Basal Ganglia Pathways Associated With Therapeutic Pallidal Deep Brain Stimulation for Tourette Syndrome

Autor: Albert F.G. Leentjens, Fangang Meng, Michael S. Okun, Wei Hu, Kelly D. Foote, Aysegul Gunduz, Eileen M. Joyce, Thomas Foltynie, Marwan Hariz, Ludvic Zrinzo, Mauro Porta, Kara A. Johnson, Harith Akram, Domenico Servello, Christopher R. Butson, Alberto R. Bona, Gordon Duffley, Tommaso Francesco Galbiati
Přispěvatelé: RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Psychiatrie & Neuropsychologie, MUMC+: MA Med Staf Spec Psychiatrie (9)
Jazyk: angličtina
Rok vydání: 2021
Předmět:
TRANSCRANIAL MAGNETIC STIMULATION
Internal capsule
Neurologi
REPETITIVE BEHAVIORS
Deep Brain Stimulation
medicine.medical_treatment
FUNCTIONAL-ANATOMY
Stimulation
Pallido-subthalamic
Tourette syndrome
DOUBLE-BLIND
0302 clinical medicine
Basal ganglia
Medicine
Computational model
05 social sciences
Parkinson Disease
Globus pallidus internus
Treatment Outcome
Neurology
HIGH-FREQUENCY STIMULATION
Tics
Neurovetenskaper
Deep brain stimulation
Cognitive Neuroscience
Obsessive-compulsive behavior
Globus Pallidus
Article
050105 experimental psychology
03 medical and health sciences
TIC SUPPRESSION
Humans
0501 psychology and cognitive sciences
Radiology
Nuclear Medicine and imaging
Biological Psychiatry
Retrospective Studies
HUMAN SUBTHALAMIC NUCLEUS
business.industry
Neurosciences
OBSESSIVE-COMPULSIVE DISORDER
medicine.disease
INTERNUS
Transcranial magnetic stimulation
Neurology (clinical)
business
Neuroscience
GILLES
030217 neurology & neurosurgery
Tourette Syndrome
Zdroj: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6(10), 961-972. Elsevier
Biol Psychiatry Cogn Neurosci Neuroimaging
ISSN: 2451-9022
Popis: Background Deep brain stimulation (DBS) targeting the globus pallidus internus (GPi) can improve tics and comorbid obsessive-compulsive behavior (OCB) in patients with treatment-refractory Tourette syndrome (TS). However, some patients’ symptoms remain unresponsive, the stimulation applied across patients is variable, and the mechanisms underlying improvement are unclear. Identifying the fiber pathways surrounding the GPi that are associated with improvement could provide mechanistic insight and refine targeting strategies to improve outcomes. Methods Retrospective data were collected for 35 patients who underwent bilateral GPi DBS for TS. Computational models of fiber tract activation were constructed using patient-specific lead locations and stimulation settings to evaluate the effects of DBS on basal ganglia pathways and the internal capsule. We first evaluated the relationship between activation of individual pathways and symptom improvement. Next, linear mixed-effects models with combinations of pathways and clinical variables were compared in order to identify the best-fit predictive models of tic and OCB improvement. Results The best-fit model of tic improvement included baseline severity and the associative pallido-subthalamic pathway. The best-fit model of OCB improvement included baseline severity and the sensorimotor pallido-subthalamic pathway, with substantial evidence also supporting the involvement of the prefrontal, motor, and premotor internal capsule pathways. The best-fit models of tic and OCB improvement predicted outcomes across the cohort and in cross-validation. Conclusions Differences in fiber pathway activation likely contribute to variable outcomes of DBS for TS. Computational models of pathway activation could be used to develop novel approaches for preoperative targeting and selecting stimulation parameters to improve patient outcomes.
Databáze: OpenAIRE
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