Abstract
Tourette syndrome (TS) is an idiopathic, childhood-onset neuropsychiatric disorder, which is marked by persistent multiple motor and phonic tics. The disorder is highly disruptive and in some cases completely debilitating. For those with severe, treatment-refractory TS, deep brain stimulation (DBS) has emerged as a possible option, although its mechanism of action is not fully understood. We performed a longitudinal study of the effects of DBS on TS symptomatology while concomitantly examining neurophysiological dynamics. We present the first report of the clinical correlation between the presence of gamma band activity and decreased tic severity. Local field potential recordings from five subjects implanted in the centromedian nucleus (CM) of the thalamus revealed a temporal correlation between the power of gamma band activity and the clinical metrics of symptomatology as measured by the Yale Global Tic Severity Scale and the Modified Rush Tic Rating Scale. Additional studies utilizing short-term stimulation also produced increases in gamma power. Our results suggest that modulation of gamma band activity in both long-term and short-term DBS of the CM is a key factor in mitigating the pathophysiology associated with TS.
Highlights
Tourette syndrome (TS) is a complex neuropsychiatric disorder characterized by the childhood onset of multiple motor and phonic tics [1,2]
Acute microelectrode recordings and chronic macroelectrode recordings from implanted leads will enable the elucidation of the neural correlates of symptomatology, and of the dynamic changes that occur over time with respect to deep brain stimulation (DBS) therapy
The results of this study revealed that there are band specific frequencies found in thalamic LFPs that emerge after therapeutic DBS in humans
Summary
Tourette syndrome (TS) is a complex neuropsychiatric disorder characterized by the childhood onset of multiple motor and phonic tics [1,2]. It affects an estimated 1% of the population [3] and is marked by high comorbidities (80–90%), including obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), anxiety, behavioral disorders, and depression [4,5,6,7,8,9]. The majority of tic manifestations remit by adulthood [1,2], one third of patients continue to experience tic burden that may become severe or even malignant [13,14] These symptoms can be extremely disruptive, socially inappropriate, and resistant to traditional therapies [15,16,17]. Acute microelectrode recordings and chronic macroelectrode recordings from implanted leads will enable the elucidation of the neural correlates of symptomatology, and of the dynamic changes that occur over time with respect to DBS therapy
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