Deep brain stimulation modulates pallidal and subthalamic neural oscillations in Tourette's syndrome

Abstract

IntroductionPrevious studies found subthalamic nucleus deep brain stimulation (STN‐DBS) has clinical effect on Parkinson's disease, dystonia, and obsessive compulsive disorder. It is noteworthy that only a few studies report the STN‐DBS for Tourette's syndrome (TS). Globus pallidus interna (GPi)‐DBS is the one of the most common targets for TS. So, this paper aims to investigate the neural oscillations in STN and GPi as well as the DBS effect between these two targets in same patients.MethodsThe local field potentials (LFPs) were simultaneously recorded from the bilateral GPi and STN in four patients with TS. The LFPs were decomposed into neural oscillations, and the frequency and time–frequency characteristics of the neural oscillations were analyzed across the conditions of resting, poststimulation, and movement.ResultsNo difference of resting LFP was found between the two targets. The poststimulation period spectral power revealed the high beta and gamma oscillations were recovered after GPi‐DBS but remained attenuated after STN‐DBS. The STN beta oscillation has fewer changes during tics than voluntary movement, and the gamma oscillation was elevated when the tics appeared.ConclusionThe high beta and gamma oscillations in GPi restored after GPi‐DBS, but not STN‐DBS. High beta and gamma oscillations may have physiological function in resisting tics in TS. The cortex compensation effect might be interfered by the STN‐DBS due to the influence on the hyper‐direct pathway but not GPi‐DBS.

Tourette syndrome research highlights from 2019

“…Zhu et al 23 recorded local field potentials in the globus pallidus internus (GPi) and sub-thalamic nucleus (STN) of patients with TS and found that beta and gamma oscillations in the GPi were restored after deep brain stimulation (DBS) of the GPi but not after DBS of the STN, suggesting that these oscillations may play a role in pathophysiology of persistent tics. Another study using microelectrode recordings of the STN during DBS surgery in a single TS patient was able to identify a single unit activity of the STN within the delta band, which was reliably associated to optimal DBS target site for tic control 24 .…”

Dissociation of tic generation from tic expression during the sleep-wake cycle

“…The BG have been shown to play a key role in TS pathophysiology ( Peterson et al., 2003 ; Bloch et al., 2005 ; Kalanithi et al., 2005 ; Worbe et al., 2015 ). LFP recordings performed during deep brain stimulation implantation surgeries in patients with TS have revealed tonic and phasic changes in BG output associated with tic expression ( Zhuang et al., 2009 ; Israelashvili et al., 2017 ; Zhu et al., 2019 ). Extracellular recordings in animal models inducing motor tics have led to a better understanding of the relationship between the properties of neural correlates and tic expression throughout the cortico-BG pathway ( Muramatsu et al., 1990 ; McCairn et al., 2009 , 2016 ; Israelashvili and Bar-Gad, 2015 ; Klaus and Plenz, 2016 ).…”

Effects of Chemogenetic Inhibition of D1 or D2 Receptor-Containing Neurons of the Substantia Nigra and Striatum in Mice With Tourette Syndrome

“…Therefore, we used chemogenetic strategies to selectively activate or inhibit D1R- or D2R-containing neurons in the SNpc or dSTR, which also provided guidance on the clinical treatment of TS, such as deep brain stimulation (DBS). The targets applied for DBS in TS include the STN, the GPi, and the GPe ( Rotsides and Mammis, 2013 ; Andrade and Visser-Vandewalle, 2016 ; Zhu et al, 2019 ); the exploration of these brain regions will become our next research direction.…”