Electrical Brain Stimulation in Treatment-Resistant Obsessive–Compulsive Disorder: Parcellation, and Cyto- and Chemoarchitecture of the Bed Nucleus of the Stria Terminalis – a Review

Publisher Summary This chapter reviews the parcellation, and the cyto- and chemoarchitecture of the “bed nucleus of the stria terminalis(BST),” based on postmortem studies in humans. The term “bed nucleus of the stria terminalis” was introduced in 1923 to describe a brain nucleus embedding the stria terminalis. The main part of the BST is the paraseptal sector, located immediately posterior to the nucleus accumbens and surrounding the crossing of the anterior commissure, caudoventral to the septum. Other more distantly located sectors of the BST are the intraamygdaloid and the supracapsular sector. Cyto- and chemoarchitectonic studies demonstrate that the BST is a highly complex structure. Currently there is no direct evidence that the neurotransmitters, neuropeptides, and receptors observed in the BST are involved in the pathophysiology of obsessive compulsive disorder (OCD). Although, there is some evidence from plasma and CSF studies that several of these neurotransmitters and neuropeptides are affected in OCD. As the BST is small, it is therefore reasonable that surrounding structures, such as the septal nuclei and the lateral hypothalamus are also stimulated to some extent, depending on the stimulation parameters.