Ventral Tegmental Area (VTA)
Disorders Treated with Stimulation
- Primary indications: Currently no FDA-approved indications for VTA DBS
- Investigational applications: May be effective in treating depression, chronic cluster headache, chronic pain, and psychotic-like behaviors [1-4]
Location
- The VTA is located along the anterior surface of the midbrain medial to the red nucleus and substantia nigra [5]
Associated Tracts
- Mesolimbic Pathway: Connects VTA to nucleus accumbens and olfactory cortex [6,7]
- Mesocortical Pathway: Connects VTA to the prefrontal cortex [8]
- The VTA is a complex midbrain structure comprised of diverse neuronal types and circuits. The dopaminergic mesocortical and mesolimbic pathways are believed to be the major circuits modulated by DBS for depressive and pain symptoms. The mesocortical pathway is primarily involved in decision-making, working memory, and emotional regulation. The mesolimbic pathway is primarily involved in reward processing and motivation. [9,10]
References
- Cappon, D., Ryterska, A., Lagrata, S., Miller, S., Akram, H., Hyam, J., Zrinzo, L., Matharu, M., & Jahanshahi, M. (2019). Ventral tegmental area deep brain stimulation for chronic cluster headache: Effects on cognition, mood, pain report behaviour and quality of life. Cephalalgia, 39, 1099 - 1110. https://doi.org/10.1177/0333102419839957.
- Li, A., Sibi, J., Yang, X., Chiao, J., & Peng, Y. (2016). Stimulation of the ventral tegmental area increased nociceptive thresholds and decreased spinal dorsal horn neuronal activity in rat. Experimental Brain Research, 234, 1505 - 1514. https://doi.org/10.1007/s00221-016-4558-z.
- Friedman, A., Frankel, M., Flaumenhaft, Y., Merenlender, A., Pinhasov, A., Feder, Y., Taler, M., Gil-Ad, I., Abeles, M., & Yadid, G. (2009). Programmed Acute Electrical Stimulation of Ventral Tegmental Area Alleviates Depressive-Like Behavior. Neuropsychopharmacology, 34, 1057-1066. https://doi.org/10.1038/npp.2008.177.
- Lu, C., Feng, Y., Li, H., Gao, Z., Zhu, X., & Hu, J. (2022). A preclinical study of deep brain stimulation in the ventral tegmental area for alleviating positive psychotic-like behaviors in mice. Frontiers in Human Neuroscience, 16. https://doi.org/10.3389/fnhum.2022.945912.
- Trutti AC, Fontanesi L, Mulder MJ, Bazin PL, Hommel B, Forstmann BU. A probabilistic atlas of the human ventral tegmental area (VTA) based on 7 Tesla MRI data. Brain Struct Funct. 2021 May;226(4):1155-1167. doi: 10.1007/s00429-021-02231-w. Epub 2021 Feb 12. PMID: 33580320; PMCID: PMC8036186.
- 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.
- Seo JP, Ryu HJ. Aging of the mesolimbic tract in the human brain: A diffusion tensor imaging study. Medicine (Baltimore). 2022 Oct 14;101(41):e30924. doi: 10.1097/MD.0000000000030924. PMID: 36254037; PMCID: PMC9575822.
- Seo JP, Ryu HJ. Aging of reward dopamine tracts in the human brain: A diffusion tensor imaging study. Medicine (Baltimore). 2023 Nov 17;102(46):e36112. doi: 10.1097/MD.0000000000036112. PMID: 37986323; PMCID: PMC10659658.
- Kabanova, A., Pabst, M., Lorkowski, M., Braganza, O., Boehlen, A., Nikbakht, N., Pothmann, L., Vaswani, A., Musgrove, R., Monte, D., Sauvage, M., Beck, H., & Blaess, S. (2015). Function and developmental origin of a mesocortical inhibitory circuit. Nature Neuroscience, 18, 872-882. https://doi.org/10.1038/nn.4020.
- Torta, D., & Castelli, L. (2008). Reward pathways in Parkinson's disease: Clinical and theoretical implications. Psychiatry and Clinical Neurosciences, 62. https://doi.org/10.1111/j.1440-1819.2008.01756.x.