By Lennart Heimer; et al
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Additional info for Anatomy of neuropsychiatry : the new anatomy of the basal forebrain and its implications for neuropsychiatric illness
This is not to say, however, that MacLean and other proponents of the limbic system concept do not regard the accumbens as an important part of the limbic system. In historical context, the accumbens and olfactory tubercle, together referred to as the “olfactostriatum” by C. Judson Herrick (1926), were considered to serve as an intermediary between rostral forebrain areas and the medial forebrain bundle, a main conduit to the hypothalamus and brainstem tegmentum. Herrick stated with regard to the olfactostriatum that “its efferent fibers go in part to globus pallidus and thence to the cerebral peduncle, and in part they go out directly into the medial forebrain bundle” (Herrick, 1926).
This discovery paved the way for our current appreciation of parallel frontal cortico-subcortical reentrant circuits, which are now promoted as a basic framework for explaining the symptomatology of neuropsychiatric disorders (Mega and Cummings, 1994; Lichter and Cummings, 2001). In this process of discovery, the accumbens has lost its status as an independent functional-anatomical unit, not to mention its standing as a nucleus. The notion of accumbens as a critical “limbic-motor” or “emotional-motor” interface, furthermore, has become equally dubious.
It was said that psychiatry and neurology could be separated by the Sylvian fissure, and the two were generally believed to have little in common from a brain-oriented perspective. The fundamental flaw in the scheme, however, was its conspicuous lack of concordance with many clinical observations. Obvious behavioral problems and psychiatric illnesses accompanying movement disorders (such as Parkinson’s disease or Huntington’s chorea), and the obviously abnormal movements in the clinical picture of psychiatric disorders across the spectrum from anxiety (tremor) to schizophrenia (tics, dystonias, dyskinesias, and catatonias) were a baffling conundrum to clinicians.