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

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
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
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
Zrinzo, Ludvic (författare)
Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
Joyce, Eileen M. (författare)
Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
Akram, Harith (författare)
Functional Neurosurgery Unit, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
Servello, Domenico (författare)
Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Galbiati, Tommaso F. (författare)
Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Bona, Alberto (författare)
Neurosurgical Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Porta, Mauro (författare)
Tourette's Syndrome and Movement Disorders Center, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
Meng, Fan-Gang (författare)
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
Leentjens, Albert F.G. (författare)
Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, Netherlands
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
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
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
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
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.
Ingår i: Biological Psychiatry. - : Elsevier. - 2451-9022. ; 6:10, s. 961-972
Relaterad länk:
https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
https://doi.org/10.1...
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • 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

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