Pallidal and thalamic neural oscillatory patterns in tourette's syndrome

Wolf‐Julian Neumann · Julius Huebl · Christof Brücke · Roxanne Lofredi · Andreas Horn · Assel Saryyeva +3 more

90 citations0/0 files storedAnnals of Neurology

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Obsessive-Compulsive Spectrum Disorders Neurological disorders and treatments Transcranial Magnetic Stimulation Studies

Abstract

OBJECTIVE: Aberrant oscillatory activity has been hypothesized to play a role in the pathophysiology of Tourette's syndrome (TS). Deep brain stimulation (DBS) has recently been established as an effective treatment for severe TS. Modulation of symptom-specific oscillations may underlie the mechanism of action of DBS and could be used for adaptive neuromodulation to improve therapeutic efficacy. The objective of this study was to demonstrate a pathophysiological association of pallidal and thalamic local field potentials (LFPs) with TS. METHODS: Nine medication-refractory TS patients were included in the study. Intracerebral LFPs were recorded simultaneously from bilateral pallidal and thalamic DBS electrodes. Spectral and temporal dynamics of pallidal and thalamic oscillations were characterized and correlated with preoperative Yale Global Tic Severity Scale (YGTSS) scores. RESULTS: Peaks of activity in the theta (3-12Hz) and beta (13-35Hz) were present in pallidal and thalamic recordings from all patients (3 women/6 men; mean age, 29.8 years) and coupled through coherence across targets. Presence of prolonged theta bursts in both targets was associated with preoperative motor tic severity. Total preoperative YGTSS scores (mean, 38.1) were correlated with pallidal and thalamic LFP activity using multivariable linear regression (R² = 0.96; p = 0.02). INTERPRETATION: Our findings suggest that pallidothalamic oscillations may be implicated in the pathophysiology of TS. Furthermore, our results highlight the utility of multisite and -spectral oscillatory features in severely affected patients for future identification and clinical use of oscillatory physiomarkers for adaptive stimulation in TS. Ann Neurol 2018;84:505-514.

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References

2015Lifetime Prevalence, Age of Risk, and Genetic Relationships of Comorbid Psychiatric Disorders in Tourette Syndrome 1999Stereotactic treatment of Gilles de la Tourette syndrome by high frequency stimulation of thalamus 2011Double-blind clinical trial of thalamic stimulation in patients with Tourette syndrome 2014Altered structural connectivity of cortico-striato-pallido-thalamic networks in Gilles de la Tourette syndrome 2018Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome 2015Bilateral globus pallidus stimulation for severe Tourette's syndrome: a double-blind, randomised crossover trial 2010Gilles de la Tourette syndrome and deep brain stimulation 2017Anterior pallidal deep brain stimulation for Tourette's syndrome: a randomised, double-blind, controlled trial

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