Bilateral globus pallidus lesions in a patient with Tourette syndrome and related disorders

Demirkol, Aydin; Erdem, Hacer; İnan, Levent Ertuğrul; Yiğit, Aytaç; Güney, Melike

doi:10.1016/s0006-3223(99)00087-6

Cited by 29 publications

(9 citation statements)

References 28 publications

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“…Sampling differences, including differences in prior pharmacologic exposure, could also account for discrepant findings. Our findings are consistent with case reports linking globus pallidus pathology to obsessive-compulsive phenomenology (17,18). Similarly, Laplane et al (40) reported obsessive-compulsive behavior in seven patients with basal ganglia lesions, five of whom specifically had globus pallidus pathology.…”

Section: Discussionsupporting

confidence: 92%

“…Several prior structural magnetic resonance imaging (MRI) studies of the caudate nucleus have reported no volume differences between patients and healthy volunteers (9)(10)(11)(12)(13), although others have reported larger (14) or smaller (15) volumes in patients. Studies of other parts of the corpus striatum, including the putamen (13,16) and globus pallidus (16)(17)(18), in OCD have also yielded mixed findings.…”

Section: (Am J Psychiatry 2004; 161:1049-1056)mentioning

confidence: 99%

See 1 more Smart Citation

Brain Structural Abnormalities in Psychotropic Drug-Naive Pediatric Patients With Obsessive-Compulsive Disorder

Szeszko

MacMillan²,

McMeniman³

et al. 2004

AJP

175

107

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These findings provide evidence of smaller globus pallidus volume in patients with OCD without the potentially confounding effects of prior psychotropic drug exposure. Volumetric abnormalities in the anterior cingulate gyrus appear specific to the gray matter in OCD, at least at the gross anatomic level, and are consistent with findings of functional neuroimaging studies that have reported anterior cingulate hypermetabolism in the disorder.

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Section: Discussionsupporting

confidence: 92%

Section: (Am J Psychiatry 2004; 161:1049-1056)mentioning

confidence: 99%

Brain Structural Abnormalities in Psychotropic Drug-Naive Pediatric Patients With Obsessive-Compulsive Disorder

Szeszko

MacMillan²,

McMeniman³

et al. 2004

AJP

175

107

View full text Add to dashboard Cite

show abstract

“…Consistent with anatomical models and with prior case reports linking globus pallidus lesions to the onset of OCD symptoms (Demirkol et al 1999; Escalona et al 1997; Laplane et al 1989), our results support a role for the globus pallidus in the neurocircuitry of OCD. Such a role is not entirely unexpected given that the globus pallidus gives rise to the main output (inhibitory) of the basal ganglia to the thalamus (Blumenfeld 2002; Larson et al 1982).…”

Section: Discussionsupporting

confidence: 93%

“…A number of functional and structural neuroimaging studies have implicated aberrant modulation of circuits linking frontal cortex, basal ganglia, and thalami in the neuropathophysiology of OCD (Atmaca et al 2006; Aylward et al 1996; Baxter et al 1996; Choi et al 2006; Jenike et al 1996; Robinson et al 1995; Saxena et al 1998; Scarone et al 1992; Szeszko et al 2004). In a number of case reports, focal injury to the basal ganglia, especially the globus pallidus, was associated with the onset of OCD symptoms (Demirkol et al 1999; Escalona et al 1997; Laplane et al 1989). Such observations highlight the potential role of the globus pallidus in OCD, particularly since the globus pallidus gives rise to the main inputs from the basal ganglia to the thalamus (Blumenfeld 2002; Larson et al 1982).…”

Section: Introductionmentioning

confidence: 99%

Basal Ganglia MR Relaxometry in Obsessive-Compulsive Disorder: T2 Depends Upon Age of Symptom Onset

Correia

Hubbard

Hassenstab

et al. 2009

Brain Imaging and Behavior

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Dysfunction in circuits linking frontal cortex and basal ganglia (BG) is strongly implicated in obsessive-compulsive disorder (OCD). On MRI studies, neuropsychiatric disorders with known BG pathology have abnormally short T2 relaxation values (a putative biomarker of elevated iron) in this region. We asked if BG T2 values are abnormal in OCD. We measured volume and T2 and T1 relaxation rates in BG of 32 adults with OCD and 33 matched controls. There were no group differences in volume or T1 values in caudate, putamen, or globus pallidus (GP). The OCD group had lower T2 values (suggesting higher iron content) in the right GP, with a trend in the same direction for the left GP. This effect was driven by patients whose OCD symptoms began from NIH Public Access Author ManuscriptBrain Imaging Behav. Author manuscript; available in PMC 2011 January 10.

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“…Imaging studies demonstrated bilateral lesions in the globus pallidus in patients with GTS. [18] Successful pallidotomy for dystonia was reported by Lozano and co-workers,[57] while Coubes and co-workers pioneered DBS of the globus pallidus internus (GPi) for dystono-dyskinetic syndrome. [1516] McCairn and co-workers demonstrated recently[61] in a non-human primate model of Tourette's syndrome that stimulation of the globus pallidus blocks tic-related phasic changes in the firing pattern of pallidal cells and reduces the peak amplitude of tic events in the electromyography record.…”

Section: Introductionmentioning

confidence: 99%

Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

Saleh¹,

Gonzalez-Martinez²,

Cif³

et al. 2012

Surg Neurol Int

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Background:Gilles de la Tourette's syndrome (GTS) is a complex neuropsychiatric disorder characterized by disabling motor and vocal tics. The pathophysiology of GTS remains poorly understood. Conventional treatment consists in pharmacological and behavioral treatment. For patients suffering severe adverse effects or not responding to pharmacological treatment, deep brain stimulation (DBS) presents an alternative treatment. However, the optimal target choice in DBS for GTS remains a divisive issue.Methods:A PubMed search from 1999 to 2012 was conducted. Thirty-three research articles reporting on DBS in patients with GTS were selected and analyzed.Results:Eighty-eight patients with Tourette's syndrome were treated since 1999 with DBS. The majority of patients received thalamic stimulation. Significantly fewer patients were treated with globus pallidus internus stimulation. Occasionally, the anterior limb of the internal capsule and the nucleus accumbens were implanted. The subthalamic nucleus was selected once. All targets were reported with positive results, but of variable extent. Only 14 patients exhibited level 1 evidence.Conclusion:In light of the wide spectrum of associated behavioral co-morbidities in GTS, multiple networks modulation may result in the most efficacious treatment strategy. The optimal locations for DBS within the cortico-basal ganglia-thalamocortical circuits remain to be established. However, at the current stage, comparison between targets should be done with great caution. Significant disparity between number of patients treated per target, methodological variability, and quality of reporting renders a meaningful comparison between targets difficult. Randomized controlled trials with larger cohorts and standardization of procedures are urgently needed.

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Bilateral globus pallidus lesions in a patient with Tourette syndrome and related disorders

Cited by 29 publications

References 28 publications

Brain Structural Abnormalities in Psychotropic Drug-Naive Pediatric Patients With Obsessive-Compulsive Disorder

Brain Structural Abnormalities in Psychotropic Drug-Naive Pediatric Patients With Obsessive-Compulsive Disorder

Basal Ganglia MR Relaxometry in Obsessive-Compulsive Disorder: T2 Depends Upon Age of Symptom Onset

Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation

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