Pallidal and thalamic neural oscillatory patterns in tourette's syndrome
Pallidal and thalamic neural oscillatory patterns in tourette's syndrome
复制标题
DOI：
10.1002/ana.25311
复制
发表时间：
2018-10-01
影响因子：
11.2
通讯作者：
Kuehn, Andrea A.
中科院分区：
文献类型：
--
作者：
Neumann, Wolf-Julian;Huebl, Julius;Kuehn, Andrea A.
异常振荡活动已被假设为在抽动秽语综合征（TS）的病理生理学中发挥作用。脑深部电刺激（DBS）最近被确定为严重TS的有效治疗方法。脑电特异性振荡的调节可能是DBS作用机制的基础，并可用于适应性神经调节以提高治疗效果。本研究的目的是证明苍白球和丘脑局部场电位（LFPs）与TS的病理生理相关性。9例药物难治性TS患者被纳入本研究。双侧苍白球和丘脑DBS电极同时记录脑内LFP。苍白球和丘脑振荡的频谱和时间动态的特点和相关性与术前耶鲁全球抽搐严重程度量表（YGTSS）scores. ResultationInterpretationPeaks的活动在θ（3- 12赫兹）和β（13- 35赫兹）存在于苍白球和丘脑记录从所有患者（3名女性/6名男性，平均年龄，29.8岁）和耦合通过跨目标的连贯性。两个靶点的θ波延长与术前运动性抽搐的严重程度相关。术前YGTSS总评分（平均38.1分）与苍白球和丘脑LFP活性相关（R-2=0.96; p=0.02）。此外，我们的研究结果突出了多位点和频谱振荡功能在严重影响的患者的实用性，为未来的识别和临床使用的振荡生理标志物的适应性刺激TS。神经学年鉴2018;84：505-514
ObjectiveMethodsAberrant 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.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.ResultsInterpretationPeaks 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 (R-2=0.96; p=0.02).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