Connectivity Patterns of Deep Brain Stimulation Targets in Patients with Gilles de la Tourette Syndrome.

Connectivity Patterns of Deep Brain Stimulation Targets in Patients with Gilles de la Tourette Syndrome.
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DOI:
10.3390/brainsci11010087
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发表时间:
2021-01-11
期刊:
影响因子:
3.3
通讯作者:
Andrade P
Andrade P
中科院分区:
医学4区
文献类型:
--
作者:
Heiden P;Hoevels M;Bayram D;Baldermann JC;Schüller T;Huys D;Visser-Vandewalle V;Andrade P

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自1999年以来,在抽动秽语综合征(GTS)中进行脑深部电刺激(DBS)的几个目标已经出现,显示出类似的成功率。使用不同纤维束成像技术的研究已经确定了与个体目标的更好结果相关的连接概况。然而,GTS患者可能需要个体化治疗。本研究的目的是分析GTS的不同DBS目标的连接配置文件。我们确定了中央正中核/腹口内侧核(CM/Voi)、CM/束旁(CM-Pf)复合体、前内侧苍白球内侧核(amGPi)、后腹侧GPi(pvGPi)、腹侧前/腹外侧丘脑(VA/VL)和内侧核/内囊前肢(Nacc/ALIC)的标准靶坐标。根据患者特异性成像和标准连接组(HCP),从目标到不同的边缘系统和运动区进行概率纤维束成像。我们的分析显示,标准DBS靶点的连接特征之间存在显著差异(p < 0.05)。在所有目标中,pvGPi显示出与感觉运动皮层的最强连接,而amGPi在患者特异性成像中显示出与前额叶皮层的最强连接。当使用基于患者数据和HCP的概率纤维束成像时,观察到连接性配置文件之间的差异。我们的研究结果表明,不同的DBS目标的连接配置文件的主要运动和边缘系统的地区显着不同。将来,当采用个体化方法为GTS患者规划DBS时,可能会考虑这些差异。当使用不同的纤维束成像技术时,连通性剖面存在令人信服的差异。
Since 1999, several targets for deep brain stimulation (DBS) in Gilles de la Tourette syndrome (GTS) have emerged showing similar success rates. Studies using different tractography techniques have identified connectivity profiles associated with a better outcome for individual targets. However, GTS patients might need individualized therapy. The objective of this study is to analyze the connectivity profile of different DBS targets for GTS. We identified standard target coordinates for the centromedian nucleus/nucleus ventro-oralis internus (CM/Voi), the CM/parafascicular (CM-Pf) complex, the anteromedial globus pallidus internus (amGPi), the posteroventral GPi (pvGPi), the ventral anterior/ventrolateral thalamus (VA/VL), and the nucleus accumbens/anterior limb of the internal capsule (Nacc/ALIC). Probabilistic tractography was performed from the targets to different limbic and motor areas based on patient-specific imaging and a normative connectome (HCP). Our analysis showed significant differences between the connectivity profiles of standard DBS targets (p < 0.05). Among all targets, the pvGPi showed the strongest connection to the sensorimotor cortex, while the amGPi showed the strongest connection to the prefrontal cortex in patient-specific imaging. Differences were observed between the connectivity profiles when using probabilistic tractography based on patient data and HCP. Our findings showed that the connectivity profiles of different DBS targets to major motor and limbic areas differ significantly. In the future, these differences may be considered when planning DBS for GTS patients employing an individualized approach. There were compelling differences in connectivity profiles when using different tractography techniques.
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