbens (NAcc) of the ventral striatum is critically 
      involved in goal- and reward-based behavior. Structural and functional 
      abnormalities of the NAcc or its associated neural systems are involved in 
      neurological and psychiatric disorders. Studies of neural circuitry have shed 
      light on the subtleties of the structural and functional derangements of the NAcc 
      across various diseases. In this systematic review, the authors sought to 
      identify human studies involving the NAcc and provide a synthesis of the 
      literature on the known circuity of the NAcc in healthy and diseased states, as 
      well as the clinical outcomes following neuromodulation. METHODS: A systematic 
      review was conducted using the PubMed, Embase, and Scopus databases. Neuroimaging 
      studies that reported on neural circuitry related to the human NAcc with sample 
      sizes greater than 5 patients were included. Demographic data, aim, design and 
      duration, participants, and clinical and neurocircuitry details and outcomes of 
      the studies were extracted. RESULTS: Of 3591 resultant articles, 123 were 
      included. The NAcc and its corticolimbic connections to other brain regions, such 
      as the prefrontal cortex, are largely involved in reward and pain processes, with 
      distinct functional circuitry between the shell and core in healthy patients. 
      There is heterogeneity between clinical studies with regard to the NAcc indirect 
      targeting coordinates, methods for postoperative confirmation, and blinded trial 
      design. Neuromodulation studies provided promising clinical results in the 
      context of addiction and substance misuse, obsessive-compulsive disorder, and 
      mood disorders. The most common complications were impaired memory or 
      concentration, and a notable serious complication was hypomania. CONCLUSIONS: The 
      functional diversity of the NAcc highlights the importance of studying the NAcc 
      in healthy and pathological states. The results of this review suggest that NAcc 
      neuromodulation has been attempted in the management of diverse psychiatric 
      indications. There is promising, emerging evidence that the NAcc may be an 
      effective target for specific reward- or pain-based pathologies with a reasonable 
      risk profile.
FAU - Yan, Han
AU  - Yan H
AD  - 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
AD  - 2Institute of Health Policy, Management and Evaluation, University of Toronto, 
      Ontario, Canada.
AD  - 4McMaster Medical School, Hamilton, Ontario, Canada.
FAU - Shlobin, Nathan A
AU  - Shlobin NA
AD  - 3Department of Neurological Surgery, Feinberg School of Medicine, Northwestern 
      University, Chicago, Illinois.
FAU - Jung, Youngkyung
AU  - Jung Y
AD  - 4McMaster Medical School, Hamilton, Ontario, Canada.
FAU - Zhang, Kristina K
AU  - Zhang KK
AD  - 5Program in Neuroscience and Mental Health, Hospital for Sick Children Research 
      Institute, Toronto, Ontario, Canada; and.
AD  - 6Institute of Medical Science, University of Toronto, Ontario, Canada.
FAU - Warsi, Nebras
AU  - Warsi N
AD  - 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
AD  - 5Program in Neuroscience and Mental Health, Hospital for Sick Children Research 
      Institute, Toronto, Ontario, Canada; and.
FAU - Kulkarni, Abhaya V
AU  - Kulkarni AV
AD  - 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
AD  - 2Institute of Health Policy, Management and Evaluation, University of Toronto, 
      Ontario, Canada.
FAU - Ibrahim, George M
AU  - Ibrahim GM
AD  - 1Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
AD  - 5Program in Neuroscience and Mental Health, Hospital for Sick Children Research 
      Institute, Toronto, Ontario, Canada; and.
AD  - 6Institute of Medical Science, University of Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20220722
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
SB  - IM
MH  - Humans
MH  - *Nucleus Accumbens/diagnostic imaging
MH  - *Brain
MH  - Prefrontal Cortex
MH  - Reward
MH  - Pain
MH  - Magnetic Resonance Imaging/methods
OTO - NOTNLM
OT  - functional neurosurgery
OT  - neuromodulation
OT  - nucleus accumbens
OT  - review
OT  - reward
EDAT- 2022/07/29 06:00
MHDA- 2023/02/04 06:00
CRDT- 2022/07/28 18:24
PHST- 2021/11/02 00:00 [received]
PHST- 2022/05/17 00:00 [accepted]
PHST- 2022/07/29 06:00 [pubmed]
PHST- 2023/02/04 06:00 [medline]
PHST- 2022/07/28 18:24 [entrez]
AID - 10.3171/2022.5.JNS212548 [doi]
PST - epublish
SO  - J Neurosurg. 2022 Jul 22;138(2):337-346. doi: 10.3171/2022.5.JNS212548. Print 
      2023 Feb 1.