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Basal Ganglia Pathw...
Basal Ganglia Pathways Associated With Therapeutic Pallidal Deep Brain Stimulation for Tourette Syndrome
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- Johnson, Kara A. (författare)
- Scientific Computing and Imaging Institute, University of Utah, UT, Salt Lake City, United States; Department of Biomedical Engineering, University of Utah, UT, Salt Lake City, United States
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- Duffley, Gordon (författare)
- Scientific Computing and Imaging Institute, University of Utah, UT, Salt Lake City, United States; Department of Biomedical Engineering, University of Utah, UT, Salt Lake City, United States
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- Foltynie, Thomas (författare)
- Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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- Hariz, Marwan (författare)
- Umeå universitet,Neurovetenskaper,Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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- Zrinzo, Ludvic (författare)
- Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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- Joyce, Eileen M. (författare)
- Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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- Akram, Harith (författare)
- Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
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- Servello, Domenico (författare)
- Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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- Galbiati, Tommaso F. (författare)
- Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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- Bona, Alberto (författare)
- Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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- Porta, Mauro (författare)
- Tourette's Syndrome and Movement Disorders Center, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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- Meng, Fan-Gang (författare)
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
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- Leentjens, Albert F.G. (författare)
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, Netherlands
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- Gunduz, Aysegul (författare)
- Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States; J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, FL, Gainesville, United States
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- Hu, Wei (författare)
- Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States
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- Foote, Kelly D. (författare)
- Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States
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- Okun, Michael S. (författare)
- Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States
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- Butson, Christopher R. (författare)
- Scientific Computing and Imaging Institute, University of Utah, UT, Salt Lake City, United States; Department of Biomedical Engineering, University of Utah, UT, Salt Lake City, United States; Department of Neurology, University of Utah, UT, Salt Lake City, United States; Department of Neurosurgery, University of Utah, UT, Salt Lake City, United States; Department of Psychiatry, University of Utah, UT, Salt Lake City, United States
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(creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: Biological Psychiatry. - : Elsevier. - 2451-9022. ; 6:10, s. 961-972
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
Nyckelord
- Computational model
- Globus pallidus internus
- Internal capsule
- Obsessive-compulsive behavior
- Pallido-subthalamic
- Tics
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Johnson, Kara A.
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Duffley, Gordon
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Foltynie, Thomas
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Hariz, Marwan
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Zrinzo, Ludvic
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Joyce, Eileen M.
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Akram, Harith
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Servello, Domeni ...
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Galbiati, Tommas ...
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Bona, Alberto
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Porta, Mauro
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Meng, Fan-Gang
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Leentjens, Alber ...
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Gunduz, Aysegul
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Hu, Wei
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Foote, Kelly D.
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Okun, Michael S.
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Butson, Christop ...
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Medicinska och f ...
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och Neurovetenskaper
- Artiklar i publikationen
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Biological Psych ...
- Av lärosätet
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Umeå universitet