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  • Johnson, Kara A.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 (författare)

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

  • Artikel/kapitelEngelska2021

Förlag, utgivningsår, omfång ...

  • Elsevier,2021
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:umu-181036
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-181036URI
  • https://doi.org/10.1016/j.bpsc.2020.11.005DOI

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  • Språk:engelska
  • Sammanfattning på:engelska

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  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • 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.

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Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Duffley, GordonScientific 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 (författare)
  • Foltynie, ThomasFunctional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom (författare)
  • Hariz, MarwanUmeå universitet,Neurovetenskaper,Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom(Swepub:umu)hama0032 (författare)
  • Zrinzo, LudvicFunctional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom (författare)
  • Joyce, Eileen M.Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom (författare)
  • Akram, HarithFunctional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom (författare)
  • Servello, DomenicoNeurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy (författare)
  • Galbiati, Tommaso F.Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy (författare)
  • Bona, AlbertoNeurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy (författare)
  • Porta, MauroTourette's Syndrome and Movement Disorders Center, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy (författare)
  • Meng, Fan-GangBeijing Neurosurgical Institute, Capital Medical University, Beijing, China (författare)
  • Leentjens, Albert F.G.Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, Netherlands (författare)
  • Gunduz, AysegulNorman 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 (författare)
  • Hu, WeiNorman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States (författare)
  • Foote, Kelly D.Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States (författare)
  • Okun, Michael S.Norman Fixel Institute for Neurological Diseases, Program for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida, FL, Gainesville, United States (författare)
  • Butson, Christopher R.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 (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 StatesFunctional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Biological Psychiatry: Elsevier6:10, s. 961-9722451-9022

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