Deep brain stimulation for psychiatric disorders: Are nucleus accumbens and medial forebrain bundle two branches of the same tree?

Purpose of this commentary is to discuss the relation of the nucleus accumbens (NA) with the medial forebrain bundle (MFB) and compare them as deep brain stimulation (DBS) targets in psychiatric disorders. Could a bundle be a more effective target than a nucleus? Or, more correctly, could an important modulator be a more effective target than a highly significant pleasure center? The answer hides in the fact that NA is a key component of the MFB. Thus NA dysfunction is synonym to MFB dysfunction. The NA is a hot-spot in the neurocircuitry of psychiatric disorders and further experimental investigation is needed for the MFB as a target for neuromodulation in depression, as well as to optimize benefit of psychiatric patients from neuromodulation treatment efforts. Are the NA and MFB two branches of the same tree? They definitely could be, particularly if the tree is the brain's motivation super-system. (C) 2015 Elsevier Ltd. All rights reserved.